Care Transformation Center Blog

The insights, tools, and resources you need to take on population health management

3 phases of establishing pharmacy systemness

by Molly Stein November 30, 2016

A show of hands from pharmacy executives from across the nation confirmed what we have felt to be true for leaders tasked with establishing pharmacy systemness. Though many pharmacies are part of a health system by name, their daily reporting and operations often remain separate and out of sync.

This is not surprising. Implementing a system strategy can take years or decades, even when it is well planned. Persistence and a deliberate approach to change distinguish those system-level pharmacy programs that have made the most progress.

As leaders work to form a cohesive system, they typically move through three phases, which we look at in more depth below. However, I also want to note that in many cases, systems may go through these phases multiple times, such as when systems change leadership or implement system-wide quality or cost initiatives. But each iteration typically represents another step toward systemness.

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4 key questions to ask when building your retail pharmacy strategy

by Samantha Freedman November 18, 2016

In our conversations with members across the nation, we have learned that retail pharmacy strategy often takes a backseat to other institution- and system-wide priorities.

Many of our members have inherited an established retail pharmacy or have been tasked with implementing one on short notice. Neither instance gives our pharmacy leaders the time to think critically about retail pharmacy's role in organizational goals or to identify the features and services that will drive prescription volumes.

Retail pharmacy not only has the potential to bring in new revenues, but it also addresses many core challenges in care delivery including medication management, care continuity, and the patient experience. Regardless of your existing pharmacy infrastructure, now is the time to evaluate your retail pharmacy strategy to maximize these benefits.

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Fighting an uphill battle with physician alignment? You're not alone.

Dennis Weaver, MD, MBA November 17, 2016

I had the pleasure of connecting with physician executives from across the country at Advisory Board's recent Chief Clinical Executive Summit. The conference was abuzz with discussions about strategies—and challenges—for reducing unnecessary care variation. And one of the main focal points of the conversations was engaging physicians in reducing clinical variation, which also happened to be the number one concern among C-suite hospital executives according to a 2016 Health Care Advisory Board poll.

Coming out of the Summit, two themes struck me as being top of mind for most of the physician executives I spoke with.

First, clinical executives are feeling a lot of pressure to make progress on their quality and clinical efficiency initiatives—and fast. Second, they're concerned about their ability to engage physicians in these initiatives. As I've said before—aligning with physicians requires appealing to their hearts, minds, watches, and wallets. So let me tell you what I've seen work effectively to do just that.

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Three ways hospitals are addressing patients' unmet housing-related needs

Rebecca Tyrrell November 15, 2016

Where we live influences our health. In the U.S., approximately three million people experience an episode of homelessness in a given year and many more experience housing instability, unsafe living conditions, or lack of social support that makes medical recoveries more difficult. Each of these scenarios can lead to poor health outcomes, increased high-cost health care utilization, and gaps in care.

In an effort to tackle the increasing number of patients stuck in the cycle of readmission to the emergency department due to non-optimal housing conditions, hospitals and health systems across the country are partnering with local government, housing authorities, and nonprofits to provide more upstream interventions. The range of innovation in this space is tremendous, but three specific hospital-led trends stand out.

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Your top questions on risk stratification—answered

Rebecca Tyrrell November 9, 2016

Risk stratification forms the foundation of effective population health management, providing a powerful framework for strategic resource allocation. Despite how fundamental this capability is for identifying which patients would benefit from additional support, there are a number of common missteps and questions we hear from leaders across the country.

Keep reading for answers to some of the more common ones.

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Q&A: How MemorialCare makes disease management work for its employees

by Taydra Jones November 3, 2016

Disease management is certainly not a new idea in the world of population health, but many providers still find it difficult to bridge the gap between theory and reality. With a driving mission to empower their 12,000 employees to maintain and improve their complete wellness, MemorialCare, a five-hospital integrated health system in southern California, launched the award-winning, Good Life's In Balance program in 2012, which works to support employees with chronic conditions.

Recently, Melanie Cumbee, Employee Well-Being Program Director for MemorialCare, joined me to discuss what makes their program so unique, and how they've used automation to exponentially expand its reach.

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Why your organization may want to consider a system-level P&T committee

by Colleen Keenan November 1, 2016

Health system leaders report that clinical standardization is one of their top priorities, and for many, a critical early step toward standardization is the creation of a system-level pharmacy and therapeutics (P&T) committee and system-wide formulary.

For example, Riverside Health System in Newport News, Va., saved $1 million annually through its system P&T committee policies. Similarly, Johns Hopkins Health System created a Formulary Management Committee to standardize its formulary and saved almost $2.1 million through a single formulary change that restricted IV acetaminophen use.

To better understand the current state of system standardization, the Pharmacy Executive Forum recently surveyed health system pharmacy leaders across the country. Keep reading to find out what we learned about system-level P&T and formulary committees.

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4 referral network solutions that can have a big impact

Hunter Sinclair, MBA October 31, 2016

Building a high-performance referral network on paper is relatively easy compared with building one that actually works in practice. I often work with organizations that have spent months or even years building a referral network that appears to have the right components on paper, but their referral volumes continue to decline.

More often than not, the problem is that these organizations have overlooked small but impactful operational issues that are necessary to get patients from Point A to Point B. In fact, our research finds that over 40% of patient outmigration is caused by operational issues in the referral process. Making just a few changes to your referral strategy can have a huge impact on the number of patients that stay in-network and on the quality of care they receive.

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