New Opportunities for Contract Pharmacies

1,102 views

Published on

Multiple Contract Pharmacy Presentation at 2010 340B Coalition Winter Conference

Published in: Health & Medicine
1 Comment
2 Likes
Statistics
Notes
No Downloads
Views
Total views
1,102
On SlideShare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
0
Comments
1
Likes
2
Embeds 0
No embeds

No notes for slide
  •  
  • Study re Medicaid Pre-rebate Medicaid to 340B comparison Implementation and on-going administration costs Savings vary by program Managed Medicaid plan Post-rebate to 340B comparison
  • Study re Medicaid Pre-rebate Medicaid to 340B comparison Implementation and on-going administration costs Savings vary by program Managed Medicaid plan Post-rebate to 340B comparison
  • Study re Medicaid Pre-rebate Medicaid to 340B comparison Implementation and on-going administration costs Savings vary by program Managed Medicaid plan Post-rebate to 340B comparison
  • Study re Medicaid Pre-rebate Medicaid to 340B comparison Implementation and on-going administration costs Savings vary by program Managed Medicaid plan Post-rebate to 340B comparison
  • Talk about New and walk-up Rx’s and how they follow a different process. 80% of Rx’s are refills
  • Study re Medicaid Pre-rebate Medicaid to 340B comparison Implementation and on-going administration costs Savings vary by program Managed Medicaid plan Post-rebate to 340B comparison
  • Staff-Buy-in
  • Study re Medicaid Pre-rebate Medicaid to 340B comparison Implementation and on-going administration costs Savings vary by program Managed Medicaid plan Post-rebate to 340B comparison List 5 opportunities that the health system has seen as a result… (ex.financial, operational efficiencies, satisfaction, cost savings, increased clinical functions)
  • New Opportunities for Contract Pharmacies

    1. 1. New Opportunities with Contract Pharmacies Anthony L. Lesser, MSHA Pharmacy Inventory Manager, Harris County Hospital District February 2, 2010 6 th Annual 340B Coalition Winter Conference
    2. 2. Learning Objectives List 3 Challenges of Central Fill Describe Harris County Hospital District 1 Understand why HCHD chose to apply for an AMDP 2 4 List 3 advantages to our patients. 3 List 5 Opportunities with Central Fill 5
    3. 3. AMDP Q&A <ul><li>An AMDP is approved by: </li></ul><ul><li>CIA </li></ul><ul><li>FBI </li></ul><ul><li>OPA </li></ul><ul><li>ABC </li></ul>
    4. 4. Harris County Hospital District <ul><li>Three major hospital facilities: Ben Taub, Lyndon Baines Johnson (LBJ), Quentin Mease </li></ul><ul><li>Recognized as one of the leading trauma centers in the nation </li></ul><ul><li>15 ambulatory pharmacies </li></ul><ul><li>Plans to expand ambulatory services </li></ul>
    5. 5. Harris County Hospital District <ul><li>Harris County Hospital District </li></ul><ul><li>Ambulatory Pharmacy Services </li></ul><ul><ul><li>Annual Pharmaceutical Budget: $77 Million </li></ul></ul><ul><ul><li>Outpatient Pharmaceutical Budget:$61 Million </li></ul></ul><ul><ul><li>Outpatient Visits/Encounters per year: 1.6 Million </li></ul></ul><ul><ul><li>Outpatient Prescriptions per year: 2.5 Million </li></ul></ul><ul><ul><li>Ambulatory Pharmacy FTEs: 254 </li></ul></ul>
    6. 6. Why HCHD needed a non-traditional pharmacy model <ul><li>High volume pharmacies in need of greater efficiency (lack of automation) </li></ul><ul><ul><li>Meet greater demand for pharmacy services </li></ul></ul><ul><ul><li>Advantages to patient </li></ul></ul><ul><ul><ul><li>Wait times </li></ul></ul></ul><ul><ul><ul><li>Patient access </li></ul></ul></ul><ul><ul><ul><li>Clinical services </li></ul></ul></ul>
    7. 7. Deciding to apply for an AMDP <ul><li>Designed to have selected prescriptions filled at an off-site contracted pharmacy and delivered to HCHD pharmacies </li></ul><ul><li>Application filed November 2006 </li></ul><ul><li>Project approved December 15, 2007 </li></ul><ul><li>“ Go-Live” - August 2008 </li></ul><ul><li>First productive use - November 2008 </li></ul><ul><li>IT infrastructure to support regulatory requirements </li></ul><ul><li>Third party management and audit </li></ul>
    8. 8. Central Fill Inventory <ul><li>Fully automated, off-site facility located in Fort Worth, Texas </li></ul><ul><li>Closed formulary consisting of approximately 200 solid oral dose forms and 50 unit of use packages. </li></ul><ul><li>Replenishment model with prescriptions filled from an initial seed inventory </li></ul><ul><li>Strict formulary and inventory controls necessary for cost containment and regulatory compliance </li></ul><ul><li>Complemented central fill “go-live” with strong inventory management initiatives </li></ul>
    9. 9. Central Fill Prescriptions Receive Refill Request From Patient Is item available in central fill formulary? YES No Fill Prescription Locally Send to Central Fill Process Prescription -DUR -Billing Central Processing Center Reviews IVR
    10. 10. Central Fill Pharmacy Central Fill Pharmacy Receives Request Is item in stock and available to fill? YES No Complete Filling Process Return to Pharmacy for Local Fill Send to Originating Pharmacy for Pick-up by Patient
    11. 11. Receiving of Prescriptions Packages Arrive From Central Fill Pharmacy Electronically Receive Prescriptions and Place in Will-call Area <ul><li>Pick-up duties: </li></ul><ul><li>Collect appropriate payment </li></ul><ul><li>Counsel as required </li></ul><ul><li>Obtain signature to document transaction </li></ul>Did customer pick up prescription? YES No Follow RTS Procedure
    12. 12. Ensuring Compliance <ul><li>Closed system (340B eligibility) </li></ul><ul><li>Focus on anti-diversion safeguards </li></ul><ul><li>Comprehensive reporting system covering inventory reconciliation and cost allocation </li></ul><ul><li>Internal audits (quarterly) </li></ul><ul><ul><ul><li>Verify process integrity </li></ul></ul></ul><ul><li>External audit (annual) </li></ul><ul><ul><ul><li>Eligibility </li></ul></ul></ul><ul><ul><ul><li>No duplicate discount on Medicaid claims </li></ul></ul></ul><ul><ul><ul><li>Drug dispensed versus quantity purchased </li></ul></ul></ul><ul><ul><li>3 rd Party consultant assists with reporting, audits, and formulary/inventory management </li></ul></ul>
    13. 13. Central Fill Challenges real-time seed inventory management shortages IVR campaign patient buy-in centralized processing workflow inefficiencies   - visibility - discrepancies - daily reconciliation - system development - automation - concurrent go-live reporting enhancements dispensing software Solutions Challenges
    14. 14. Central Fill Reporting <ul><li>Fully automated reports resulting in greater efficiency </li></ul><ul><li>Inventory reconciliation </li></ul><ul><ul><ul><li>Daily reconciliation of items received in dispensing software versus items shipped from central fill pharmacy </li></ul></ul></ul><ul><ul><ul><li>Daily reconciliation of discrepancies </li></ul></ul></ul><ul><ul><ul><li>Daily verification of central fill pharmacy receipt of product </li></ul></ul></ul><ul><ul><li>Visualization </li></ul></ul><ul><ul><ul><li>Real-time access to seed inventory levels and fluctuations </li></ul></ul></ul><ul><ul><ul><li>Daily reporting of inventory levels and products dispensed from central fill pharmacy </li></ul></ul></ul><ul><ul><ul><li>Daily reporting of items not in stock at central fill pharmacy </li></ul></ul></ul><ul><ul><ul><li>Increased visualization of central fill transactions </li></ul></ul></ul>
    15. 15. Opportunities of Multiple Contract Pharmacies <ul><ul><li>Operational Efficiency </li></ul></ul><ul><ul><ul><li>70% of duties transferred off-site (40% to Rx.com) </li></ul></ul></ul><ul><ul><ul><li>23% improvement in wait times </li></ul></ul></ul><ul><ul><li>Focus on Critical/Immediate-Need Prescriptions </li></ul></ul><ul><ul><li>Clinical Opportunities </li></ul></ul><ul><ul><ul><li>Basic lab monitoring pilot </li></ul></ul></ul><ul><ul><ul><li>Ultimate goal of decentralization </li></ul></ul></ul><ul><ul><li>Staff Reduction (nearly 10%) </li></ul></ul><ul><ul><li>Waste Reduction </li></ul></ul>
    16. 16. AMDP Q&A <ul><li>An AMDP is approved by: </li></ul><ul><li>CIA </li></ul><ul><li>FBI </li></ul><ul><li>OPA </li></ul><ul><li>ABC </li></ul>
    17. 17. Thank You! Anthony Lesser [email_address] (713)873-2572

    ×