Pharmacy Track
The health system pharmacy plays a vital role in patient outcomes and pharmacy executives continue to look for innovative methods of improving quality while keeping costs low. The problems facing the pharmacy segment of healthcare are complex and include maintaining compliance with a myriad of changing regulations while attempting to keep up with increased demand. Value-based drug pricing and its implications will be discussed, as well as real-life lessons learned from the restructuring and reexamining of current pharmacy systems.
1:00 pm – 2:15 pm Lessons Learned From the Restructuring of the UPMC Pharmacy
Frank Lloyd Wright GH
Moderator: Gloria Graham, DNP, RN, Clinical Materials Specialist, Cincinnati Children's Hospital Medical Center
Presenter: Mary Beth Lang, Vice President, HC Pharmacy and UPMC Supply Chain Management and Commercial Services
View the slide presentation here.
Listen to an audio recording of this session here.
Faced with compressed reimbursement and significant expense reductions, UPMC implemented the adoption of horizontal service line management. UPMC executives asked supply chain management to assume responsibility for running the pharmacy supply chain’s horizontally integrated, centralized mechanism for controlling pharmaceutical spend under a consolidated services procure-to-pay for-profit company, HC Pharmacy.
In this session, attendees will learn how SCM has added operational efficiency through focus on people and process. Additionally, HC Pharmacy leadership has been added to the UPMC Health System Pharmacy & Therapeutics Committee, to expand the pharmacy service line efforts to increase formulary compliance and limit product selection.
Learning Objectives:
- Define methods for creating a management structure that fosters innovation as well as alignment with your strategic plan.
- Analyze the decisions that need to be made in order for service lines to be truly effective.
- Identify the benefits that the service line model can provide for clinical specialties.
2:30 pm – 3:45 pm 2017 OPPS Updates: Connections Between Data and Dollars
Frank Lloyd Wright GH
Moderator: Regine (Honore) Villain, VP Supply Chain Operations, NYU Langone Health System
Presenter: Bonnie Kirschenbaum, MS, FASHP, FCSHP, Healthcare Consultant, Columnist
View the slide presentation here.
Listen to an audio recording of this session here.
The ongoing healthcare revolution inexplicitly ties data and reimbursement with the demand for analytics that provide insights into a variety of areas from treatment to business intelligence vital to the management of healthcare organizations and practices. Significant changes will continue, ranging from reform in reimbursement philosophy to coding changes inherent to the adoption of ICD10. Pharmacy can't afford to assume billing systems work correctly or that anticipated revenue is being realized without understanding reimbursement rules and careful system monitoring.
This session provides an in-depth look at how rules are formulated, what they are for 2017 and what this means to pharmacy practice. Additionally it will provide suggestions and tools for assessing current practice and making needed changes. Health Care Reform has set the stage for additional dramatic changes. Some of these will be reviewed with suggested action steps requiring intra site and department collaboration. As the largest payor, CMS is stressing the critical need for accurate information and data transmission and pharmacy billing represents the mechanism for submitting medication use information to the data pool. It's no longer just about money but about assuring data accuracy!
Learning Objectives:
- Explain 2017 changes to Medicare reimbursement and identify operational changes required to implement them.
- Describe three Medicare reimbursement challenges and complexities in your practice setting.
- List the compliance requirements for Medicare and how they apply to the 2017 changes to Outpatient Prospective Payment Systems (OPPS).
4:00 pm – 5:15 pm Panel: Evaluating the Value of Value-Based Contracting
Frank Lloyd Wright GH
Moderator: Terry Cox, Interim Leadership Consultant
Panelists: Jeromie Atkinson, Sr. Manager, Supply Chain Solutions, Intermountain Healthcare; Richard Epstein, RPh, MBA, Vice
President Operations & Strategic Program Development - Ocean Medical Center, Corporate Director of Pharmacy, Meridian Health; and Fred J. Pane, R.Ph., FASHP, FABC , The Advisory Board
Rising pharmaceutical costs and consumer demand for value and economy have resulted in an increase in value-based drug pricing. Value-based deals tie the final cost of drugs directly to how well they work, giving discounts to insurers if medications don’t help patients as much as expected. With the number of prescriptions written steadily rising each year, this trend is likely to continue.
There are several factors to consider when evaluating the effectiveness of value-based pricing. Aligning the incentives of manufacturers and purchasers can be tricky, and there are differing perceptions on the definition of value as well. Increased paperwork and difficulty collecting and evaluating accurate data add another level of potential problems that must be solved. There are benefits for all involved parties as well – including better shared risk scenarios and increased transparency for consumers. Explore the workings of value-based contracting and what it means for your organization.
Learning Objectives:
- Analyze and identify the factors contributing to the increase in value-based contracting in the pharmaceutical industry.
- Outline the potential methods for implementing value-based contracting.
- Compare the risks and rewards that make value-based contracting a complex solution.