Synopsis: Acentrus Specialty was able to provide the University of Arkansas for Medical Sciences (UAMS) with support and access to medications that have helped propel the success of their specialty pharmacy program.

Challenge: UAMS needed more access to limited distribution drugs (LDD) and needed assistance with a manufacturer with which they had been unsuccessful.

Scenario: UAMS became an Acentrus client in 2016 and started at the Essential level of participation to gain support for their specialty pharmacy program. By the end of 2017 UAMS was on their way to becoming a Prime level member to gain access to a limited distribution network consisting of 5 oral oncolytics, by achieving the required data reporting necessary to meet the terms of the agreement.

UAMS is at the leading edge of the specialty pharmacy industry, with a focus on patient care and improving clinical outcomes.

UAMS Size:

• 455 Beds ¹

• $2.2M Total Patient Revenue ¹

• 315,00 Adjusted Patient Days ¹

• 27,996 inpatients ²

• 495,329 outpatient visits ²

• 19,245 surgical cases ²

• 60,559 Emergency Department cases ²

• 161,746 patients at UAMS Regional Centers ²

• 10,000 - 25,000 Estimated Annual Ambulatory Prescriptions including Specialty ³

• 5,000 - 10,000 Estimated Annual Specialty Prescriptions ³

How Acentrus Specialty Supported UAMS

University of Arkansas for Medical Sciences collaborated with the Acentrus team to expand their specialty pharmacy program and gained the opportunity to access limited distribution medications for their patients.

Specifically, both teams worked together to develop the infrastructure for data reporting and an environment to learn from others.

1. Helped with Data Reporting Prep

Acentrus was in constant communication with UAMS to get them prepared to move from the Essential level of participation to Prime. Manufacturers require a level of data reporting that had to be built out and integrated within the existing EMR. UAMS and Acentrus worked together to configure the necessary data while staying flexible within the existing formats and capabilities of the EMR. In the end, UAMS was able to report out better data than required.

The data capture process became a vital part of the program beyond being a core component of moving to the Prime level. UAMS also provides the necessary quality of care and scope of services from their pharmacy and health system.

2. Access to Limited Distribution Drugs

Previously, UAMS had access to a manufacturer’s oral oncolytics for their patients but eventually lost access. Acentrus has an LDD network contract with this manufacturer and UAMS was able to regain access to these critical medications for their oncology patients. When UAMS became aware of the agreement with Acentrus, they began working with Acentrus to achieve Prime level status to gain access to the LDD network.

Through its LDD network agreement, Acentrus is facilitating advancement in the quality and scope of the UAMS specialty pharmacy program by expanding access to medications and providing UAMS access to total integrated care within their own health system.

3. Providing the Environment to Learn From Others

Acentrus creates a collaborative network for health systems to work together and learn from one another. Currently, the specialty medication market is growing at an unprecedented rate, often with new drugs coming out faster than anyone can keep up. The National Association of Specialty Pharmacy is projecting that half of drug sales will be specialty by 2020.

By collaborating with peer group specialty pharmacies, health systems find better ways of providing care to their patients. UAMS is excited to share what they have learned to help others advance their programs.

What UAMS Did to Support Their Success

UAMS has created a culture and team of excellence. They are dedicated to improving the clinical outcomes and the processes of care for their patients along their journey.

For UAMS excellence is not based on the number of letters behind a name, but on the commitment to care. All pharmacists have to be skilled but not all have the commitment and dedication necessary to provide specialty care. Satisfaction surveys provide a measure of excellence and those completed by UAMS Specialty Pharmacy patients have yielded nearly 100% overall satisfaction with both the UAMS specialty pharmacists and the UAMS Specialty Program program.

1. Utilizing Specialized Staff with Data and Pharmacy Specialties

No program can function without the right specialized staff. The specialty pharmacy at UAMS is supported by an expert data specialist with a background as a pharmacy resident, Brett Bailey, PharmD. Brett is able to leverage his experience in pharmacy to provide relevant specialty pharmacy patient data that exceed the Prime level requirements. His expertise has helped grow the program and provide seamless integration with the Acentrus team.

2. A Culture of Dedication and Excellence

Corporate cultures don’t just happen by accident. UAMS drives a culture that promotes personal accountability and excellence in everything they do, and strives to do it the best they can. Starting with the hiring process, the UAMS team focuses on hiring experienced staff.

As part of maintaining and cultivating their culture, each morning starts off with a staff meeting to discuss any issues that arose the day before, problems, suggestions, etc. Everyone has an opportunity to speak. Discussions are encouraged and are sometimes lively. Together the UAMS team keeps reinforcing that their focus is patient care and this should be the foremost concern.

The UAMS team believes in participating to the fullest extent possible. This drove them to pursue the goal from the beginning of their partnership with Acentrus to move to the Prime level of membership.

3. Placing Pharmacists in Clinics

Along with a culture of cultivating the best results, UAMS placed expert pharmacists in specialty clinics where their interests and area of expertise help make a difference. Each pharmacist is a member of the team of clinical staff members working with patients and providing them with the care they need.

Clinicians are currently embedded in all of the specialty clinics and assist in drug therapy management, patient education, and counseling at the time of visits. Coordinators work on prioritization processes and communications with patients, physicians, and pharmacists.

Outcomes

The expanded specialty pharmacy program has greatly enhanced the quality of care provided to patients. Both the physicians and the patients can feel the difference.

Before UAMS had access to the Pfizer oral oncolytics through their agreement with Acentrus, patients receiving care from UAMS providers could not get these prescriptions filled at the UAMS ambulatory pharmacy. Not only were these patient prescriptions going to external pharmacies, but also the associated prescription revenue. In addition, since the dispensing pharmacies are outside of the UAMS system, communication between these pharmacies and UAMS providers was difficult leading to many frustrated patients and potentially less than ideal treatment outcomes. Now that UAMS can dispense these life-saving medications, UAMS patients can get their Pfizer oral oncolytic prescriptions filled at the UAMS ambulatory pharmacy resulting in additional revenue for the organization and better overall coordinated care and treatment for these patients.

1. Improved Patient Care

Often the patients are overwhelmed by the level of service and express their deep gratitude for the compassionate care they receive from staff. Often UAMS will receive personal thanks from their patients for the level of services they provide during treatment of difficult disease states.

2. Time to Treatment

The time it takes to provide medications to patients matters, especially with life-threatening disease states treated by specialty medications. UAMS has reduced the time it takes to receive authorization by the patient’s prescription insurance company from about 7 days to under 3 days, which results in bringing patients their treatments faster than ever.

3. Improved Dispensing and Distribution Accuracy

Dispensing and distribution accuracy have increased to near perfect numbers. Dispensing accuracy sits between 99 and 100% accuracy, while distribution accuracy comes in at 99%.

Conclusion

UAMS is on the leading edge of health system-based specialty pharmacy. Their facilities provide care to patients from across the state, and they have become an example of what excellent patient care can be for other medical centers.

Their specialists and coordinators have strived to do their best; they continue to go above the scope of duties to help people beyond the standard pharmacy steps. In the end, Acentrus and UAMS have worked together to increase the quality of care, patient satisfaction, and improved clinical outcomes of patients through the specialty pharmacy program.

Sources:

1. July 2018 Medicare Cost Report

2. University of Arkansas for Medical Sciences

3. Acentrus Client Questionnaire October 2017