Specialty Pharmacy Solves Three Challenges Facing Healthcare Executives

Nicole Faucher, President
May 24, 2024

Of the many challenges facing healthcare executives, Clearway Health is best positioned to help with three at the top of the list: provider satisfaction, patient engagement and new sources of revenue.

Provider Satisfaction

When a patient is diagnosed with a complex illness and prescribed a specialty medication, a number of needs, expectations and risks arrive for the health system. Navigating the many requirements to fulfill the medication creates a burden on providers, fear for the patient and a potential financial risk or miss for the organization. Every specialty medication prescribed can easily require 60 to 90 minutes of administrative time. This assumes a staff member is very familiar with the benefits investigation and prior authorization for a broad range of payers and financial assistance processes. This process is difficult and can cause burnout for clinical staff. Any delay in this process can create gaps in starting therapy as quickly as possible leading to increased anxiety for patients. An incomplete administrative effort can also lead to missed revenue for the health system.

 For one client, we recently saved them over 207 hours of clinical staff time within a one month time period, increased patient compliance and adherence, and substantially grew their revenue for their pharmacy, all leading to provider satisfaction scores that exceeded 90%. Often when I speak to healthcare executives, I say, imagine a service that helps alleviate burdens for physicians and nurses, facilitates the access and financial assistance for patients and provides a new growing and sustainable source of revenue.

Patient Engagement

When pharmacy teams are integrated into the care team at a hospital, it helps patients navigate complex processes so they never have to worry about affording, receiving and understanding their medications. Our specialty pharmacy teams are embedded into outpatient specialty clinics, working alongside providers and are more available to patients than in a typical pharmacy setting.

Every incremental outcome, such as taking a specialty medication as prescribed, can improve a patient’s health and wellbeing. When patients have a positive experience getting their medications through the hospital, instead of at a retail pharmacy setting where care is not integrated and followed by a medical team, patient engagement and healthcare outcomes improve and loyalty is earned.

Revenue Growth

During the course of our partnerships, our clients experience exponential growth and enhanced patient outcomes. In two years, Clearway Health created a specialty pharmacy program for a client that served 4,524 patients and delivered more than $288 million in revenue. We focus on the specialty pharmacy programs and operations, clinically integrated initiatives in ambulatory clinics and strategic actions with payors, PBMs and manufacturers to improve cost and access. Our hospital partners focus on their inpatient and retail programs and their overall organizational imperatives. Together, we provide a high functioning specialty pharmacy that’s patient-centered, clinically-focused and business aware.

Because Clearway Health originated at Boston Medical Center, we have been in our client’s shoes. We’ve learned how to make difficult decisions and how to accelerate growth in an environment that’s often looking for how to do more with less. Such success requires making complex decisions because of opportunities identified or challenges to be resolved. Whether we’re discussing organizational structural changes, investments or tactical processes, our clients receive an honest voice from every Clearway Health team member.

To learn more about how Clearway Health’s specialty pharmacy services can help your hospital or health system, read our latest case study at OU Health.