As 2018 is coming to a close, companies get down to year-end business reviews and planning the strategy for the next 12 months. Different businesses will implement various tactics to show a greater profit next year. Pharmacies that are looking to optimize their revenue model and improve business practices in 2019, should consider accreditation.
What Is Pharmacy Accreditation?
Accreditation is the process by which a pharmacy is validated by an accreditation organization as a healthcare business that provides patient-centric services care and demonstrates the ability to meet a variety of regulatory requirements and quality standards (HIPAA included). All types of pharmacies can apply for accreditation, community, specialty, and DMEPOS.
In the USA, there are several accreditation organizations which can formally recognize pharmacies that satisfy the laid out criteria. These include URAC, ACHC, and CPPA. While all of these bodies have a distinctive set of accreditation standards, in recent years, efforts have been made to align them.
Pharmacy Accreditation Benefits
Although accreditation is not mandatory, it provides compelling advantages to pharmacies. In a highly-competitive, strictly regulated industry such as pharmaceuticals, proving a business’s commitment to delivering personalized, quality care, streamlined processes, and enhanced patient outcomes, becomes a key factor that differentiates your pharmacy from other healthcare suppliers.
Accredited pharmacies also benefit from:
Driving continuous improvement and optimization of business processes through compliance with industry standards.
Enhancing patient outcomes by demonstrating value and dedication to high-quality services.
Increasing profit margin. In certain programs, accredited pharmacies may be granted higher reimbursement that the ones without accreditation.
Obtaining more payer agreements. An increasing number of payers and specialty drug vendors expect pharmacies to be accredited. This concerns especially manufacturers of medications with limited distribution or biologic drugs that require strict monitoring.
In order to become accredited, a pharmacy must first comply with state and local laws governing pharmacy operation. Apart from that, it must also meet a range of accreditation criteria issued by the selected accreditation organization.
The list of requirements to be fulfilled by a pharmacy seeking to obtain accreditation varies from one standards body to another, however, all applying pharmacies must prove their commitment to a common purpose - delivering an advanced, consistent level of patient care. This goal can be realized by implementing a number of practices covering several aspects of pharmacy care, such as enhancing patient safety, improving the quality of care, or simplifying access to pharmacists’ services.
Pharmacies can drive improvement in these areas through rearrangement of administration and pharmacy organization, the introduction of patient care programs and services, and implementation of quality programs.
Where to Start?
Pharmacy accreditation is a long and complex process. In order to meet all the requirements, you will have to audit practices across all areas of your pharmacy operation and apply diversified measures to perform as expected.
If you’re not sure where to start with the process, first review the following points and see if your pharmacy complies with them:
Get your staff licensing and training in order. Audit the pharmacy staff’s skills, document them and provide means for their storage and review. Accurate records of staff qualifications are one of the crucial requirements for complying with accreditation standards.
Audit Prescription Drug Orders for integrity and authenticity and implement measures to ensure prescription medications aren’t prescribed remotely, without a former in-person examination.
Investigate methods of improving time to first-fill. Electronic prior authorization solutions are invaluable here as they decrease the administrative burden and improve patient outcomes by shortening time to therapy.
Automate and streamline management of medications. Document your approach to obtaining patient medication profiles and other related data. Review your policy of contacting the prescribers. Think about implementing a computerized medication monitoring system to enhance the detection of potential adverse drug reactions.
Enable 24/7 phone contact with your pharmacy. The new accreditation laws require pharmacies to offer around-the-clock patient support and monitor key indicators for call management, such as speed to answer calls, wait times, or abandoned calls. The most efficient way to fulfill this requirement is to engage an HIPAA-compliant medical answering services who can handle and trace all your calls in a professional manner or provide your patients with specialist after-hours phone support.
Ensure patient privacy. To improve your customers’ comfort and provide them with privacy, create an isolated or semi-isolated space to handle patient inquiries. If you cannot allocate a separate room for that purpose, use background music to reduce the noise, isolate the dispensary with barriers or partitions, and mark out the waiting area with two or three chairs.
Define, implement and enforce a set of policies and procedures regarding pharmacy operations. Document how your pharmacy reviews, updates, and archives these policies and procedures.
Delivering More Than Just Prescriptions
Instead of relying on cost-cutting alone, modern pharmacies are more and more inclined to adapt their revenue models to embrace patient-centric care and process optimization.
Obtaining accreditation from one or more bodies will not only help you define a set of business objectives for your pharmacy but also identify areas for optimization to provide high-touch, individualized service to your patients and enjoy a greater profit in 2019.