Improving pharmacy performance by prioritizing patient needs

As pharmacy reimbursement is changing to focus on patient outcomes, Cardinal Health’s Reimbursement Consulting Services (RCS) is expanding the ways it can help pharmacists focus on their patients to drive those outcomes.

[caption id="attachment_588273" align="alignright" width="150"] Jeff Monroe, Cardinal Health director of reimbursement solutions[/caption]

“One of the primary goals of our Reimbursement Consulting Services solution is to free up resources for our pharmacists so they can spend more time with their patients,” Jeff Monroe, Cardinal Health director of reimbursement solutions, said. The two cornerstones of RCS have been the professional consultant, who works with pharmacists to help identify new or overlooked opportunities for reimbursement or other revenue opportunities, and the RCS dashboard, to which Cardinal Health is adding a new feature — the Action Center within RCS — ahead of Cardinal Health RBC 2018.

The Action Center within RCS was designed to help pharmacists with two key needs, Monroe said. The first need is prioritizing patients that would benefit the most from their attention, and the second is the ability to see the adherence and clinical care needs of their patients on the individual level, highlighting services that could improve patient health and present expanded reimbursement or other revenue opportunities.

The Action Center within RCS was the result of listening to pharmacists, who Monroe said often have several staff members reaching out to patients, sometimes multiple times for different reasons.

“What we found was that stores were often calling the same patient one or two different times,” Monroe said, noting that the Action Center within RCS is meant to make it easy for pharmacists to see the multiple areas requiring outreach in one place. “The new functionality  not only prioritizes the work to help the pharmacist know where to start, it also rolls everything up. We wanted to make sure we brought all of the adherence, clinical care and other reimbursement or revenue opportunities together at the patient level — which helps both the pharmacist and the patient by maximizing those interactions and outreach calls, and by addressing multiple issues at the same time.”

As a result, the Action Center within RCS also helps pharmacists streamline their workflow — removing redundant phone calls — and deliver patient services that can improve adherence and delivery on quality measures. The Action Center within RCS is “targeted to help scores that affect things like DIR fees,” Monroe said, by allowing pharmacists to see where there might be DIR adjustments on the patient level and highlighting steps to mitigate or plan for them. The new feature is a tool that Monroe said can be implemented alongside the new Dispill adherence packaging solution — both of which will be on display at Cardinal Health RBC 2018.

“We're really excited to show pharmacists the changes we made to RCS to prioritize their patients and help them understand what they need to tackle per patient,” Monroe said. “By bringing all those opportunities together at that patient level, we're really looking to help our stores address those nonadherent patients early in the process when we can still bring them back to adherent levels, deliver better care and address other needs.”