340B Savings Equal Improved Patient Care Lisa Scholz, PharmD, MBA Chief Operating Officer/Chief Pharmacy Officer Safety Net Hospitals for Pharmaceutical Access 10 th Annual 340B Coalition Winter Conference February 7, 2014 1 Lisa Scholz has no actual or potential conflicts of interest in relation to this presentation 2 Speaker Panel Carol Millage, County of Santa Barbara Public Health Binita Patel, Froedtert & Medical College of Wisconsin Lisa Scholz, Safety Net Hospitals for Pharmaceutical Access 3 1
Track 3 Clinical Best Practices Hear how colleagues are using 340B savings in ways to improve patient outcomes and to deliver cost effective care: Engaging Colleges and Universities in 340B Residents, Students, Collaborative Approaches 340B Savings Equal Improved Patient Care Examples of patient stories and the impact of 340B 4 Who is in the room? A Entities B Government C Vendors D Manufacturers 2013 9 th Annual 340B Winter Conference 5 Today s Goals Review the intent of the 340B Program. Provide examples of how 340B savings are used. Review methods used by entities to calculate savings from 340B. Review how patient care and 340B are connected through examples of a community health center and hospital that are utilizing 340B savings to serve more vulnerable patients and provide care to improve health outcomes. 6 2
Questions to Reflect On How is the 340B Program changing? What are entities doing with the program savings? How can you track your program savings? How can you share your story? 7 CE Question The 340B Program benefits entities by reducing program costs and providing resources that allow them to help their patients, such as by improving access and increasing patient care for their uninsured, underinsured and other vulnerable populations. True or False 8 Intent of the 340B Program Permits eligible safety net providers to stretch scarce Federal Resources as far as possible, reaching more eligible patients and providing more comprehensive services. Reference: H.R. Rep. No. 102-384(II), at 12 (1992) 9 3
340B Program: Overview and Benefits Provides discounts on outpatient drugs to certain covered entities Average savings of 25-50% Savings used in many ways, including but not limited to: Reduce price of pharmaceuticals for uninsured and lowincome patients Expand services offered to patients Provide services to more patients Estimated $6.9 billion in 340B drug purchases last year Manufacturers that participate in Medicaid and Medicare Part B must participate in the 340B Program 10 2013 SNHPA Survey Results Majority of respondents reported 340B Savings were used to: $5,500,000 Reduce the cost of care Reduced drug costs to the uninsured Increase charity care Improve care model Improve quality Expand services Improve access Rural Hospitals $890,000 Average Annual Savings DSH Cancer Children s Hospitals 11 Study Shows Savings Used to Improve MTM Disease Management Programs Patient Outreach Care Model Quality of Care Mental Health Reduce Readmissions Hospice Addition of new staff Open outpatient pharmacies Open new clinics Service Expansion Access to Care Oncology Services Keep doors open Prescriptions at no cost 12 4
What Would The Impact Be of Discontinuing in The Program? reduced charity care higher drug cost for uninsured reduced pharmacy services staff reduction reduced pharmacy related programs closure of one or more clinics more restrictive formulary reduced non pharmacy related programs higher medical bills for uninsured closure of outpatient pharmacy longer lines in the pharmacy 13 How do you use 340B savings? A Access B Expansion of services C Quality initiatives D Care model improvements E More than one of the above. 2013 9 th Annual 340B Winter Conference 14 SNHPA Recommendations Directed at Hospitals SNHPA s Stewardship Principles Invest 340B savings in indigent care Have meaningful charity care policy that extends to pharmacy Use contract pharmacies to enhance access for indigent patients No cosmetic uses No altering admission/discharge policies Advance purchase only to meet public health need http://www.snhpa.org/files/principles_of_340b_program _Stewardship.pdf 15 5
How can you calculate your 340B savings? Starting point: Engage inventory management team Engage students and/or residents Work with your finance team Know your costs Document the difference between GPO/WAC and 340B for all purchases. Note the number for discussions within your organization. 16 Have you calculated your bottom line? A Yes B Yes, but need to update it. C No D No and need resources to help calculate savings. 2013 9 th Annual 340B Winter Conference 17 Pharmacy Reform Initiatives Patient Safety Initiatives Cost Avoidance Initiatives Order Review Interventions Adverse Drug Reaction Monitoring Systems HEDIS indicators pharmacy specific programs Hospital re admissions Emergency room reduction; focused programs on high risk populations 18 6
Pharmacy Reform Initiatives Regulatory Adherence Costs to manage 340B compliance Automation/Technology installation Medication Use Management Care Coordination Patient education Discharge programs Patient Satisfaction HCAPS scores impacted by medication use process 19 Pharmacy Reform Initiatives Materials Management/Supply Chain Formulary selection Procurement standardization References Improving Patient and Health System Outcomes through Advanced Pharmacy Practice: A Report to the US Surgeon General 2011. 20 What is your story? Share patient care outcomes data. Participate in a collaborative or engage in pharmacy practice model initiatives share your practices! Know the value of the 340B program to your organization and to your patients. Describe what it would look like WITHOUT 340B. Know the savings the 340B program brings to your entity. How does the savings translate to providing care know the dollar amount! 21 7
Contribute your story like these hospitals. Using 340B to Help Patients: The Tennessee Experience Using 340B Savings to Improve Oncology Care: Stories from Unique Communities with a Common Mission Using 340B Savings To Improve Patient Health Outcomes: A Perspective from Minnesota s Urban and Rural Communities Your story contact us if you would like to share your story with your peers! 22 340B Matters to Patients My hospital spends My hospital saves My hospital reinvests in Our patients have been impacted by Without 340B my hospital would no longer provide 23 Questions to reflect on How is the 340B Program changing? What are entities doing with the program savings? How can you track your program savings? How can you share your story? 24 8
CE Question hold up card. The 340B Program benefits entities by reducing program costs, providing resources that allow them to help their patients, such as by improving access and direct patient care for their uninsured, underinsured and other vulnerable populations. True or False 25 CE Question the answer. The 340B Program benefits entities by reducing program costs, providing resources that allow them to help their patients, such as by improving access and direct patient care for their uninsured, underinsured and other vulnerable populations. True or False 26 Additional Questions? Lisa Scholz, PharmD, MBA Chief Operating Officer/Chief Pharmacy Officer Safety Net Hospitals for Pharmaceutical Access 1101 15th Street, NW, Suite 910 Washington, DC 20005 Phone: 202 552 5857 Lisa.scholz@snhpa.org 27 9