The National Association of Specialty Pharmacy (NASP) celebrated its 10th anniversary this year during its Annual Meeting & Expo in Orlando, Florida. In just 10 years, the pharmacy industry landscape has changed dramatically. Prochant infusion expert Jon Love was in attendance and spoke on a recent episode of The Modern Healthcare Back Office about hot topics discussed at NASP and his takeaways for pharmacy providers.
Providers are struggling to get paid.
While the NASP meeting was more about clinical processes, another critical part of the business is the billing side. Attendees discussed the difficulties of getting reimbursed. For example, large insurance providers failing to carry out processes correctly often makes providers feel like the system is working against them with no solution in sight.
There is also the tall order of staying compliant with countless measures, leaving a lot of pharmacies struggling to treat their patients, stay in business, and get paid.
Providers are trying to find ways to leverage resources in order to put more pressure on payers to pay quicker. The urgency of this should not be understated. Pharmacy deals in reimbursement, so for example, when a $20,000 drug is used by a patient, that puts the provider out $20,000. If it takes an extra month to get paid from the payer, that’s a month without $20,000 in the business. Being paid timely is essential.
Roles are expanding and pharmacies are expected to do more.
From supplying standard cold medicine to life-saving medications and infusion antibiotics, specialty pharmacies are now expected to do it all. However, every single drug has different compliance measures and billing needs. Providers at NASP were asking: “How do we stay efficient? How do we make sure the data is clean?”
Technology for pharmacy is changing.
Tech is changing rapidly in the healthcare industry, and even in specialty pharmacy, there are providers still doing everything on paper. With minimal staffing and increased workloads, this leaves room for a lot of human error. Providers should look into automation, e-referrals, and other digital solutions that would help keep mistakes from happening that would cost your business time and money.
New players are coming into the marketplace.
Every year, there’s a new competitive software company, which is going to happen more in a growing industry like pharmacy reimbursement. The ocean’s only going to get redder. Jon Love predicts that software companies will continue creating a mid-tier market with better pricing and onboarding, but possibly not as much customization.
Have questions about infusion or specialty pharmacy billing? Looking for tech-driven solutions? Contact Jon Love at jonl@prochant.com or visit prochant.com. Set up a 15-30 minute meeting to learn about Prochant and how we work with clients.
Prochant has a proven track record of helping pharmacy and HME providers meet their financial goals. Our scalable solutions, years of experience, and advanced technology provide best-in-class results to the healthcare community. Headquartered in Charlotte, North Carolina, our client base includes national pharmacy and HME providers and health systems.