McKesson Corporation · NYSE:MCK
McKesson — Investor Presentation (May 2020)
21 slides from McKesson's investor presentation, May 8, 2020
Slide 1: Collaborative Work Effort to Improve Coordination of Benefits
Collaborative Work Effort to Improve Coordination of Benefits For Medicare Hospice Beneficiaries 1 © 11/08/2026 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Slide 2: Issue & Goal
Issue & Goal • Issue: Part D Plans need to receive timely notification of enrollment in other Medicare coverages to ensure they are not paying for drugs that should be paid under a bundled payment and to reduce post-payment recoveries (burden for plans and hospices) • Goal: To minimize the number of
Slide 3: Stakeholders & Work
Stakeholders & Work The Gold Standard for Collaboration • CMS • Hospice EMRs • NCPDP • CMS/Transaction Facilitator • Hospice • Clearinghouses (billing • Plan sponsors entity that generates 837I or • Pharmacy feeds data directly to Direct • Hospice PBM or Data Entry (DDE) System) intermediary • Hospi
Slide 4: Context
Context • 1.55 million Medicare beneficiaries were enrolled in hospice care for one day or more in 2018. • 50.7% of Medicare decedents were enrolled in hospice at the time of their deaths. • The average length of service for Medicare beneficiaries was 89.6 days, with the median length being 18 days.
Slide 5: Examples of Delays
Examples of Delays Hospice Hospice Hospice Hospice Days Part Admission Submits TRR to Enrollment D Notice of Plan Data processes Election to Loaded at Part A CWF* PBM drugs 01/13/201 1/18/2019 02/28/201 03/01/2019 46 9 9 09/04/201 9/9/2019 09/19/201 09/20/2019 16 9 9 07/03/201 7/8/2019 07/24/201 07/
Slide 6: Hospice Required Notifications
Hospice Required Notifications • To CMS via Claims or Direct Data Entry (DDE) – Admission / Transfer-in – Discharge / Revocation • To Others – PBM via defined process – Long Term Care Pharmacy via defined process – Patient or other providers via Patient Notification of Non-Covered Services Addendum
Slide 7: 5 Day Notification Requirement
5 Day Notification Requirement Admission/Transfer In Discharge Process • Collect patient • Live discharge information (Patient or Hospice • Initial assessment initiated) • Patient consent if new • Transfer out pt. • Death CMS Notified via DDE CMS Notified via DDE or or 837I 837I • Admission (NOE w/i
Slide 8: Current CMS Reporting Barriers
Current CMS Reporting Barriers • CMS does not return validation to Hospice provider that the actual beneficiary enrollment has been accepted and processed through CMS systems. DDE system is used to validate but creates a separate workflow • Some EMRs have created a way to validate within their syste
Slide 9: Proposed Process
Proposed Process • Establish transmission between the Hospice EMR and the Transaction Facilitator • The Transaction Facilitator would send the data to the Part D Plan • An 835/response-like process is needed for this new process. – Beneficiary was matched – Forwarded to Part D plan – Part D accepted
Slide 10: Plan Notification for Hospice and Other Coverage Phase I
Plan Notification for Hospice and Other Coverage Phase I 10 © 11/08/2026 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Slide 11: Phase I – Enrollment / Election
Phase I – Enrollment / Election • Need to expedite transmission of information from hospice to Part D plan sponsors and not be hindered by CWF delays • Part D plan sponsors need the following: – Facility information (NPI) – Demographics (MBI, Last Name, First Name, DOB) – Election date – NOE (81A or
Slide 12: Termination Reasons and Part D Example Edits
Termination Reasons and Part D Example Edits • Beneficiary that is deceased will result in all claims being denied – no more coverage (814 or 824) • Beneficiary that is transferring – Should continue negative PA for up to xx days or until new Hospice is identified and plan can confirm drugs – If rec
Slide 13: Phase II
Phase II • Drug information – Related to terminal condition – Not related to terminal condition – Patient responsibility – EMRs may not have NDC level data – only drug name, strength and dosage – NDC, quantity dispensed and days supply (if available) • Diagnosis codes • Prescriber information 13 © 1
Slide 14: Beneficiary Identification
Beneficiary Identification • Very likely that Hospice does not know what Part D plan the beneficiary is enrolled in • EMR will send Medicare Beneficiary Identifier (MBI) • Transaction Facilitator will identify beneficiary and collect Part D Plan transaction routing information 4RX (BIN/PCN/Group/Car
Slide 15: Data Formatting
Data Formatting • Medical world and pharmacy world use different transaction/communication standards • Data from EMR will need to be translated from Medical (X12) to Pharmacy (NCPDP Information Reporting (Nx)) • Need to determine transmission mechanisms between EMR and Transaction Facilitator (new c
Slide 16: Validation Approach
Validation Approach • Beta test first – Identify one EMR that services beneficiaries within a Part D Plan’s coverage area to test process – Hospice provider(s) – Part D plan(s) 16 © 11/08/2026 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Slide 17: Outside of Scope
Outside of Scope • NOE/NOTR/NOC transmission for MACs due to concerns related to payments • Notification to MA only plans (no current connection to Transaction Facilitation or NCPDP ability) • Hospice providers that enter election information manually into Direct Data Entry (DDE) and do not have the
Slide 18: Task Group Request
Task Group Request • Utilize this approach to solve for the lag time in notifying the Part D Plan • CMS support work effort of task group • CMS communicate work effort to Hospices and Part D sponsors • CMS modify their transaction process to create a response from the CWF after processing that conta
Slide 19: Task Group Request
Task Group Request • Consider the possibility of using one transmission for notification of both CMS and the Transaction Facilitator (if billing issue can be addressed) • Standardize all collected data elements in a manner that data can be used for future electronic use. For example: – Standard reas
Slide 20: Hospice work flow
Hospice work flow 20 © 11/08/2026 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Slide 21: Thank you for your time!
Thank you for your time! 21 © 11/08/2026 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.