The Shaeffer Consulting Group guides its clients to make strategic, intelligent decisions that will ultimately result in safe, clinically sound, and cost-effective solutions that are beneficial for their patients and organization.
In 2016, PRMC Home Scripts approached The Shaeffer Consulting Group about improving their ambulatory pharmacy operations. PRMC Home Scripts, part of the Peninsula Regional Medical Center (PRMC) in Salisbury, Maryland, is a first-fill pharmacy with two locations—onsite at the hospital and a retail location in Ocean Pines, a senior living facility.
While the hospital-based PRMC Home Scripts pharmacy is designed for first fills only, PRMC Home Scripts Ocean Pines is a full-service community pharmacy. Patients who choose to stay with PRMC Home Scripts in the Ocean Pines, Berlin, Bishopville and lower Sussex County Delaware communities can continue to have their prescriptions filled there.
PRMC has 289 hospital beds and has been serving the healthcare needs of nearly 500,000 patients since 1897. It currently has about 3,300 physicians, staff and volunteers who provide safe, compassionate and affordable care.
PRMC Home Scripts has worked with Shaeffer Consulting previously on other projects and knew the results they could expect by working with them again.
THE CLIENT—PRMC HOME SCRIPTS
Since opening in January 2014, PRMC Home Scripts has been providing patients the opportunity of up to a 30-day first fill of their prescribed medications to take with them, at the time of discharge, to ensure they are not only getting their initial medications before they get home, but are also getting the correct medications and information on how to properly use them and why. PRMC Home Scripts also serves the employees of the hospital.
The pharmacy accepts most insurance coverage. Pharmacists will not only fill up to a 30-day supply of new medication, but will also transfer the remaining prescription refills to the patient’s preferred pharmacy or recommend a pharmacy near their homes if they don’t have one.
One of the main goals and objectives is ensuring that patients have the medications they need when they leave the facility.
“We wanted to grow the business with our Home Scripts operations and increase our overall market,” said Dennis Killian, director of pharmacy for PRMC Home Scripts.
To accomplish this, there were three primary issues that PRMC Home Scripts wanted to address:
- Implement a better remote point-of-sale (POS) system to deliver medicine to patient bedsides
- Ensure that its PBM contract and relationship were aligned with their goals with its ambulatory pharmacy
- Analyze and improve its specially prescription capture
1. Implementing a Remote Point-of-Sale System
One of the first objectives was to help PRMC Home Scripts implement a remote POS system to deliver medication to a patient’s bedside. Previously, they were capturing only a small portion of the hospital’s inpatient discharge prescriptions. A remote system would work wirelessly and securely with its current POS system. The device would process the transaction as well as update its inventory and recordkeeping at the same time.
There are several advantages to offer a remote POS system:
- Generate revenue growth by providing convenient bedside medication delivery to patients.
- Minimize abandoned prescriptions and enhance pharmacy efficiency and profitability.
- Improve adherence by ensuring patients receive prescription refills in a timely fashion.
Shaeffer Consulting identified several key leaders in the remote POS system marketplace and examined each of their solutions. Together with PRMC Home Scripts, they met with each vendor and discussed their recommended solutions.
“Greg and his team carefully vetted each of the vendors and helped us determine who would be the best partner for us,” said Killian.
In addition, by working with the nurses, PRMC Home Scripts pharmacists can now educate patients, in advance of their discharge, about proper medication usage. This could improve adherence and improve prescription refills.
Prior to implementing the remote POS, PRMC were filling, on average, about 700 prescriptions per month. Today, they are now averaging about 1,900 prescriptions per month.
“Thanks to Shaeffer Consulting, we were able to more than double the amount of prescriptions that we fill on an average monthly basis,” said Killian.
2. Revising the Current PBM Contract
Like many other hospitals, the pharmacy was under-utilized by PRMC’s employees. Since PRMC Home Scripts wanted to drive more internal traffic to the pharmacy, it employed a pharmacy benefits management (PBM) partner.
Prior to working with Shaeffer Consulting, PRMC’s contract with its current PBM was written as a full pass-through model PBM. In this pricing model, the PBM charges the hospital the same price for the medication they pay the pharmacy—so in effect, “passing through the cost.” An administrative fee is added on per prescription which is how the PBM gets paid for the service.
After reviewing the contract, Shaeffer Consulting recommended a pay-as-submit type of pricing model. In this more traditional pricing model, the PBM will charge the hospital an agreed-upon price for prescription drugs accompanied by a rebate that would be paid on a per-drug brand basis.
In this model, administrative fees are waived. The price they agree upon is usually different from what the PBM will pay the pharmacy for prescription drugs. This difference is how the PBM gets paid.
“Greg pointed out to us that a pay-as-submit model allows you to adjudicate a claim so you get paid what you are submitting,” said Bill Cooper, ambulatory pharmacy manager for PRMC Home Scripts. “After we changed the contract terms for 2018, our margins have improved. Our capture rate is about 80% now which is unheard of. If you can fill the majority of your own prescriptions that saves you a lot of money out the gate.”
3. Improving Specialty Pharmacy Capture
Another way, many hospital pharmacies produce revenue is through a specialty prescription capture program where prescriptions written by hospital physicians are filled by outside 3rd party pharmacies. PRMC Home Scripts asked Shaeffer Consulting to also thoroughly evaluate its current specialty prescription capture program and help them improve it.
Similar to what it did for the remote POS system, Shaeffer Consulting identified several new partners PRMC Home Scripts could work with.
“They reviewed and analyzed several vendors who could best meet our needs,” said Killian. “We worked collaboratively with Shaeffer Consulting to determine who would be the best one to partner with. It was a very collaborative process and they helped immensely by acting as a project manager to ensure things were moving along and the vendor was abiding by the timelines.”
Cooper added, “We are directing the hospital employees to come here first to fill their prescriptions. If, for any reason, we are unable to fill any of their prescriptions, we now follow them to their specialty pharmacy. That’s a win-win.”
In the first three months of 2018, PRMC Home Scripts’ overall prescription capture is 90% for employees; 75% for specialty prescriptions. Both of these numbers have increased nearly 15%.
According to Killian, one of the biggest advantages that The Shaeffer Consulting Group offers over other consultants is its esteemed team of experts and their experience in the industry.
“You get Greg, the owner, an expert in many things, who has connections with the right people to tackle many of the challenges that ambulatory pharmacies face today,” he said. “Greg and his team have various expertise and can guide you to the right decisions. They have their finger on the pulse of what strategies work best for contemporary practices.”
What Killian appreciated most is the collaborative manner in which Shaeffer Consulting works.
“It’s a two-way process where we look to their expertise and they look at what we need,” said Killian. “They inform us of the strategies and best practices that have been successful, but we don’t go through this alone. They are with you every step of the way.”
Cooper agreed, and added, “Greg and his team bring so much to the table and since they have been in many venues. They understood our current situation and what we was required to get us to the next level. Through their expertise and contacts, they were able to assist us and get us to where we needed to be.”
In addition, Cooper said they have been impressed working with Shaeffer Consulting over the years which is why they continue to work with them.
“The experience we’ve had with them is over the top,” he said. “Their communication and personability are two of their important attributes. Their product knowledge and information they bring to the tables been far and above what we anticipated.”
About Shaeffer Consulting
The Shaeffer Consulting Group advises and supports its clients throughout the entire process. They keep everything simple and straightforward and will help you make informed decisions regarding your pharmacy strategy—decisions that will ultimately be beneficial for your patients, employees and your bottom line.
They will assess your needs with a fresh, objective perspective. No other consulting firm can match their resources and expertise in conducting a thorough evaluation to determine the viability of your pharmacy. They ask you the tough questions and will always be candid with you.
Their scope of Ambulatory Care services includes:
- Comprehensive Assessment of Your Ambulatory Strategy
- Business Plan Development
- Project Management and Implementation
- Strategic Pharmacy Marketing Plan
- Talent Acquisition
- Results Driven Assessment of Your Existing Pharmacy
For more information, visit www.shaefferconsultinggroup.com.