With accountability for patient outcomes increasingly spread throughout the continuum of care, pharmacies play a larger role than ever in delivering quality care.
Pharmacy is increasingly involved in patient management, helping with coordination of care, providing education to patients—particularly those with chronic conditions—and acting as a clinical advisor to other providers.
While the majority of payers and many manufacturers require accreditation for specialty pharmacies, there are still many pharmacies that are not accredited, resulting in a wide range of approaches and standards on the part of pharmacies. That’s why an independent audit of pharmacies by an accrediting organization can be critical to ensuring positive patient outcomes.
“Pharmacies have different approaches to delivering care, but not all will result in optimal patient care,” said Heather Bonome, URAC’s director of pharmacy. “Accreditation requires compliance with well-researched standards based on industry best practices and requires measurement of outcomes. This can help organizations learn how to measure outcomes and demonstrate the value of their operations and patient services.”
In the case of URAC accreditation, Bonome says participating pharmacies are required to validate patient outcomes for a three-year period, with URAC providing a template for these organizations to collect and report those numbers to payers. Specialty Pharmacies must report their own outcomes measures, as well as report measures to URAC. As the trend of transparency continues, Bonome says such reporting will eventually be available to the general public.
“Pharmacies are transitioning from more transactional processes to services rooted in a more value-based approach. This is a positive trend for patients as well as the industry,” she says. “URAC understands what’s necessary to make this transformation, and the accreditation process can facilitate this process. We are routinely thanked by applicants who say our accreditation process has helped make their organizations better.”
There are many ways patients benefit by working with accredited pharmacies. The standards ensure that pharmacies are properly protecting health information, following the best drug safety protocols—including monitoring potential drug interactions and drug alerts — and ensuring access to appropriate medications within a network. Patients can be assured that an accredited pharmacy meets standards for staff qualifications and oversight, adhering to proper procedures and following a quality management plan. Specialty pharmacies track not only clinical outcomes, but also quality of life, patient satisfaction and financial outcomes.
“By earning accreditation,” says Bonome, “a pharmacy is letting its patients, payers, and other providers know they were evaluated and found to successfully meet standards known to promote better patient care.”
She adds that URAC takes a uniquely educational approach to the accreditation process, spending time upfront with organizations to help them fully understand the requirements and taking proactive measures to be fully prepared in their documentation and compliance with the standards.
Plenty of pharmacies pursue accreditation after they are well-established, but some pursue accreditation to get a new practice off on the right foot.
“For new pharmacies, seeking accreditation is a move that can help them build their organization as well as stand out in the marketplace. They can use our standards as a framework for how to structure their operations and patient services,” says Bonome.