Executive Summary
This content was written by Excelera, a Shields company.
Excelera was engaged to a home delivery and specialty pharmacy operation to capitalize on new revenue/margin opportunities. The engagement was comprised of providing advisory, project management and SME assistance for the specialty pharmacy and home delivery design, build out and implementation including related pharmacy support operations, e.g. call c
enter, revenue cycle and business office functions. The goals of the engagement were:
- rapidly develop and implement its specialty pharmacy and home delivery/central fill capabilities;
- gain access to LDD and payer contracts;
- connect with Excelera’s data aggregation platform to send data to pharma for LDD reporting;
- ability to benchmark against other network members
Challenges
Banner Health had recently executed a structure change creating Banner Pharmacy Services (BPS), LLC. Their projected timelines for implementation drove their decision to engage a known and proven consultant to guide and assist them with their objectives, to avoid “pitfalls” and complete the projects on time and on budget.
How Excelera helped
The engagement included the coordination of planning, development and implementation support for:
- Overall Project Plan
- Specialty Pharmacy Build-out
- Clinical Therapy Management
- Call Center/Pre-Authorization and Financial Assistance
- Revenue Cycle: licensing, credentialing, billing and revenue integrity, finance and accounting, audit defense, payer relations, 340B program
- Job Descriptions & Human Resource Planning: staffing models and training process
- Related Pharmacy Operations
- Central Fill Robot/Mail Service/Automation: planning and implementation
- MTM: CPAs, PBM services
- Retail Pharmacies: assessment, planning, ongoing SME support
- IT: decision support for: case management software, phone and reporting systems; connectivity to Excelera data aggregation system
- Compliance, Quality, Regulatory, P&P Plans: including URAC accreditation support
- Provider Integration: targeting, measurement, best practices
Results
Banner Pharmacy Services opened their home delivery / central fill pharmacy operation on time, within 6 months from initial engagement. The Specialty Pharmacy service commenced first, and the home delivery and central fill service lines were added within 3 months of the specialty pharmacy opening. The project was completed within budget and without any significant roll-backs or changes in scope.
“The successful launch of Banner Health’s specialty and home delivery pharmacy was due in large part to the guidance and support that we received from Excelera. Leveraging their expertise, contacts in the industry, and other resources, we were able to avoid many of the risks and pitfalls that go along with launching a new business line. Specialty pharmacy is very important to our health system, and our partnership with Excelera helps to ensure that our patients get the best specialty pharmacy care and service available.”
– Melissa Skelton Duke, PharmD, MS, BCPS, Senior Director, Specialty and Home Delivery Pharmacy Services, Residency Director, Health-System Pharmacy Administration Residency Program
Member Profile:
- Twenty-eight owned acute-care hospitals and health care facilities
- More than 39,000 employees
- Largest private employer in Arizona
- Member of Excelera since 2014
For more information on Banner Health Specialty Pharmacy, visit the Banner Health website
