Patient Support Programs (PSPs) play a vital role in ensuring patients start and stay on therapy. Yet, operational hurdles – such as benefit verification delays, prior-authorization bottlenecks, and fragmented case management – often slow down access and compromise adherence. By combining Salesforce Health Cloud with Agent Force AI capabilities, PSPs can move from reactive, manual processes to proactive, intelligent workflows that accelerate therapy initiation and enhance patient experience.
Industry Trends
The PSP landscape is undergoing a digital revolution:
- From Manual Access to AI-First Access: Zero-touch onboarding is becoming the norm. AI agents automate benefit checks, prior authorization submissions, and payer communications in real time – reducing turnaround from day to minute.
- From Siloed Data to Patient 360 Ecosystems: Unified case management through Salesforce Patient 360 ensures transparency across all stakeholders. Adaptive AI continuously updates risk scores, benefit status, and adherence signals for a holistic view.
- From Call Centers to Digital Companion: AI copilots and chatbots resolve routine queries, while advanced digital avatars offer multilingual, empathetic support – creating a patient experience that feels personal and accessible 24/7.
- From High Cost to Scalable Personalization: PSPs can now deliver mass-personalized journeys tailored to therapy type, socio-economic profile, and digital preferences-at a fraction of traditional costs.
Key Pain Points PSPs Must Address
- Manual Benefit Verification & PA Delays: Fax and phone-based processes lead to long approval cycles, causing therapy abandonment.
- Fragmented Case Management: Multiple systems for patient data and payer rules create inefficiencies and lack visibility for HCPs and field teams.
- High Operational Costs & Staff Burden: Call center agents spend hours chasing documentation, leading to burnout and errors.
- Inefficient Escalation Handling: Without intelligent triage, escalations get lost, delaying resolution and patient care.
Recommendations for Next-Gen PSP Operations
To overcome these challenges, PSPs should adopt a unified, AI-driven approach built on Salesforce Health Cloud and Agent Force AI with three core pillars:
1. AI-Driven Benefit Verification & Prior Auth Automation
- Automate eligibility checks and prior auth submissions using payer integrations and AI-driven predictions. Free up 30–40% of staff time and improve first-pass approval rates by up to 25%
2. Intelligent Escalation & case Routing
- Deploy AI bots for triage and routine query resolution, reducing case resolution time by 25–35%. Route complex cases to specialized agents with contextual insights
3. Unified Case Management & Experience Layer
- Health Cloud Patient 360 Agent → Create a longitudinal patient view across all PSP touchpoints. Provide real-time updates to HCPs and patients through omnichannel communication.
4. Continuous Learning & Feedback Agents
- NVIDIA Morpheus (cyber/data pipelines) + NeMo Fine-Tuning→ Agents monitor PSP performance data, patient interactions, and payer responses to continuously fine-tune engagement and workflow models. Adaptive AI agents that evolve with policy changes and real-world patient behavior and reduce time to update PSP workflows by 50% compared to manual retraining.
Strategic Value for stakeholders:
- Patients: Faster therapy initiation, reduced abandonment.
- HCPs: Less administrative burden, greater confidence in prescribing.
- Pharma: Reduced PSP operating costs, improved program effectiveness, higher patient persistence.
The future of PSPs lies in intelligent automation and connected ecosystems. By leveraging Salesforce Health Cloud and Agent Force AI, pharma companies can transform patient access journeys – delivering speed, transparency, and personalization at scale.