Understanding drug reimbursement is vital for pharmacy staff, finance leaders and billing personnel. As drug prices soar and insurance policies become increasingly complex, hospitals and other healthcare facilities must learn how they are compensated for the drugs they administer. Drug reimbursement varies depending on inpatient and outpatient settings as well as use of commercial insurance […]
Author: GFA5497
HealthTrust Specialty GPO: A New Approach to Reducing Costs
Escalating costs of specialty medications are a pressing financial burden for providers. HealthTrust is working to address this challenge, providing a strategic approach to securing contracts and managing expenses for these high-cost drugs. HealthTrust’s Pharmacy team has pioneered a collaborative strategy within the specialty market. Watch this three-minute intro to learn more: Let’s explore Specialty […]
Pharmaceutical Distribution Models for Hospitals and Physician Practices
Pharmaceutical distribution models are set up to ensure patients receive drugs when they need them. While most pharmaceutical products and supplies are ordered through wholesalers, there are times when hospitals purchase direct from a manufacturer or a 503A or 503B compounding pharmacy. Each patient setting may call for a different distribution model. Outlined below are […]
Improving Laundry & Linen Services in Healthcare Facilities
Laundry and linen services play a critical role in supply chain in the healthcare industry. Clean, high-quality linen is crucial for patient care, influencing not just the patient’s experience but also hygiene and safety standards in hospitals, helping to reduce healthcare-associated infections. Managing linen services involves various challenges, like negotiating contracts, selecting suppliers and optimizing […]
Pharmacy Wholesaler Optimization
Terms to know for Effective Distribution Management This article is designed to clarify some of the complex terminology involved in pharmacy distribution, helping you navigate the details of contract prices and wholesale acquisition costs. Watch the 3 minute intro to learn more: Pharmacy Contract Price, Wholesale Acquisition Cost, and Acquisition Cost The foundation […]
An Introduction to Pharmacy 340B
The 340B program, established by Congress in 1992, is integral for safety-net providers serving uninsured or vulnerable patients. It mandates drug manufacturers to offer discounts to certain federally-funded clinics and hospitals—known as “covered entities”—as part of their participation in Medicaid. This initiative allows these entities to stretch federal resources, reaching more patients and enhancing service […]
The Importance of GPO Language
Understanding Group Purchasing Organization (GPO) Pharmacy terms is an important step in driving cost savings, efficiency, and compliance. Having a clear understanding of the language and how strategic contracting processes can benefit healthcare organizations of different sizes. Watch this 3 minute intro to learn more: The article below is a walkthrough of the essential language […]
Understanding the Importance of Class of Trade (COT) in Healthcare
In healthcare, the classification of trade channels—known as Class of Trade (COT)—plays a pivotal role in the distribution and pricing strategies of pharmaceutical products. As healthcare systems continue to evolve and expand, understanding COT’s impact on these systems becomes increasingly critical. This article covers the fundamental aspects of COT, its benefits, challenges, and why it […]
Why You Need a Process for Reviewing Your Preference Cards
And why it needs to be done regularly The Power Supply Podcast recently interviewed Drew Preslar to discuss the importance of data utilization and change management in healthcare. The conversation focuses on the challenges faced by clinicians and healthcare organizations, and how optimizing preference cards can improve patient outcomes and unlock efficiencies and cost savings. […]
ShiftShapers Podcast | Managing Pharmacy Costs
The need for streamlined and efficient solutions in the ever-evolving landscape of pharmacy is crucial. Former HealthTrust SVP of IHP, Joey Dizenhouse, was a guest on the ShiftShapers podcast where he discussed healthcare optimization, particularly in managing pharmacy costs. Explore the complex dynamics of the healthcare industry and how professionals navigate these challenges. An intriguing […]
Formulary Exclusions & Pharmacy Benefit Managers
HealthTrust IHP How can plan sponsors protect themselves? Over the past 10 years, Pharmacy Benefit Managers (PBMs) have implemented an ever-increasing list of formulary exclusions, citing the need to drive down cost from low-value or questionably effective medications. But these exclusions have evolved, as many commonly used drugs are now subject to exclusions due to […]
Talk to Your Pharmacist Interview | Pharmacy Innovations
Pharmacy innovations The first topic of conversation was the exploration of cheaper alternatives for patients. Former HealthTrust SVP of IHP, Joey Dizenhouse, explained that it is essential for prescribers and the healthcare system to consider alternative options that can save costs for both patients and the overall plan. By utilizing better technologies and customized solutions, […]
Demystifying PBM Contracts to Identify Maximum Value
Pharmacy benefit manager (PBM) contracts are complex and can seem difficult to decipher. It’s important to take the time to ensure your contract aligns with your firm’s objectives and allows employees access to the drugs they need at the right price. The good news is you don’t need to do this by yourself: there are […]
New Out-of-Pocket Cost Cap for Medicare Beneficiaries Could Be Significant for Some
This interview was originally published in Pharmacy Times and is reprinted with permission. Patients who had previously hit their out-of-pocket maximums could see a significant change. Aislinn Antrim: Hi, I’m Aislinn Antrim with Pharmacy Times®, and I’m here with Joey Dizenhouse, [now former] senior vice president and head of pharmacy services at Health Trust, to […]
Healthcare Crossroads Podcast | Recent PBM trends
On the podcast, Healthcare Crossroads, HealthTrust’s Joey Dizenhouse shares his experiences and observations from his work in the PBM industry.
Top 5 Things You Must Know When Negotiating a PBM Contract
As one of the largest prescription drug buyers in the US, we negotiate $14 Billion of pharmaceuticals annually for our members. About 30% of that is in our PBM program, which serves 300 different plan sponsors across the country. As a result, we have “seen it all” when it comes to types of PBM contracts. […]
How Do Rebates Work?
How do the rebates work that are paid from PBMs to plans? Did you know that over the last couple of decades, this number has grown from 3% to nearly 30% of total spend? Check it out below. For the complete guide, download it here.
It All Starts With the Contract
Many plans do not realize they are getting something very different from what they think their PBM is promising. In fact, the actuarial value of a high performing contract is at least 10% benefit on overall spend. Check it out and for the complete guide, download it here.
Fight for Clarity in Pharmacy Benefit Manager Contracts
The concept of transparency is central to any discussion about pharmacy benefit manager (PBM) contracts. But what exactly does it mean? Over the years, HealthTrust SMEs have had this conversation many times. And while the circumstances vary, understanding the various nuance`s of transparency is absolutely critical to anyone responsiblefor a PBM plan. Critical, but not […]
Specialty Drugs vs. Non-Specialty Drugs
How do PBMs take advantage of the difference between specialty & non-specialty drugs? Between 1990 and the 2000s, the number of specialty drugs has grown from 30 to over 500. How do PBMs take advantage of the differences between specialty and non-specialty drugs when it comes to pricing? Specialty and non-specialty drugs differ significantly […]
