Hospital executives seeking to increase profits may turn to pharmacy to develop new revenue streams. Though it is often thought to be a high-cost center, the pharmacy can also be a great source of revenue. Executive teams should work closely with pharmacy leadership to identify how to increase pharmacy business and develop opportunities that will bring in additional revenue.
Discover How to Increase Pharmacy Profit with Three Key Opportunities
Utilize Your Retail Pharmacy
A retail pharmacy is an important business opportunity to explore for strategic growth of outpatient services and alignment with existing service lines and outpatient clinics. Here are a few key strategies to make sure you’re utilizing it to its fullest potential:
Make Sure Patients Know You’re There
New builds should consider locations with heavy foot traffic, and existing pharmacies need to make sure signage is clear, especially if the pharmacy isn’t in a high-traffic area. But even if you do face challenges with your location, excellent customer/patient services will go a long way to overcome them.
Provide Excellent Patient Services
- Be aware of patients’ needs and be willing to be creative and innovative in finding solutions to meet those needs.
- Support HCAHPS medication education survey questions through the deployment of a “meds to beds” program.
- Continue with drive-up/curbside delivery options that were put into place during Covid.
- Capturing discharge prescriptions and outpatient prescriptions from your outpatient treatment areas and clinics can keep patients within your network and improve revenues.
- Additionally, an outpatient pharmacy can target filling employee prescriptions and reducing your health plan prescription costs.
The American Society of Health Systems Pharmacists practice survey  showed that almost half of all health systems pharmacies have implemented an outpatient pharmacy prescription program. Some of these growth strategies may include:
- Filling prescriptions for assisted living and nursing homes within your market area
- Providing prescription delivery services and supplying durable medical equipment, which can differentiate your outpatient pharmacy and provide more value to your patient
Enhance Your Marketing Efforts
There’s an opportunity to introduce programs and services from the first moment a patient comes in at registration. Place clear signage about programs and services in ER waiting rooms, etc. to remind both patients and caregivers that they are available. Bottom line: make it as easy as possible for the patients and caregivers, who are already in a stressful situation, to find out about the services your pharmacy offers.
Make the Most of Your 340B Program
Being a 340B covered entity may have significant positive impact on the revenue performance of your pharmacy and the ability to expand ambulatory service lines. Simply being included in the 340B program increases revenue, but there are additional tactics you can implement:
- Have staff that are dedicated to purchasing, which allows oversight and monitoring of specifics like contractual changes, fluctuation in drug prices, the best price options for the hospital based on the primary location, and the best fit for utilization needs.
- Convert local doctor practices to hospital-based providers to capture their 340B scripts.
- Consider implementing a prescription referral program. A covered entity’s providers may refer patients out to specialists for care at a location that is not 340B eligible, such as a specialist’s private office. If the specialist writes a prescription for the patient as a result of the referral by the covered entity’s provider, those prescriptions are considered referral prescriptions, which can qualify as 340B eligible.
Optimize Your Business Operations
From purchasing to fulfillment, creating organized and easy to implement processes, like those listed below, will go a long way to optimizing your business operations and increasing pharmacy revenue.
- Ensure the chargemaster is set up correctly so that the prices are aligned. Incorrect NDCs and HCHPS codes can lead to denials. Reimbursement will go more smoothly when it is clear that what you are charging is appropriate.
- Review your top 20 outpatient billed drugs to determine actual reimbursements for specific drugs. Include a breakdown by insurance provider as there are sometimes big differences in what providers will reimburse.
- Verify that provider descriptions meet any prior-approval process. This will help prevent delay in payments and will minimize issues if there is a denial. Having a pre-approval process in place that is coordinated between pharmacy and finance can also help reduce denials.
- Bill for your pharmacist’s time. Increase their value even more if you can get them decentralized and talking to the patients, which ends up as billable time. This varies with each state based on the scope of practice.
- Make sure pharmacy is a player at the table throughout the entire pharmacy revenue cycle. Successful teams are moving pharmacy towards the front of the process so that someone with a better understanding is there at the beginning to do things like help negotiate payer contracts. Medical Necessity is required by insurance companies: more pharmacists with clinical experience who are involved in process can inform these decisions and make sure everything lines up, which also prevents denials. Ideally, the pharmacist who is doing the purchasing should have transparent insight into what is coming back to the hospital as well; this ensures the hospital is being paid correctly, especially with high-cost medications.
by Dana Fox, CompleteRx Director of Quality & Compliance