Sean Falsey isn't your traditional pharmacist. He spends time in a different pharmacy every day - maybe even a different state. As a Pharmacy Optimization Manager for McKesson, Falsey helps specialty practices implement and optimize medically integrated pharmacy services and improve the patient experience. In this Q&A, we asked him how specialty practices can tackle hurdles impeding pharmacy success.

1. What are you responsible for in your role?

As a pharmacy optimization manager, I help specialty practices, like rheumatology, gastroenterology, or oncology practices, establish an in-house pharmacy or dispensary and hire a community pharmacist. I work with practices to implement pharmacy revenue management tools to streamline drug spend, reimbursement and billing workflow. I look for opportunities to help address whatever challenges they are facing by sharing best practices from similar practices around the country. Ultimately, my goal is to deliver expertise and evidence-based suggestions to help them improve pharmacy performance and be as successful as possible.

2. What's the biggest challenge to sustainability you hear from practices?

Reimbursement and access are at the top of the list for most pharmacies. Whether in a retail setting or as part of a specialty practice, pharmacists' top priority is providing quality patient care. However, they must have access to payer contracts to fill prescriptions for the patients they serve and capture adequate reimbursement to stay in business. They also need to confirm economic viability before implementing practice dispensing capabilities and continually evaluate payer mix and employer group contracts to improve sustainability.

3. How can pharmacies in specialty practices control spending?

Pharmacies should establish a formulary their practice stakeholders can stick to and use patient mix, drug utilization and reimbursement analytics to continually fine tune the formulary from both a clinical and an economic standpoint. For example, if two therapies are clinically similar, is it possible to gain consensus among the practice providers to streamline to one that all can get behind?

4. How can medically integrated pharmacies increase the volume of prescriptions filled in-house and increase profitability?

The best way to increase prescription volume is education about how filling a prescription in the practice can benefit patients. Often, this starts with staff training and something as simple as changing workflow so pharmacy staff doesn't go into the EMR and automatically click on a default external pharmacy without proactively discussing options with the patient.

5. Why are pharmacy management systems important to driving profitability for community practices?

Pharmacy management systems, like Pharmaserv, can streamline workflow for prescription processing and claims adjudication, as well as provide dashboards and benchmarking to assess performance. Fill and refill reports show pharmacists who is coming into the office in the next day or week so they make sure they have the needed medications, supporting improved inventory and cash flow management. Plus, these systems monitor for adherence issues and can trigger a patient conversation where the pharmacist can intervene to address adherence barriers.

6. What benefits do specialty practice pharmacies have on the patient experience and care delivery?

Specialty practices offer patients with complex diseases convenience with all services under one roof. This leads to comprehensive and holistic care with a dedicated pharmacist who not only knows them personally, but their disease and full treatment plan as well. As part of the practice care team, pharmacists can offer better insight into what's going on with the patient in terms of adherence and compliance. This also gives pharmacists the ability to troubleshoot concerns around dosage or side effects on the spot.

7. What trends should community practice pharmacists keep their eyes on?

This goes back to the challenges and access we discussed earlier. As payers and employer groups sign with mail-order pharmacies, community practices must continue to show the value that face-to-face pharmacy interactions with patients plays in supporting optimal outcomes, better patient satisfaction and improved engagement. Transparency is another trend to watch as we work closely with practices on policies and procedures. Transparency helps demonstrate value and will also help build relationships with PBMs.

Learn more about implementing or optimizing integrated pharmacy services.

McKesson

About the author

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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