Manager of Population Health Shields Health Solutions
Learning Objectives:
Illustrate how specialty pharmacy can be leveraged to achieve quality measures within value-based care (VBC) arrangements.
Describe the value of expanding the scope of specialty pharmacy into large-scale chronic diseases.
Illustrate how specialty pharmacy can help reduce total cost of care and improve outcomes.
Session Description: Health systems have not traditionally viewed specialty pharmacy (SP) as a tool to enhance value-based care performance. The growth in Value Based Care (VBC) contracts has made it more important than ever to equip health systems with the resources and strategies they need to thrive under these arrangements while continuing to provide outstanding patient care. Studies have shown that specialty pharmacy care models can reduce total cost of care by as much as 13%. There is also evidence demonstrating that deploying a SP care model within a VBC setting like an accountable care organization (ACO) has a similar impact on total medical expenditure reduction. In recent years, specialty pharmacies have begun to expand their scope of care beyond traditional disease states to include non-traditional specialties such as diabetes, chronic obstructive pulmonary disease, and congestive heart failure. As a result, there is a significant opportunity to extend specialty pharmacy support to more patients, potentially leading to an even greater impact on performance under VBC contracts. We will demonstrate how SP can be used to improve success within VBC arrangements through various tiers of patient support including clinic-based liaisons, ambulatory care pharmacists, and pharmacist coaches. Successful integration of SP care and VBC ultimately leads to increased shared savings, quality-based rewards, and improved clinical outcomes, while simultaneously generating specialty pharmacy revenue.
