The evolution of healthcare is demanding that all stakeholders become better shoppers. Billions of dollars flow through the high-stakes Specialty Pharmacy market, but performance metrics and outcomes accountability often remain elusive for both the payers (insurers) and the patients (consumers). Just like many other business markets, buyers need to get better at buying and sellers need to get better at providing more value. The 2,550 Specialty Pharmacies in the U.S. have one major thing in common: they all distribute prescription drugs. After that, the pharmacy differences can be substantial. This means the quality, service, and business models of pharmacies can also vary greatly. This does not make shopping easy.
Smart shoppers use platforms like Amazon to compare retail prices, read product reviews, and possibly even haggle a bit with the brick and mortar locations that try to overcharge them. Unfortunately, this shopping experience isn’t here for specialty pharmacy – not yet anyway. In the interim, healthcare shoppers can better understand the value of pharmacy accreditation and why it should matter to them while shopping for their important healthcare needs. The two major accreditation organizations are URAC and ACHC. Only 136 specialty pharmacies in the U.S. have achieved dual accreditation. Yes, this means that only 5% of the entire Specialty Pharmacy market is accountable to regulations and policies established by the top two accreditation authorities. This startling reality gets even more shocking when you add in the fact that only one specialty pharmacy has created a formalized Pharmacy Patient Experience (RXPX) program to align with their dual URAC and ACHC accreditations – Heritage Biologics.
A PHARMACY SMART SHOPPER asks the question: Why are there so few dual accredited pharmacies in the market for me to choose from? The answer is relatively easy to answer. Accreditation policies, procedures and resulting audits hold pharmacies to a standard that can only be achieved through authentic commitment to preeminent care. An extremely complex methodology and operational foundation are necessary to accomplish the protocols that accreditation requires. The insurance payers and the patients themselves will be essentially charged the same rate no matter which “in-network” provider they choose to provide their care. So yes, a PHARMACY SMART SHOPPER would be wise to select the provider they believe will provide the best accountable care outcomes. For many smart shoppers today, this translates into seeking only dual accredited pharmacies!
Heritage Biologics is the recognized leader in Rare Disease Outcomes Management (RDOM). We provide preeminent value-based specialty pharmacy and high performance nursing services nationwide. Heritage is credited with developing the industry's first formalized Pharmacy Patient Experience (RXPX) program designed to ensure accountable performance-driven care for patients. We look forward to sharing our "rare tradition of care" with you and your family.