Doing more with Less – A Look at the 2012 Trends For Hospital Pharmacies.
With a new year upon us, hospitals continue to face challenges from the uncertainties of the healthcare landscape. However, this year hospital pharmacies are considering new solutions that can help relieve quality and financial woes. Now, more than ever, hospitals are looking to leverage the pharmacy as both a profit center and a key driver for clinical excellence in order to provide the best possible patient care to their community.
1. The need for increased connectivity between the inpatient and the outpatient settings will intensify: The hospital-reimbursement paradigm has changed as we move toward a pay-for-quality system. Key market dynamics, such as outcome-based payments, emphasis on the patient’s continuum of care beyond hospital discharge, and the actualization of accountable-care organizations, are forcing hospitals to maximize existing hospital assets to manage the paradigm change. This includes the role of its pharmacy.
- Focus on Ambulatory Pharmacy: Ambulatory pharmacies are unique environments capable of generating revenue for health systems as well as contributing significantly to the care and outcome of the patient. Leading, visionary health systems fully understand the importance of connecting patient data between the inpatient and outpatient settings.
2. Pharmacist’s Increasing Role in Meaningful Use: A large component of meaningful use is the closed-loop medication cycle. The pharmacy touches all the components in the loop and as a result, can and should be involved in implementing the most effective computerized physician order entry (CPOE) for the hospital. Not only do pharmacists understand how physicians order drugs in their organizations, but the pharmacy information system has the ability to help reduce transcription error and confusion.
- Focus on Attaining 100% Dispensing of Barcoded Medications: Many hospital pharmacists are heavily involved in the implementation and rollout of barcode medication administration (BCMA) at their organizations because every medication that they stock needs to have a barcode. This is being driven by incentives contained in the American Recovery and Reinvestment Act (ARRA). As part of meaningful use Phase II contained in the Act, these medications need to be bar-coded for scanning at the bedside. However, the challenge is that not all medications purchased have a barcode and pharmacists are looking at cost-effective solutions to repackage them.
3. Spotlight on the hospital pharmacy to help reduce readmissions: Hospital executives need to have a better understanding of the pharmacy’s role in reducing or eliminating hospital readmissions. Many studies have shown that the primary reason patients visit an emergency room or are readmitted to the hospital is due to non-adherence with medication therapy once the patient is at home. The hospital pharmacy can have a significant impact on the reduction of hospital readmissions by proactively educating patients on the proper use of their medications.
- An ambulatory pharmacy is ideally suited to help the hospital identify patients who are at high risk of non-adherence or may be managing chronic diseases at the point of discharge, and provide support required to help patients adhere to their prescribed drug regimens.
4. Hospital pharmacy will be closely scrutinized and expected to decrease costs and increase revenues: In most hospital departments, operating cost is usually composed of 80% labor and 20% supplies; it is inverted within the pharmacy with 80% drugs and 20% labor. The director of pharmacy can help keep budgets in check by looking at innovative services that enhance revenue.
- Offsetting Indigent-Care Costs: Hospitals are treating more uninsured patients and looking for ways to recover the cost. Pharmacy-Assistance Programs (PAPs) offered by manufacturers are available to help offset the cost, but many hospitals find them too complex to manage.
- 340B Contract Pharmacy: The multiple-contract pharmacy option that is part of the 340B program offers an opportunity for hospitals to expand their reach in the community to capture a greater number of prescriptions.
- In addition, hospitals will look for ways to provide employee Rx benefits utilizing their own resources and purchasing agreements.
5. Growth in the specialty-pharmaceutical segment will influence the pharmacy’s revenue and profits: Specialty pharmaceuticals, while impacting only a small population of patients with specific diseases, represent the largest average cost at $1,500 per dispense. Estimates are that growth in the specialty segment will range from 16–20% each over the next several years, until 8 out of 10 of the nation’s top prescription-revenue items are considered specialty pharmaceuticals.
While no hospital department is unaffected by the strains of modern healthcare, few have the capacity of the hospital pharmacy to meet the onslaught of challenges. Every aspect of the way a hospital operates is under pressure to become more efficient, to improve processes and reduce costs, and to deliver better care outcomes. The hospital pharmacy has always been accustomed to the intricacies of integrating with the larger system, to the business realities of profit and loss, and to the need to adopt new and better technologies. Now it is being given the green light to leverage its skill set like never before. In the coming years, the hospital pharmacy will become a leading force for driving clinical excellence and process innovation in efficient, cost-effective, and profitable new ways.
