The business of pharmacy extends across the entire continuum of care, but for some hospitals and health systems, pharmacy may be an undervalued and underutilized resource. An optimized pharmacy enterprise has the potential to significantly contribute to expense reduction, revenue enhancement, improved therapeutic outcomes, improved safety profile around medications and a reduced risk profile around regulatory compliance.
UCSF Health in San Francisco recently began an initiative to transform its pharmacy business into a strategic asset for the health system. By partnering with Visante, a pharmacy services company, the health system was able to identify several areas where it could advance its pharmacy business, save money and improve patient care.
Sheila Antrum, senior vice president and COO for UCSF Health; Desi Kotis, chief pharmacy executive at UCSF Health; and James Jorgenson, CEO of Visante, discussed how the health system transformed its pharmacy business into a high-performance pharmacy enterprise during the Becker's Hospital Review CEO + CFO virtual event Jan. 20.
Five takeaways from their discussion:
- To begin its transformation, UCSF formed a multidisciplinary steering committee to oversee the project, which included people from finance, nursing, informatics, legal, compliance and value improvement, Ms. Antrum said. The health system then defined 12 goals for its pharmacy business and created a budget and a scorecard to track outcomes and financial performance.
- Visante's first priority was to create a team of strong leaders, Mr. Jorgenson said. The company brought in experienced Visante leaders to fill open positions while it recruited full-time leaders. Because members of the Visante team have all been in the pharmacy industry for 20 to 30 years, they have many connections that enable them to better recruit the most effective leaders.
- Visante then asked different entities across UCSF Health what changes to the pharmacy business would best help them. Medical staff said help with refill management would give them more time to spend with their patients, so the team focused on moving that functionality to pharmacists, Mr. Jorgenson said. The ambulatory clinic staff said it needed help with prior authorizations, so the Visante team helped UCSF create a combined central service center with UC Davis to handle both refill management and prior authorizations. The top ask from the health system's CFO was to create an analytics and report package that finance could rely on to accurately demonstrate what was happening in the pharmacy program and give insight into what was coming. Visante subsequently helped UCSF create a pharmacy pricing scheme and comprehensive pharmacy revenue cycle assessment.
- The 340B program was another top priority in UCSF's transformation, according to Mr. Jorgenson. Since UCSF treats a high population of low-paying and no-paying patients, the 340B program is incredibly important. It was critical to ensure the program was in full compliance and taking full advantage of all discount opportunities. Visante provided the health system with a 340B manager and three 340B analysts. All regulatory gaps have been closed, and the system has picked up an additional $13 million per year for the 340B program.
- UCSF created a unique leadership structure that includes both a chief pharmacy executive and chief pharmacy officer. The chief pharmacy executive works in the C-suite and focuses on strategy and the 30,000-foot view of the pharmacy enterprise and provides a direct line to the CEO, Ms. Kotis said. The chief pharmacy officer's work is tactical and operationally focused. Having both the chief pharmacy executive and chief pharmacy officer in step is key, Ms. Kotis said. The health system also created a medication safety and regulatory compliance director and an ambulatory medication safety officer. In total, the system's value improvement initiatives reduced expenses by $21 million.
To view the entire virtual panel, click here.