How Two Health Systems Generated Savings with PINC AI™ Service Line Analytics (SLA) for Pharmacies

Does your formulary management process truly translate into optimal patient outcomes? PINC AI™ SLA-Pharmacy provides a holistic view of how the medications a hospital system provides impact their bottom line and contribute value to their patients.

Like all healthcare facilities and providers, hospital pharmacies are under tremendous pressure today to lower costs and drive greater overall value. Hospitals spend millions on pharmaceuticals every year, often with only limited data and insight into medication utilization and appropriate use. Successful organizations use SLA-Pharmacy to inform a more cost-effective approach to medication selection.

The cloud-based application enables providers to make smarter, evidence-based formulary updates, ensure clinical decision support for therapies across the pharmacy landscape. These users influence clinical practice change with data to generate savings while maintaining or improving quality.

How it Works

SLA-Pharmacy offers rich data analytics to help hospitals understand the connection between costs and quality outcomes in their pharmacy service lines. It goes beyond reports that simply show total costs or broad quality metrics. With SLA-Pharmacy, you get a more in-depth analysis that is designed to:

• Identify where your investment in medication cost is focused, with drill-down to the provider level.
• Benchmark medication utilization to internal and 1,300+ external peers.
• Evaluate pharmaceutical marketing claims of value.
• Compare medication utilization against risk-adjusted outcomes.
• Monitor variation, spend and outcomes on an ongoing basis, including:
  • Supply chain data: acquisition costs, drug names and purchase order information.
  • Quality outcomes and billing information: patient demographics, clinical coding, billing charges and outcomes like readmissions or complications.

SLA-Pharmacy then compares the relative value of various treatments, medications and prescribing behaviors. The data is available in an easy-to-read dashboard so you can quickly see where variation exists, then drill down into more detail for each data point.

Spend Less, Achieve More

SLA-Pharmacy makes it possible to:

• Identify critical data points that will make a difference in your bottom line.
• Act quickly to pinpoint and reduce waste while improving quality.
• Transform the way your hospital uses data to make better overall pharmacy operation and patient care decisions.

Address Clinical Variation

Every provider and patient is different, so a broad overview of total costs won't give you the complete picture. There might be valid medical reasons that a patient needs higher-cost or specific brand-name medications. However, pharmacies should regularly monitor information about pharmaceutical costs and patient outcomes to identify where variation exists. Once you identify it, you can dig into the reasons behind the variation to determine if there are opportunities for cost savings and quality improvement.

SLA-Pharmacy offers two features that make this easier:

• Pair-matching methodology and outcomes: The algorithms automatically match similar patients, diagnoses and treatment plans, so the analysis compares apples to apples. This reduces natural variations that could affect the validity of your data.
• Benchmarking: Hospitals can benchmark providers against their internal peers, as well as nationally, to determine if their prescribing patterns and pharmaceutical supply costs fall within a normal distribution or are much higher or lower than their peers.

Engage in Provider Conversations

With accurate and comprehensive data in hand, hospital administrators and teams are supported with insights to help determine appropriate medication use and make evidence-based care decisions that best serve patients.

With data demonstrating that specific prescriptions or prescribing habits are not leading to better outcomes, many providers can adjust their behaviors to achieve both cost and quality goals.

Measure Effectiveness

SLA-Pharmacy is designed to give you the tools to continually monitor changes over time. Data collection is consistent and standardized with a presentation that's easy to interpret. Clinicians, administrators and staff can quickly spot trends and identify opportunities as they arise.

Member Success: Henry Ford Health and Baystate Medical Center

When Henry Ford Health and Baystate Medical Center—systems with higher-than-normal prescription pain medication costs—analyzed the data, they could see that the high-cost medications did not translate to better patient outcomes when compared with lower-cost alternatives.

Henry Ford Health (HFH) wanted to improve clinical standardization and find opportunities to save on drugs and surgical supplies. The challenge was finding a way to leverage clinical data from one site to implement system wide. SLA-Pharmacy gave HFH the tools they needed to compare utilization and outcome data from a single hospital with both internal and external benchmarks. They launched a program for clinical standardization that quickly proved successful and was soon implemented at all five HFH facilities. To date, HFH has saved $7.9 million using this technology.

In a review of drug costs at Baystate Medical Center, administrators discovered high-volume purchases of intravenous magnesium sulfate, but couldn’t explain the anomaly. An analysis using the technology helped hospital leadership identify usage patterns by provider and facility. They could compare that information to internal and external benchmarks to discover whether the purchases yielded better patient outcomes. The data provided enough information to adjust usage patterns, resulting in significant savings.

Using the information and robust data available in the application, Premier identified two hospital providers prescribing expensive pain medications at a much higher rate than their peers. SLA-Pharmacy data opened the door for important conversations that led to significant cost savings without sacrificing quality in patient care. In one year, Baystate saved $96,000 for a single medication using the tool.

Connecting the Dots Between Cost and Quality

As providers continue their focus on strategies to achieve cost savings and improve quality to meet value-based care objectives, tools like SLA-Pharmacy are invaluable. SLA-Pharmacy is powered by Premier’s PINC AI™ platform that includes benchmarking, analytics, reporting and clinical technologies. With one of the largest healthcare datasets in the industry, the PINC AI™ platform provides actionable intelligence that improves outcomes, supports improved financial performance and enables success in new, alternative payment models.

Learn more about PINC AI™ SLA-Pharmacy.