3 Questions to ask about your specialty pharmacy strategy

One key factor driving shifts in health systems’ patient care strategies is the change in patient volumes to non-hospital settings.

Vizient’s 2024 Forecast Report predicted a 17% increase in outpatient care volumes over the next decade.

With a higher volume of specialty medications prescribed, coupled with more patients interested in seeking care closer to home, outpatient pharmacies play a pivotal role in providing and improving access to high-quality health services.

Without an effective specialty pharmacy model, hospital patient care strategies are missing out on serving a broader population and increasing market share, while also improving their missions of care. Hospitals could be missing other benefits by serving their own employees, too.

Q: What benefits do specialty pharmacies provide?

• Specialty pharmacy services can be an important source of revenue for health systems and also offer key benefits for patient care and outcomes.
  
  From guiding patients’ specialty drug regimens and assisting those struggling with copays and costs through patient advocacy programs, a health system’s specialty pharmacy extends the care it provides to the community, helps improve medication adherence and provides insights into contributing factors for length of stay and outcomes. 

Q: Why don’t all hospitals take advantage of opening or maximizing a specialty pharmacy? 

• First, smaller facilities may mistakenly assume that they do not have patient volumes to justify one, but in reality, when less than 10 prescriptions have proven to make a substantial cost savings for the facilities that Cardinal Health supports.
• These pharmacy business models are complex and present unique challenges, such as labor, resources and expertise. From labor scarcity and pharmacy benefit billing resources to accreditation complexities, it’s common for these pharmacies to lack the tools and support needed to tailor operations for the optimal patient and payor mix.

Q: How can health systems get specialty pharmacy support and resources?

• There are many resources to help health systems overcome these challenges. For example, health systems can choose to customize the level of support needed based on their specific needs, labor situation and service lines. Customized services range from traditional consultative assessments to outsourcing, accreditation support and payor access solutions.
• There also are increasing choices for remote support to ensure these facilities remain compliant and best support patient needs while a providing new, sustainable revenue engine for the health system.
  
  For example, specialty pharmacy hub services today include 24-hour clinical support--a requirement of specialty accreditation--as well as remote prior authorization services and remote order entry. These services help lean on-site teams focus on delivering direct patient care.

To learn more about how your health system can unlock the benefits of a custom outpatient specialty pharmacy strategy leveraging a hub model, click here.