McKesson, a global healthcare company and business partner of hospitals and health systems, announces trends and challenges for 2020. Healthcare will be a major theme of the upcoming election cycle, resulting in uncertainty and instability.
Hospital leaders will watch potential drug pricing legislation, changes to or elimination of the 340B Drug Pricing Program, the potential repeal or modification of the Affordable Care Act and the continued expansion or contraction of government programs. The McKesson RxO® team, a group of trusted advisors helping hospital and health system pharmacy operations, addresses and analyzes challenges expected to impact hospital pharmacies in the year ahead.
“Regardless of election outcomes, hospital and health systems must proactively move from transactional relationships to insulate themselves from volatility,” reveals Tom Perry, MBA, vice president and general manager, McKesson RxO. “Pharmacy leaders need to solidify partnerships with their suppliers, distributors and vendors who help diminish complexity in advance of the 2020 election to support their goals and maintain quality patient outcomes along the continuum of care, regardless of which political party is in office.”
According to Perry and the McKesson RxO team, these are the challenges faced in election year 2020:
Increasing complexity and growth in integrated delivery networks
The lines between care settings are blurring as hospitals integrate with medical practices, infusion centers and home care, to form sophisticated networks delivering comprehensive patient care. While the number of hospital mergers declined in 2018, mega mergers are the new standard.1 This inevitable evolution is also presenting challenges around patient education, clinical workflow, systems integration, standards across care settings, contractual obligations with group purchasing organizations, payers, suppliers and various other vendors. The need for business partners to help networks diminish complexity and streamline operations across the continuum of care has become increasingly important as leaders work diligently to do what is right for the patient.
Hospitals expanding specialty pharmacy footprint, swiftly
Specialty pharmacy has been a top trend for the past several years as utilization and drug spend have dramatically increased across healthcare. As hospital and health systems experienced nearly 20% growth in the specialty drug market in 2018, 2 health systems continue to establish their own specialty pharmacies or expand their existing capabilities. While this brings positive impact on the health systems’ quality and continuity of care initiatives, administration of specialty drugs is challenging and highly complex given the number of new therapies and payer requirements. Speed to therapy and ongoing patient support are still critical.
340B delivering clinical and economic benefits
While the ongoing debate over the 340B Drug Pricing Program continues, thoughtful business planning, attention to access requirements and diligent compliance tracking will ensure successful participation in the program, resulting in diminished complexity, enhanced patient care and significant benefits to the health system. 340B savings have grown to become a material contributor to financial health, and participating pharmacies have a renewed focus on quantifying, optimizing and reporting impact. This requires continued investments in 340B tools to better track and manage program savings, which ultimately translate into resource funding necessary to appropriately care for patients in underserved communities.
Out-of-pocket costs impacting patients and revenue
Specialty drugs have emerged as important treatment options for cancer and other complex diseases, but there can be significant access and affordability issues with specialty drugs. The cost of specialty medications and the increased adoption of high-deductible health plans (HDHP) have placed a higher financial burden on patients. As out-of-pocket costs increase – from higher costs or insurance denials – patients are more likely to abandon their treatment plans. Due to this trend, health system pharmacies are more involved with the revenue cycle than ever before – ensuring providers are reimbursed for purchased drugs. Embedding financial support and patient assistance programs, along with various other charitable programs in the revenue cycle, are key to improving patient adherence and health outcomes.
Finance and pharmacy leadership relying on data-informed decisions, not intuition
Pharmacy directors face increasing pressure from performance-based reimbursement and diminishing resources. To alleviate these pressures, pharmacists need to leverage data and analytics to reduce costs, help maintain a healthy bottom line and support quality patient care. However, not all health systems have the tools and resources to aggregate and sift through data in order to apply comprehensive, real-time analytics to deliver better care effectively while maintaining a healthy balance sheet. Pharmacy leadership will need to work with their business partners, specifically distributors, to adopt proactive strategies in multiple care environments, helping health systems become the preferred provider for a patient’s continuum of care.
The McKesson team with Kalispell Regional Healthcare will present “Fosaprepitant Conversion Results in Significant Cost-Savings” Monday, Dec. 9 from 2-3:30 p.m. at Level 1, Bayside A of the Mandalay Bay South Convention Center in Las Vegas during the ASHP Midyear Clinical Meeting. The findings demonstrate the meaningful impact realized by McKesson’s Spend Analytics tool.
“Operating in a complex environment is nothing new for health systems. However, this coming year is likely to bring even more change and potentially unexpected challenges. In order to maintain quality care and outcomes, as well as strong business operations, pharmacy leadership must proactively leverage actionable insights to help manage costs, drive revenue recovery and expand capabilities,” shares Barbara Giacomelli, PharmD, MBA, FASHP, vice president, advisory services, McKesson RxO. On Tuesday, Dec. 10, Giacomelli will receive a Distinguished Service Award for her remarkable contributions to ASHP’s Section of Pharmacy Informatics and Technology.
About McKesson Corporation
McKesson Corporation, currently ranked 7th on the FORTUNE 500, is a global leader in healthcare supply chain management solutions, retail pharmacy, community oncology and specialty care, and healthcare information technology. McKesson partners with pharmaceutical manufacturers, providers, pharmacies, governments and other organizations in healthcare to help provide the right medicines, medical products and healthcare services to the right patients at the right time, safely and cost-effectively. United by our ICARE shared principles, our employees work every day to innovate and deliver opportunities that make our customers and partners more successful — all for the better health of patients. McKesson has been named the “Most Admired Company” in the healthcare wholesaler category by FORTUNE, a “Best Place to Work” by the Human Rights Campaign Foundation, and a top military-friendly company by Military Friendly. For more information, visit mckesson.com.
1 Kaufman Hall’s “2018 M&A in Review”
2 IQVIA’s “Medicine Use and Spending in the U.S.”