(NOTE: Last week, ProxsysRx released an announcement of its recently-signed contract to build and manage a specialty pharmacy for Massachusetts’ Holyoke Medical Center.)
The ultimate Win-Win situation in healthcare is increasing the quality of patient care, and getting paid to do it. While onsite specialty pharmacies are expensive, and the process is complicated, the clinical and financial returns can be nothing short of game-changing for 340B hospitals. In the video below, ProxsysRx’s experts discuss the specialty pharmacy building-and-accreditation process.
If you missed Part 1 in our video series, Click Here.
(Below is a synopsis of that discussion).
The Specialty Pharmacy Process & Requirements
It’s a long process that requires a lot of resources, a lot of effort, and a lot of time. ProxsysRx handles that process for 340B hospitals. We get into your hospital’s clinics and work closely with your providers to build good relationships. We make sure your 340B hospital has the policies, standards and protocols in place to ensure that your specialty pharmacy meets accreditation standards.
Generating Revenue
Accreditation can take 6 months to a year, but you can start filling prescriptions on Day One, IF you have reporting in place. We work to find the prescriptions you can fill immediately, as we work towards your accreditation. At the same time, we’re getting you in the networks with the PBMs to be able to fill prescriptions. As we’re getting your pharmacy’s processes, procedures and policies in place, you're moving toward accreditation.
Metrics to measure and monitor
You have to keep certain metrics for your phone calls, and there must be someone in the pharmacy — every hour it’s open — answering phone calls within 30 seconds. That means patients are getting immediate access to pharmacy professionals — which demonstrates to accreditation boards that you're providing appropriate care.
ProxsysRx takes the responsibility for specialty pharmacy service-data reporting off your back. There are a number of other patient monitoring and clinical assessments that have to be tracked and measured. For starters, every specialty pharmacy patient must be monitored by a clinic pharmacist.
Clinical assessment for patients
In initial assessments, clinic pharmacists ask patients a number of questions — including what medications they’re already on, and what side effects they’ve had. Pharmacists then work hand-in-hand with patients’ providers, to make sure that their medication regimens are always up to date, and appropriate for the patients and their disease states.
Continuous monitoring & reporting
In addition to ongoing monitoring, patients are often monitored yearly by pharmacists — who review any side effects they may be having, or any issues they have taking their medication. Pharmacists ask patients if they’ve skipped any medications, and if it’s affected their disease state. All of that is then reported back to the accrediting bodies.
Ensuring patient satisfaction
Patient satisfaction surveys, administered by independent third parties, are also required — to ensure that your pharmacy upholds high standards. ProxsysRx works with the hospitals we serve, to make sure those standards are met and exceeded.
Shipping & packaging protocols
A lot of specialty drugs require refrigeration. Some have to be frozen. Some need to stay at room temperature, and can't get too hot or too cold. All of which is why it’s so important specialty pharmacies follow shipping and packaging protocols required by the accrediting bodies. ProxsysRx already has a network of vendors, and we have processes to vet new vendors — ensuring that every medication reaches a patient’s door at the appropriate temperature.
Integrating the specialty pharmacy with your health system’s technology
ProxsysRx’s proprietary platform pulls all your relevant data, and uses analytical tools that create the necessary outlooks and outputs. Data we then report back to the accrediting bodies and to the payers — the PBMs. That way, when we're getting your specialty pharmacy in network for patients’ PBMs, we can bill for their care.
You also have to report a lot of metrics to PBMs — including everything already mentioned about measuring and monitoring — just to get in their networks. The same goes for manufacturers: You have to report to them to get access to their medications. Again, ProxsysRx’s platform handles that reporting.
ProxsysRx is here to help.
For more information on how ProxsysRx helps 340B health systems build and fund specialty pharmacies, visit our website. Or contact Howard Hall. C: 214.808.2700 | howard.hall@proxsysrx.com
To watch ProxsysRx’s entire Specialty Pharmacy video series, Click Here.
ProxsysRx offers hospital systems proven solutions for optimizing pharmacy services’ positive impact on the continuum of care; solutions ranging from management of their 340B prescription-savings programs, Retail and Specialty Pharmacy operations, to Prescription Benefits program management, and patient financial assistance.
