Becker's Hospital Review

16 EXECUTIVE BRIEFING EXECUTIVE BRIEFING 1 SPONSORED BY 'It's never too late to start': How a supported journey in specialty pharmacy services transforms hospital + health system finances and care delivery O ver the last few years, "doing more with less" has become a mantra for most hospitals and health systems. Many are now looking at specialty pharmacy services as a way to strengthen their financial portfolios, reduce administrative burden and deliver more patient-centered care. Becker's Hospital Review recently spoke with Allison Arant, senior vice president of client development and marketing at Clearway Health, about how specialty pharmacy services can support care coordination and management, community and public health and stronger contribution margins. Specialty pharmacy services can improve the financial health of hospitals & health systems Most healthcare leaders today are simultaneously striving to increase revenue and reduce costs. Only recently, however, have hospitals and health systems started to look at specialty pharmacy as a tool for achieving these goals. That's because the 340B Drug Pricing Program was designed to provide access to drugs at a discounted rate for eligible covered entities, providing revenue for health systems to stretch funding for much needed programs, Arant explained. "It is recognized as a way to drive revenue back into organizations, while providing care and increasing access for underserved patient populations," she said. Specialty pharmacy programs have been shown to substantially reduce the total cost of care by 60% annually, which translates into meaningful margin improvements. Well-executed specialty pharmacy programs, in conjunction with the 340B Drug Pricing Program, have shown substantial decrease in cost of drugs for the system and equally substantial improvement in patient adherence and outcomes. "Specialty pharmacy generates revenue in the right way to create positive, healthy operating margins for health systems," Arant said. "Millions of dollars of annual revenue are available through specialty pharmacy if healthcare organizations navigate it in the right way." Clearway Health partners with hospitals and health systems to build or strengthen their specialty pharmacy programs. Doing so can improve access to care, offer personalized support to vulnerable patients and families and eliminate crucial administrative tasks for providers and care managers. Clearway Health was born out of Boston Medical Center Health System (BMCHS) as a program to help keep the hospital's doors open and support the complex medication needs of patient populations. Eventually, Clearway Health evolved into a separate, standalone business entity. Today, specialty pharmacy services make up more than 25% of the total financial contribution for BMCHS. "That's the transformative power that these programs have," Arant said. Helping healthcare organizations take the first step in offering specialty pharmacy services Arant said it's a myth that only large, integrated delivery networks and major hospitals and health systems can have their own pharmacy and specialty pharmacy departments. Clearway Health has found that community hospitals and even solo, independent hospitals can effectively provide specialty pharmacy services. "One major barrier is understanding the data and the opportunity that exists," Arant said. "As Clearway Health explores partnerships with clients, we conduct a complete assessment of the prescriptions that are written and where they are being filled. When we review the data, we often find that health systems are capturing only a miniscule part of the total available specialty pharmacy opportunity." Another common hurdle is concerns about changes in the 340B landscape. Some pharmaceutical manufacturers have critiqued the program and how it's been used. As a result, many hospitals and health systems are wary. "Some drug manufacturers have said that hospitals and health systems must choose one contract pharmacy within a 40-mile radius, and they can only use that specific pharmacy to fill prescriptions," Arant said. "That's daunting for a community hospital, large academic medical center or major IDN. However, working within the 340B regulations in a compliant way is completely within the reach of healthcare organizations." Clearway Health eliminates these obstacles and provides hospitals and health systems with the necessary data to provide specialty pharmacy services, rather than allowing competing pharmacies to absorb that revenue. The company understands the complex specialty pharmacy landscape, the complicated and often changing government regulations and how to work with payers, pharmacy benefit managers and drug manufacturers. "From a patient perspective, medication adherence is typically defined as whether the patient takes their drugs in the way in which they were prescribed," Arant said. "We talk about access to medication first, because without access, there is no adherence. Yet, hospitals and health systems often struggle to access specialty drugs for their own organizations. Many are so

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