White Papers

Drawing upon our vast healthcare experience and varied engagements, PHS has developed many best practices and unique perspectives to help clients realize successful and timely implementation results. The white papers listed below provide insights and guidance on current critical healthcare delivery issues that will likely impact your health system.

  
Streamlining the Prior Authorization Process For a growing number of medications, the prescription is merely the first step to actual administration. For many years, managed care has used a review process called Prior Authorization to help ensure patients receive the appropriate therapy, as well as to control costs. During the Prior Authorization process, payers may review the patient’s age, medical necessity of the medication, availability of a lower-cost generic drug and potential drug interactions.
Prescribing Success: A Comprehensive Business Plan for Your New Specialty Pharmacy To enhance patient care continuity, control costs and capture new revenue streams, health systems across the country are implementing their own Specialty Pharmacies. To create momentum for, and to position your Specialty Pharmacy for success, it’s critical to have a clear strategy, build a comprehensive business case and establish organizational alignment around the initiative. A detailed, robust Specialty Pharmacy business case which is well documented can withstand organizational changes
Powering Transitional Care For hospitals and health systems, transitional care can be a key strategy to help improve quality and prevent readmissions. The approach not only positively impacts patient outcomes and satisfaction, but also helps avoid costly penalties—which can run as high as 3% of total Medicare reimbursement...
Peak Performance for Value Based Care Costs are going up, reimbursements down—and the challenges continue to grow. What can your hospital pharmacy do to not only keep up with change, but also make the most of it to improve the health of both your patients and your hospital?...
Engage With Key Stakeholders Before Opening Your Hospital Outpatient Pharmacy Owning and operating an outpatient pharmacy within the four walls of your hospital may be such an attractive idea that you might want to get started right away—engaging vendors, construction crews and boards of pharmacy. But before you do, it’s critical to fully understand the value of meeting with all of the key players first...
Why Your Hospital Pharmacy Team Should Manage Medication Reconciliation Hospitals and health systems have the relentless goal of maintaining effective transitional care programs. All of them see medication reconciliation as a critical component. Indeed, its importance has long been recognized: even before the Affordable Care Act, medication reconciliation was named a national patient safety goal by the Joint Commission. But despite the growing attention they have received, medication discrepancies remain pervasive...
How Drug Manufacturers, Health Systems and Payers Can Collaborate More Closely As healthcare reimbursements move from fee-for-service (FFS) to value-based payments, the pressure has never been greater to demonstrate the quality of patient care. In response, drug manufacturers, health systems and payers are simultaneously seeking new ways to improve value and patient outcomes, while protecting reimbursements...
How Lowering Your Ambulatory Pharmacy Profits Can Double Your Total Financial Gain (Or More) Can pursuing lower profits result in stronger financial results for an ambulatory pharmacy? Put another way, does the singular pursuit of short-term profits actually harm long-term financial performance?...
Reducing Pharmacy Costs and Improving Efficiency With Consolidated Distribution Rising pharmacy costs, declining reimbursements and the shift from fee-for-service to value-based payments: healthcare is changing like never before. It’s a fast-paced evolution to a new world where smart business and smart medicine must come together to lower costs and demonstrate new value...
Overcoming the Unique Challenges of Creating Your Own Hospital Outpatient Pharmacy To help compensate for declining reimbursements, narrowing margins and escalating costs, America’s hospitals are exploring alternative revenue streams now more than ever. Among them is the development of an on-site, outpatient pharmacy. But far too often, dreams of a new revenue stream are shattered when hospital administrators discover that managing an outpatient pharmacy is more challenging than they thought. What goes wrong?...
Implementing Successful Transitional Care Transitional care is defined as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care. Representative locations include (but are not limited to) hospitals, sub-acute and post-acute nursing homes, the patient’s home, primary and specialty care offices, and long-term care facilities. Transitional care is based on a comprehensive plan of care and the availability of health care...