Blog - ProxsysRx

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 No Comments

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

340B Best Practices You Need To Know

April 1, 2022340B, Audit, Bedside Prescription Delivery, Compliance, Contract Pharmacy, Covered Entities, Meds To Beds, Overview, Patient Eligibility, Requirements, Specialty Pharmacy, Specialty Pharmacy

If your hospital is 340B-eligible, you may be missing-out on millions of dollars in prescription reimbursements. Savings and revenue which, for some hospitals served by ProxsysRx, actually make the difference between solvency and closure. Any list of Best Practices for running a 340B program starts with maintaining compliance. Tips for maintaining 340B Program Compliance The … Read More

What is 340B Double-Dipping, and How Can You Avoid It?

March 25, 2022340B, Compliance, Contract Pharmacy, Covered Entities, Patient Eligibility, Registration, Requirements

The 340B drug pricing program allows eligible providers to replenish prescriptions to eligible patients at significantly reduced pricing, and bill normal market rates for those prescriptions —helping the entities fill revenue gaps that are inherent to their business models. That said, the program does not allow eligible providers to take advantage of 340B discounts and … Read More

How, and Why, TPAs Often Misqualify 340B-Eligible Prescriptions

March 15, 2022340B, Compliance, Covered Entities, Requirements

PLEASE NOTE: This article should not be construed as an attack on TPAs. ProxsysRx has managed 340B programs for dozens of hospitals, and we can’t imagine managing one without the services of a TPA. Is your health system 340B-eligible? We still frequently get this question, so: To qualify for 340B program eligibility, you need to … Read More

How Do I Take Advantage Of The 340B Program For My Specialty Pharmacy?

March 9, 2022340B, Compliance, Covered Entities, Specialty Drugs, Specialty Pharmacy

Getting started with the 340b program If your hospital isn’t already 340B registered and eligible, you might want to refer to our previous blog post, Are you ready to enroll in the 340B program? What is a Specialty Pharmacy? The National Association of Specialty Pharmacy defines a specialty pharmacy as a state-licensed pharmacy that solely … Read More

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