4 Strategies for Health-System Pharmacists to Optimize Care Delivery

Health systems are under immense pressure to improve care quality while reducing costs under the pay-for-performance reimbursement model.

The Pharmacy Forecast 2016-2020 published by the American Society of Health-System Pharmacists (ASHP) Foundation analyzed pharmacy trends and described strategies for health-system pharmacists to keep pace with their evolving scope of practice.

Health systems and their pharmacists must plan for and react to trends in both value-based care and the pharmaceutical marketplace to ensure financial solvency and optimize patient outcomes.

Here are 4 strategies for health-system pharmacists navigating new health care delivery trends:

1. Pursue prescription data-sharing partnerships.

Chronic conditions, changes in insurance coverage, and patients with multiple providers are some of the factors that can contribute to disparate and fragmented health care and logistics.

Pursuing prescription data-sharing partnerships and interoperability initiatives in the community can help health systems gather more complete data on patients and give caregivers access to medication histories generated by third-party payers.

However, ASHP’s Pharmacy Forecast did caution health-system pharmacy leaders against relinquishing “retail and specialty prescription business, or giv[ing] competitors access to patient data without reciprocity on their part.”

2. Ensure compliance with the 340B Drug Pricing Program.

About 87% of forecast panelists predicted that at least half of health systems would see the savings they achieved through the 340B Program decline by 25% or more.

The 340B Program “mega-guidance” released by the Health Resources and Services Administration in August 2015, imposes more restrictive patient and prescription eligibility, as well as stricter contract pharmacy requirements.

These restrictions could put organizational cost savings at risk, which could be devastating for health systems that rely heavily on 340B discounts to provide care for underserved patients. Some organizations report 340B-related savings of more than $100 million annually.

Regular, active auditing can help health systems ensure that they are adhering to program guidelines.

3. Expand pharmacist services in ambulatory care clinics.

Health-system pharmacy leaders should endeavor to replicate their cost-effective inpatient care strategy in outpatient ambulatory care clinics.

Expanding pharmacy services across settings offers opportunities to recognize and respond to medication-related patient needs during times of care transition. This can help optimize population health efforts and ultimately improve patient outcomes.

4. Manage the health-system’s formulary thoughtfully

Effective use of health care resources—including clinically sound, cost-effective medications—can help improve patient access to affordable care and minimize overall costs.

Amid the increasing number and complexity of drug products and escalating prices, continually evaluating therapeutic guidelines and fine-tuning a formulary is essential for health-system leaders to objectively distinguish between superior and marginal medications.