The pharmacy is one of the primary relationships when dealing with a Pharmacy Benefit Manager (PBM). Ask for pharmacy references and call them. The pharmacy will have a lot of insight to the level of service the hospice can expect from the PBM. Most likely, if a pharmacy has had problems so will the hospice.
Work with a PBM that offers mail order, if needed, but also one that has relationships with local pharmacies. Every hospice that works with a PBM will need to utilize local pharmacies, whether as common practice or in emergency situations. You want to be sure that pharmacy is expecting you and can service you. Many pharmacies will not regularly stock all hospice medications if they are not regularly servicing them or not expecting the hospice patient.
Though PBM's have been around for over 25 years, most are not equipped to handle hospice business. PBM's traditionally set up strict formularies without any changes; they enter the information into the computer system and do very little after the initial enrollment. Most PBM's do not have the capabilities to manipulate the data on an individual basis that is needed for hospice. This can mean unnecessary denials from the pharmacy, multiple phone calls to get a patients medications filled and non-hospice approved medications being billed to the hospice.
Whether choosing a PBM for the first time or considering a new provider, the choice is important. Hospices need to partner with a PBM for a variety of different reasons. Pharmacy services and costs are too much for most hospices to handle internally. New hospices, small rural hospices, and established nationwide hospices alike are seeking the expertise of a PBM. Choose a PBM that will sustain a long and valuable relationship. Find a PBM that meets your hospice clinical needs, provides you a competitive price and excellent customer service with a commitment to a lengthy partnership.
Choose a PBM that will meet your needs today and tomorrow. With new legislation, pharmaceutical costs on the rise and changes happening on a daily basis, be sure to choose a PBM that is able to make the changes that the future demands. Ask questions about their company, employees, pharmacy networks, continuing education and their vision for the future - you will be a part of it!
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Education Resources and Support for Hospices
Stay up-to-date on the latest hospice pharmacy benefits management information and tools with a variety of education resources and support at no extra charge. We offer presentations live at your facility, over the Internet or viateleconference, online service education programs, customized courses, and courses accredited for nursing continuing education credit.
Our palliative care experts provide clinical consulting on important medication management and care decisions. Our non-dispensing pharmacists provide focused attention and unbiased advice.
Why Use A PBM?
Contracting with multiple pharmacies, doing all the reporting, trying to stay current with medical practices and stay compliant while keeping costs down? There’s an easier and more effective way.