When it comes to ambulatory pharmacy strategies, hospital and health system leaders see multiple challenges that affect their ability to thrive. With considerable uncertainty around government policies and 340B programs, it’s hard to know what direction to go in. At the same time, doing nothing is not a recipe for success.
In a session sponsored by McKesson at Becker’s 13th Annual Becker’s CEO + CFO Roundtable, healthcare leaders discussed their current ambulatory pharmacy models and how they may pivot in response to shifts in the market to achieve more.
Four key takeaways were:
- Ambulatory pharmacy can support value-based care. While value-based care contracts can penalize providers for excessive pharmacy expenses, they also provide an incentive to utilize the pharmacy to lower total costs.
A health system in the Midwest that is part of an ACO leverages its ambulatory pharmacies to identify more cost-effective treatments for patients. Providers regularly walk down the hall to consult with pharmacists about alternative, lower-cost medications that are equally effective.
- “Meds to beds” strategies can lead to better health outcomes. When patients leave the hospital with their medications in hand – prescriptions filled by the outpatient retail pharmacy – and understand how to take them appropriately, healthcare organizations see fewer complications and readmissions.
To evaluate the success of this type of program, one organization measures the percentage of patients who get their medications before leaving the hospital. “There’s a form in our EHR that the technician clicks on when they deliver the meds,” the representative explained. “At the end of the month, we get a report.”
- 340B hospitals and health systems must prepare for change. At hospitals and health systems that participate in the 340B program, leaders agree that navigating the impending changes to 340B will be critical. It’s imperative for organizations to understand program changes and how they will be affected, especially by changes in the price of 340B drugs.
One participant recommended preparing for these changes with various technology-enabled tools and solutions.
- Infusion demand is expected to grow, as are financial pressures. According to the director of ambulatory pharmacy at an academic medical center in the Midwest, there will continue to be revenue opportunities in the specialty space. Although some drugs currently delivered via infusion may transition to become oral, there is still a significant amount of growth expected in the infusion space.
Payment for these treatments, however, can be a double-edged sword. In 2028, the Inflation Reduction Act is expected to significantly impact infusion treatments. “We’re looking very hard for other strategies to get us off drug margins and onto more stable payment processing,” said the CEO of a cancer center in the Southwest.
