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Insights for Health System Executives
to help achieve maximum revenue growth and profitability from their drug spend
every CFO and pharmacy leader should answer
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CFOs and Pharmacy Leaders have vital roles in driving revenue growth and improve profitability across the health system, but for these leaders to improve financial success, it is essential that they address key questions that help drive financial performance for the health system. This eBook goes well beyond basic wholesale drug distribution contract decisions and provides CFOs and Pharmacy leaders with 10 fundamental questions to help improve revenue integrity, analyze drug spend, and achieve financial success across the health system.
10 questions every CFO and pharmacy leader should answer to help achieve more for the business of pharmacy
1
What is our drug spend as a percentage of our total cost of care? Are there opportunities to capture additional margin, thereby improving profitability?
Do we have processes that help capture maximum upside from clinical underpayments and methods to validate that those processes are delivering desired financial outcomes?
2
Do our revenue cycle management and pharmacy teams work together consistently to maximize medication reimbursements?
3
What drug spend insights do we use to guide planning, budgeting, and forecasting across our health system? Do these insights help us improve revenue growth and profitability?
4
What service lines, locations, providers and payers are impacting drug profitability across our health system (positively and negatively)?
5
What are we doing to proactively optimize margin and reimbursement across our payer mix?
6
What tools and insights do we need to integrate, align and optimize medication utilization across our health system (from purchasing to prescribers and payers)?
7
What percentage of our annual pharmacy expense is being, or could be, offset by more comprehensive Patient Assistance Program (PAP) services?
8
What cost savings should we be generating from PAP? How can we utilize these dollars to drive future growth and profitability?
9
Does our PAP strategy serve the entire health system or specific service lines, like oncology?
10
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Question 1
How can we help
McKesson Revenue Recovery Services can help health system CFOs and pharmacy leaders analyze drug spend as a percentage of the total cost of care as well as capture additional margin and profit. Leveraging our data analysis, benchmarking, cost reduction strategies, PBM analysis, clinical performance, and financial analytics — we provide you with the insights you need to effectively manage drug costs and identify ways to improve financial performance.
BUSINESS IMPACT
$1M+
Through a rapid revenue recovery assessment, McKesson identified 76 accounts and captured $1,078,378 of revenue upside for a health system.
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Question 2
65%
from 2020 to 2022, McKesson helped Yale New Haven Health recover 65% of identified revenue enhancement opportunities.
Question 3
Do we have processes that help capture maximum upside from clinical underpayments and methods to validate that those processes are delivering desired financial outcomes? Do our revenue cycle management and pharmacy teams work together consistently to maximize medication reimbursements?
McKesson Health Systems value-added services play a crucial role in increasing collaboration between revenue cycle management and pharmacy teams to consistently maximize medication reimbursements and financial performance. By integrating data, providing education, improving processes, monitoring performance, implementing collaboration initiatives, and promoting continuous improvement — we can help you improve collaboration and business results across your health system.
30:2:1
McKesson helped a health system identify 30 underpayment accounts during each 2-month reporting period in just 1 year.
Question 4
$270K
McKesson’s Utilization Analytics enabled Shore Medical Center to rapidly realize $270,000 in additional profits in the first year.
Question 5
McKesson Utilization Analytics helps health system CFOs and pharmacy leaders determine the impact of service lines, locations, providers, and payers on drug profitability by leveraging data integration, comparative analysis, cost attribution, payer contract analysis, provider performance data, and other actionable insights. With these insights in hand, you can make well-informed decisions, implement targeted strategies, and increase drug profitability across the health system.
$250K
McKesson Utilization Analytics helped a health system capture an additional quarter of a million in profits the first year.
Question 6
McKesson Health Systems value-added services team members work with you to improve margin and reimbursement across the payer mix. We accomplish this through payer contract analysis, claims analytics, denial management, payer performance analytics, contract negotiation support, and financial analysis. By leveraging these services and our expertise, we can help you improve reimbursement rates, margins, and financial performance across your health system.
$32M
McKesson experts and analytics tool helped a mid- Atlantic medical center realize $32 million in savings.
Question 7
McKesson Health Systems provides tools and insights for integrating, aligning, and improving medication utilization across a health system. These include utilization analytics, clinical decision support systems, payer analysis, performance monitoring and reporting. We leverage these tools and insights to help you enhance medication utilization, improve patient outcomes and cost effectiveness, and align medication practices with payer requirements.
McKesson Utilization Analytics helped the health system eliminate $250,000 in losses in less than a year.
Question 8
McKesson can design a Patient Assistance Program (PAP) that provides improved flexibility and helps you achieve your financial goals. These customized PAP solutions help offset pharmacy expenses by improving medication access, reducing dispensing costs, increasing medication adherence, expanding financial assistance, and more. With our experts and the right PAP solution, you can enhance financial performance and health outcomes across your health system.
250%
McKesson PAP helped UMHC increase recovery for underinsured patients by 250%.
Question 9
McKesson's Patient Assistance Program (PAP) generates cost savings for health systems by reducing medication costs, minimizing instances of uncompensated care, and improving medication adherence. Our programs can help you expand qualified access to reduced-cost or free medications; expedite reimbursements for dispensed medications to capture pharmacy revenue; improve medication adherence to deliver better health outcomes; and reduce costly interventions or procedures by ensuring affordable access to medications. By customizing a PAP to meet your unique needs, we provide multiple ways to enhance cost savings and improve financial performance.
344%
McKesson’s PAP helped Cheyenne Regional Medical Center increase revenue recovery by 344% in one fiscal year.
Question 10
Through cost-benefit analysis, program design and customization, regulatory and compliance considerations, and industry best practices — we can help design and implement a Patient Assistance Program (PAP) that will meet the needs of your health system. Whether you are looking for comprehensive PAP services or want to improve your current in-house program, we will help create a customized model that aligns with your organization’s financial and patient care goals.
$3M
By implementing McKesson’s comprehensive PAP this health system saved $3 million on their drug spend in just two years.
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10 Questions Every CFO and Pharmacy Leader Should Answer to Help Achieve Maximum Revenue Growth and Profitability from Their Drug Spend
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