In today’s rapidly evolving healthcare landscape, patients expect high-quality, convenient healthcare that caters to their unique needs and preferences. In order to meet patient expectations and thrive in a competitive care environment, health systems need to create seamless care pathways that enable patients to receive the treatments they need, without having to leave the health system. Two of the most promising areas of opportunity for health systems in this regard are infusion and specialty pharmacy. These services represent two of the fastest-growing areas of healthcare, and potentially the most underutilized for health systems.
Chronic disease diagnoses are on the rise in the United States, and patients with chronic conditions such as cancer, rheumatoid arthritis, and multiple sclerosis often require complex and specialized treatments. From 2021-2023, specialty medication usage across the U.S. population increased by 12%. At the same time, the prevalence of infusion services also increased, with hospitals retaining 54% of infusion volume. By starting, growing and modernizing their specialty pharmacy and infusion service lines, health systems can not only enhance patient care and satisfaction, but also improve health outcomes and drive their own long-term success.
The Patient Benefits of Integrated Health System Services
Patients benefit from a seamless and coordinated care experience. This is particularly important for those who require frequent and ongoing treatments. By staying within the health system for specialty pharmacy and infusion services, patients can quickly receive quality care from a familiar care team with ready access to their health and medical history. This level of convenience contributes to increased patient trust, satisfaction, and adherence to treatment plans, ultimately achieving better health outcomes.
When patients are able to stay within a health system and have access to a single point of contact for all their healthcare needs, it reduces the stress and confusion often associated with navigating multiple providers and treatment plans. Seamless care pathways within health systems can also:
- Enhance communication and coordination: Seamless care pathways ensure that all healthcare providers are on the same page and can easily share information and make informed treatment decisions.
- Improve medication management: Integrated infusion and specialty pharmacy services allow providers to work together to ensure that patients receive the right medications at the right time, reducing the risk of medication errors and adverse drug interactions.
- Ensure timely access to treatments: Integrated services can streamline the process of obtaining and administering medications, reducing wait times and ensuring that patients receive their treatments as soon as possible.
- Enhance patient education and support: Seamless care pathways also provide opportunities for patients to receive detailed information about their conditions, treatment options, and self-care strategies from a consistent and reliable source. This empowers them to take an active role in their own care.
The Challenges for Health Systems
What benefits the patient ultimately benefits the health system, making it clear that integrated specialty pharmacy and infusion services are a winning strategy. With mature specialty pharmacy and infusion service lines, health systems meet modern patient expectations for convenience and drive positive patient outcomes, while maintaining long-term patient relationships for the betterment of the health system. While clearly advantageous, creating or enhancing specialty pharmacy and infusion programs presents complex administrative and operational challenges, including:
- Complexity of care coordination: Coordinating care across multiple specialties and departments can be challenging. Health systems need robust communication and information-sharing systems to ensure that all providers are aligned and patient care is seamless.
- Regulatory compliance: Specialty pharmacy and infusion services are subject to stringent regulatory requirements that health systems must navigate to ensure compliance and avoid legal and financial penalties.
- Financial management: Managing the financial aspects of specialty pharmacy and infusion services can be complex. Health systems need to secure payer contracts, manage revenue cycles, and enable patients to have access to financial assistance programs when necessary.
- Visibility into complex data: Understanding complex and often disparate data sets regarding drug utilization and more can be challenging or even impossible for health systems without the appropriate tools, resources, and bandwidth to do so. Insights from this data, as well as integrated technology solutions to enable access, are critical for creating a customized strategy for success that addresses the needs of each health system’s unique patient population.
How Health Systems Can Succeed in Specialty Pharmacy and Infusion
Fortunately, overcoming these challenges to start, grow and build health system specialty pharmacy and infusion programs doesn’t have to be complicated, and health systems aren’t on their own. Collaboration is key to overcoming the complexities of specialty pharmacy and infusion service operations, and building strong partnerships across the continuum of care can help health systems secure the resources and support they need to succeed.
There are a multitude of consultancy and expert advisory services that can aid health systems in developing a comprehensive strategy for their specialty pharmacy and infusion offerings to improve operational efficiency while also addressing unique challenges and providing ongoing support for long-term success. Some of these are even available through existing relationships, including with trusted distribution partners and other stakeholders. These consultancy services can help to ensure that health systems are in compliance with all relevant regulatory requirements and are staying up to date with the latest advancements in healthcare administration technology.
Considering full-service management solutions such as Intrafusion, which handles onsite administration and clinical operations, can free up health system resources. Exploring tools and services to take on areas such as prior authorization and benefit verification, site-of-care optimization and financial management are other viable options for health systems looking to grow their infusion services without additional administrative burdens.
By leveraging these strategies, health systems can create a robust and sustainable model for specialty pharmacy and infusion services, leading to enhanced patient satisfaction, improved health outcomes, and long-term health system success. These services are not only a strategic imperative to help health systems achieve more for their business of pharmacy, but also a key step in ensuring that modern patients receive the high-quality, convenient care they deserve.
About Andrew Wilson, Pharm.D., FASHP
Dr. Wilson currently leads McKesson Health Systems’ Professional & Advisory Services team, having previously served as VP of 340B Solutions. Dr. Wilson has more than 25 years of healthcare operations experience as a pharmacy director in academic medical centers and integrated health systems.
