The dual pressures to improve outcomes and control drug spending are creating new clinical and business challenges for hospital and health system pharmacies.

Among those challenges are:

  • Using advanced data analytics to drive clinical and business decision-making
  • Serving the medication needs of higher acuity patients in non-acute care settings
  • Finding unique and creative ways to control spending on acute-care pharmaceuticals
  • Responding to value-based reimbursement models that pay based on performance
  • Effectively managing 340B drug discount programs for the medically underserved

Five recent blog posts on offer a number of innovative solutions to those challenges, positioning forward-looking hospital and health system pharmacies for clinical and financial success.

In “ Four Ways Hospital Pharmacies Can Leverage Data Analytics,” McKesson’s Yen Nguyen explains the benefits to hospital and health system pharmacies of using advanced data analytics, or Big Data, to improve their clinical and financial performance. Nguyen, who is director of clinical analytics for McKesson Pharmacy Optimization, says regularly collecting and analyzing how much hospital and health system pharmacies spend on acute-care prescription medications can flag trends and variances in drug utilization and drug price. The data-driven insights can help the inpatient pharmacies determine whether specific drugs are being used appropriately and whether lower-cost yet equally effective alternatives are available. “It’s important that pharmacy directors respond to the trends and variances they identify immediately—by taking steps to arrive at their desired outcomes,” she says.

In “ Becoming a Differentiated Pharmacy Partner to Skilled Nursing Facilities,” McKesson identifies an opportunity for hospital and health system pharmacies to expand their operations by becoming valued clinical partners to post-acute care facilities. As post-acute care facilities like home-care agencies and skilled nursing facilities accept higher acuity patients, their patients have greater and more complex prescription medication needs. One way hospital and health systems pharmacies can help is by setting up a geriatric formulary for post-acute care providers that standardizes commonly used prescription medications by elderly patients being cared for in the home or in a SNF. The formulary also can identify potentially inappropriate drugs for elderly patients. In addition to helping control drug costs, geriatric formularies can improve patient care and optimize clinical outcomes by consistently making the safest and most effective medications available to patients.

In “ Building a Hospital Pharmacy Council for Drug Cost Containment,” McKesson’s Cindy Jeter outlines the four steps necessary for hospitals to create a pharmacy council to help control drug spending. A pharmacy council is a group of inpatient pharmacy directors from noncompeting hospitals and health systems who regularly share data and exchange information on the prescription medications their organizations are using, new pharmaceuticals on the market, drug shortages and how much they’re paying for the drugs they’re using. By comparing notes and data, the members can identify opportunities to reduce their drug spend without sacrificing the safety or quality of inpatient hospital care, says Jeter, a supply chain management consultant for McKesson Pharmacy Optimization. One such council reduced drug spending by its 20 rural hospital members by $10 million over five years.

In “ How Hospital Pharmacies Can Improve Antibiotic Control,” McKesson’s Kaci Wilhelm lists five common barriers that often prevent hospitals and health systems from establishing effective antibiotic stewardship programs at their facilities. Such programs not only are important from a clinical standpoint but are becoming equally important from a business standpoint because of the growth in value-based reimbursement models. Those models reward or penalize providers based on how well they score on specific clinical process and outcome measures. The appropriate use of antibiotics can greatly affect those measures. “That means prescribing antibiotics appropriately for complex patient cases, understanding the proper use of niche antibiotics, choosing narrow-spectrum antibiotics to treat specific infections and knowing when not to prescribe antibiotics,” says Wilhelm, who is a clinical advisor at McKesson.

In “ How to Manage Indigent Care Reimbursement,” McKesson’s Andrew Wilson reflects on the three areas of concern he hears most from hospitals and health system regarding their 340B drug discount programs for patients who need financial assistance. Some are concerned about being compliant with 340B rules and regulations, some are concerned about keeping up with changes in 340B rules and regulations and others are concerned their programs are not as effective as they can be. Wilson, who is president of 340B Solutions at McKesson, details the three operational strategies that hospitals and health systems can use to alleviate those concerns: institute routine checks of 340B tracking systems; align supply chain and 340B functions; and improve compliance with better communication.

As the solutions identified by the subject-matter experts in the blog posts demonstrate, hospitals and health system pharmacies that aggressively use data and assertively think outside the box can respond to the dual pressures to improve outcomes and lower drug spending, substantially adding value to their own organizations and the patients they serve.

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McKesson editorial staff is committed to sharing innovative approaches and insights so our customers can get the most out of their business solutions and identify areas for operational improvement and revenue growth.

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