Demonstrating Value in a Health System

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Value-added pharmacy services come in all shapes and sizes. The “Value” chapter in the management text reviews future changes in the health care system and questions whether pharmacists will create value for health care industry stakeholders, which includes employers, employees, insurance companies, government agencies, and taxpayers. It contends that the most promising careers for future pharmacists is determined by the ability they can demonstrate value for these stakeholders.

Keedy et al describe a program to manage the formulary at a large health system.1 They describe how their PBM implements a wide-scale cost savings initiative for the health system but without individualized review occurring for employees accounting for the highest expenditures. The pharmacy program involved a review of the top 100 individuals accounting for the largest expenditures. Retrospective chart review was used to access employee prescription data through the PBM’s website and electronic medical record. Areas for potential cost savings including switching employees to formulary alternatives, interchanging to generic medications when able, and identifying those individuals who did not fill their prescriptions at the health system’s preferred outpatient pharmacy. After identification, employees were contacted by phone. Seventy-nine individuals were assessed, with 25 of them having potential formulary interventions. Cost savings were $85,654 to the health system and $48,664 to employees ad their spouses.

Further analysis of this program demonstrated substantial cost-effectiveness when taking into account program costs (personnel time). In the grand scheme of things, savings of under $100,000 to a large health system might not sound like that much. Yet this was a simple intervention taking relatively little time, some of which was handled by technicians and other staff. The cost-savings to the hospital employees was rather substantial. One can bet that at least some of those employees (mostly other health professionals) were very pleased by the efforts of the pharmacy and had good things to say about pharmacy staff to other employees. The hospital system was pleased that pharmacy personnel spending just a few hours of time could produce such a savings. The pharmacy demonstrated its value. Managers can always be on the lookout for ways to demonstrate value to other stakeholders.

Additional information about Creating and Managing Value and Implementing Value-Added Services can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing.

1Keedy CA, Schnibben AP, Crosby AF Jr, McGlasson ACL, Misher A. Implementation of a pharmacist-driven formulary management service within a community health-system insurance plan. Am J Health Syst Pharm. 2018;75:1854-1556. 

Shane Desselle

Professor of Social and Behavioral Pharmacy, Touro University California


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about 1 month ago

What are some other “simple” ways that pharmacists and technicians an demonstrate value?