Use Your Hospital’s Retail Pharmacy 340B Savings To Build A Specialty Pharmacy

September 12, 2022340B, Compliance, Covered Entities, Specialty Drugs, Specialty Pharmacy

For 340B-eligible hospitals dealing with increasingly tight bottom lines (which essentially means all 340B-eligible hospitals), an in-house specialty pharmacy offers enormous savings and revenue potential. Some hospitals generate as much as 600% in 340B specialty pharmacy revenue as they do in traditional retail / outpatient pharmacy 340B revenue. Specialty pharmacy 340B revenue potential: overview As … Read More

Avoid These Six Common Errors When Reporting 340B-Eligible Prescriptions Through 340B ESP

August 26, 2022340B, 340B ESP, Covered Entities, Requirements

As we noted in a previous post, 340B ESP is nothing less than a brazen and (in our opinion) unlawful ploy by the drug manufacturers to evade the discounts they are legally obligated to offer eligible entities — by placing extraordinary, and unnecessary, reporting burdens on hospitals submitting claims for 340B savings. That said, until … Read More

How Can Your Outpatient Pharmacy Help You Avoid “30-Day Readmission Rule” Medicare And Medicaid Penalties?

July 26, 2022CMS Star Ratings, Medicare, Medication Compliance, Outpatient Tracking, Readmissions, Readmissions Reduction, Retail / Outpatient Pharmacy, Value-Based Care

What is the Hospital Readmissions Reduction Program? HRRP is a value-based Medicare purchasing program that encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, prevent avoidable readmissions. According to the Centers for Medicare & Medicaid Services, “Value-based programs reward health care providers with incentive … Read More

How Drug Manufacturer Restrictions And PBMs Undermine Hospitals’ 340B Savings And Outpatient-Pharmacy Margins

July 6, 2022340B, Contract Pharmacy, PBM, Prescription Discounts, Requirements, Retail / Outpatient Pharmacy

If you’re an eligible hospital with an existing 340B program, you know that your wholly-owned outpatient pharmacy is required to buy non-340B medications at Wholesale Acquisition Cost (WAC) — unless you’ve put it in an LLC, and registered it as a child site, or you’re a Critical Access Hospital, and exempt from the requirement. You’ve … Read More

How Hospital Retail Pharmacies Can Track Patients For Better Outcomes After Discharge

June 16, 2022Medication Compliance, Outpatient Tracking, Readmissions, Retail / Outpatient Pharmacy

The impact of medication non-adherence on hospital readmissions We’ve reported the following elsewhere in this forum, but it bears repeating: Statistics indicate that up to 70% of all preventable outpatient readmissions are due to prescription non-compliance. Making matters worse for hospitals, the analytics generated by ProxsysRx’s proprietary software indicate that readmissions from prescription non-compliance are … Read More

How Outpatient Pharmacies in Hospitals Impact the True Costs of Readmissions

May 31, 2022Bedside Prescription Delivery, CMS Star Ratings, Medication Compliance, Meds To Beds, Meds To Beds, Prescription Discounts, Readmissions, Readmissions Reduction, Retail / Outpatient Pharmacy

How can outpatient pharmacies reduce hospital readmissions? We’ve reported the following statistical finding elsewhere in this forum, but it bears repeating: Up to 70% of all preventable outpatient hospital readmissions are due to prescription non-compliance. Making matters worse for hospitals, the analytics generated by ProxsysRx’s proprietary software indicate that average hospital readmissions from prescription non-compliance … Read More

How Meds To Beds Programs Improve Outpatient Medication Compliance

May 17, 2022Medication Compliance, Meds To Beds, Prescription Discounts, Readmissions, Retail / Outpatient Pharmacy

As we’ve reported elsewhere in this forum, statistical evidence indicates that up to 70% of all preventable hospital readmissions are caused by patient prescription non-compliance. What’s more, analytics generated by our own proprietary software further indicate that readmissions from prescription non-compliance are, on average, more expensive than other readmissions — often much more. Why Aren’t … Read More

What Is Value-Based Care, and How Can Your Outpatient Pharmacy Help?

May 12, 2022Medicare, Medication Compliance, Meds To Beds, Pharmacy As A Service (PAAS), Prescription Discounts, Readmissions, Retail / Outpatient Pharmacy, Value-Based Care

One of the Affordable Care Act’s most far-reaching legacies is the ever-increasing impact that Value-Based Care has had on healthcare systems and physicians. In hospitals it’s seen primarily in the form of Per Diems and Readmission Adjustments. For physicians it’s reflected in MIPS (Merit-Based Incentive Payment) scores. What are value-based care programs? According to the … Read More