Measuring the financial performance of your in-house pharmacy in real-time is table stakes for any pharmacy business. Yet, we are surprised to meet many Covered Entity leadership teams that don’t have access to their own financial and operational data in real time. Instead, they blindly rely on a reconciliation check from their various TPA partners, and reconcile their 340B proceeds after the fact.
Release #4 Highlights =>
✅ Real-Time Financial Metrics
✅ Custom Date Ranges, Export CSV
✅ User Access Controls
The Importance of Real-Time Metrics
Being able to monitor your financial performance in real-time is a key to managing a successful in-house pharmacy program. Knowing how your pharmacy is performing and a claim level for every prescription that is adjudicated through third party insurances can help you manage and mitigate a number of things that will directly impact your overall 340B proceeds.
- Optimize Capture Rate. Having access to your financial metrics in real-time can train your entire pharmacy and clinical teams to build intuition around what we refer to internally as “HVMOs” (High Value Missed Opportunities). Not all scripts are created equal and most Covered Entities measure capture rate based on the number/percentage of prescriptions captured by the in-house pharmacy The reality is, the optimal way to measure capture rate is base don total dollar value capture of the total prescriptions written by the Covered Entity. And
- Pricing Transparency. Everyday we hear from CEs across the country “Wait really? Our current vendor does not show us the exact reimbursement amount per prescription." This is absurd, this is your 340B ID, your pharmacy, your data. Whether you manage your own in-house pharmacy or use a partner like Alchemy, real-time metrics ensure you have full transparency on all your inventory expenses and reimbursements in real-time. This enables covered entity partners to have very predictable 340B proceeds every month to manage your business optimally, versus a surprise amount credited to your every month.
- 340B Wholesaler Pricing: Watching your COGS (cost of drugs purchased) at a line item level in real-time allows you to quickly reconcile against the latest 340B ceiling prices. We wont say who, but we have spotted numerous examples of reductions in 340B price every quarter not reflected in the catalogue price in a timely manner. But surprise surprise, any increases to 340B catalog prices seem to be reflected immediately, This means you are leaving dollars on the table by not reconciling this with your wholesaler partners.
- Third-Party Reimbursement Shifts: Your PBM contracts stipulate what you are supposed to be paid for brands and generics, but your reimbursement seems to be different from what you expected. Well, this should come as no surprise to anyone who has operate din the pharmacy industry and without real-time metrics you have no ability to consider a quick shift to an alternate NDC in the event of adverse reimbursement shifts across payors.
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