Outpatient Hospital Pharmacy

Outpatient Pharmacies in HospitalsOutpatient pharmacies in hospital facilities are on the increase as hospitals and  healthcare systems across the nation are adjusting and attempting to provide their patients with better overall care. The number of hospitals that now offer their patients the convenience of picking up their prescriptions as they are being discharged is at a record high. Hospital pharmacies that provide outpatient services are basically simply community retail pharmacies that happen to be physically located at the hospital or healthcare center.

Why Outpatient Pharmacy Services At Hospitals Are Increasing

Although numerous reasons for the increase can be discussed, the two primary motivating forces behind hospitals choosing to go through a pharmacy startup process are both based on financial considerations.

  1. Medicare Penalties for Patient Readmissions –
    As a part of the Affordable Care Act, the Hospital Readmissions Reduction Program was created in an attempt to reduce the large number of discharged patients who ended up coming back to the hospital and being readmitted for treatment again. Intended and designed as a way to effectively give hospitals an incentive to pay better attention to their patients after being discharged, the program penalizes a hospital for re-admissions and unacceptable rates of patient injuries following their discharge. Many may remember that exactly one year ago (January of 2017) thirteen hospitals in Georgia were penalized one-percent (1%) of their annual Medicare payments based on the program. It is important to note that the penalty imposed on a particular hospital will increase each year up to a three-percent (3%) reduction in their annual Medicare revenues. Attempting to decrease the number of patient injuries and readmissions after discharge and thus avoiding Medicare penalties, many hospitals have responded to the Hospital Readmissions Reduction Program by providing their discharged patients the opportunity to use an onsite outpatient pharmacy. The theory behind this is that by decreasing Medicare penalties (in some instances equating to millions of dollars), the hospital “wins” even if the outpatient pharmacy doesn’t make a profit.
  2. Increased Patient Medication Compliance –
    Although obviously having an impact by reducing the number of discharged patient injuries and readmissions, and thus a decreased Medicare penalty for the hospital, the importance of medication compliance is worthy of a separate discussion. With so much dialogue and debate taking place in regards to mandated patient counseling, an outpatient pharmacy at a hospital presents a perfect scenario for the opportunity to ensure that patients both receive their medications and understand how to take them at the time of their discharge. Patient medication compliance issues throughout the US cost an estimated $17 – $29 billion annually. Take into consideration the following:
    1. An NIH (National Institute of Health) study documented that approximately 55% of all senior citizens take their medications incorrectly.
    2. Over four-percent (4.3%) of senior citizens that are enrolled in Medicare HMO’s required help taking their prescription medicines.
    3. US News reported that elderly patients taking their prescription drugs incorrectly is actually the 4th leading cause of death and hospitalizations for senior citizens in the USA.

Even worse is the fact that the National Institute of Health’s claim’s that nearly twenty-five percent (25%) of patients discharged from hospitals never even pick up their first month’s prescription drugs. As the NIH abstract states, it “is particularly important at the time of hospital discharge because new medications are often being prescribed to treat an illness rather than for prevention”. Reasons cited such as a lack of transportation to a pharmacy, cost and the lack of insurance can be better dealt with if the hospital had an outpatient pharmacy and taken care of prior to the patient being discharged and going home.

Outpatient Hospital Pharmacy Startups

The planning and execution involved with retail community pharmacy startups, specialty pharmacy startups and compounding pharmacy startups are similar in nature to those required for an outpatient hospital pharmacy, but there are also several additional considerations. It is important to address these to ensure that a successful pharmacy operation results.
– Hours of Operation:
It’s critically important that the pharmacy’s operational hours take into account both the peak hours of the hospital’s discharging of patients and that of the emergency room (ER). If these hours are not all aligned, then the issues discussed above regarding both Medicare penalties and medication compliance will not be as effectively dealt with.
– Staffing:
As with the operational hours, its just as important that the pharmacy’s staffing of personnel be determined by both the peak hours of the hospital’s discharging of patients and that of the emergency room volume. If the staffing is not appropriately timed, the result can lead to long wait times, frustrated patients and an unhappy hospital staff.
– Training and Education:
Both the pharmacists and pharmacy technicians may require some additional training. Although the outpatient hospital pharmacy is in many ways very similar to a retail community pharmacy operation, in certain ways they may differ. Of special note is the fact that a member of the hospital staff may be present along with the patients (as this is never seen outside of the hospital environment). How to deal with certain situations unique to a hospital setting may require some customized training, plus perhaps ongoing support and education for the pharmacy’s staff.
– Marketing:
Perhaps the greatest (and only) marketing opportunity that the pharmacy has available is promotion from within. It’s important to get the hospital’s staff and resources promoting the pharmacy and availability at every opportunity possible.
– Getting Involved:
It is critically important that the hospital’s administrators recognize that the pharmacy is a resource that is available to help the entire hospital’s operation. What better way is there to establish communication than to get involved? Routinely meeting with the hospital administration, nursing staff, case managers and social workers show that the outpatient pharmacy is part of the team and ready to get involved. Helping to address items such as lowering re-admission rates and increasing patient satisfaction and HCAHPS scores all show that the pharmacy is getting involved.

Contact HCC If You Have Questions

Healthcare Consultants has helped plan and open more pharmacies nationally than perhaps any other Pharmacy Consulting firm in the nation. HCC has also helped hospitals to both plan and implement successful outpatient pharmacy operations. We offer the additional advantage of having experienced in-house pharmacy consultants on staff who are knowledgeable in all areas of Pharmacy Staffing and Pharmacy Management. With a proven track record for over 28 years now and a history of success, HCC can you to plan and execute a strategy that ensures your success. Contact us online or call us today at 800-642-1652 to discuss how we can help you.

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