Overcoming Hospice Pharmacy Direct Contracting Challenges

Hospice pharmacies play a crucial role in patient care, but direct contracting with hospices comes with significant challenges. From financial risks to operational inefficiencies, pharmacies often find themselves burdened by administrative tasks that take time away from their core mission: dispensing medications. Below, we explore the most pressing challenges and how our connected RX platform can streamline operations. 

Creating and Managing Contracts and Contract Terms  

Negotiating and maintaining contracts with hospices can be complex. Each hospice may have unique terms, formularies, and compliance requirements, making it difficult to standardize agreements, especially across states. Without a streamlined approach, pharmacies may struggle to keep track of contract details and that may lead to billing errors or disputes.  

Chasing Down Payments from Hospices  

One of the biggest financial risks for pharmacies is collecting payments from hospices. When payments are delayed or not received, pharmacies lose revenue and must dedicate additional resources to collections. Worse, if a hospice fails to pay, the pharmacy absorbs the financial loss. With better visibility into outstanding payments and more streamlined billing processes, pharmacies can reduce the risk of revenue loss and improve cash flow. 

Conflict Over Non-Formulary Medications  

Pharmacies often face a dilemma when a hospice nurse requests a medication that is not on the formulary. Dispensing the medication can lead to reprimands and additional costs, while refusing to dispense could result in patient care concerns. Clear communication and real-time reporting tools help pharmacies manage formularies efficiently, ensuring proper coordination between hospice teams and pharmacy staff.  

Time-Consuming Phone Orders  

Taking medication orders over the phone is inefficient, prone to errors, and a drain on resources. Pharmacies must dedicate valuable staff time to processing these requests manually. By using mobile ordering and digital tracking systems, pharmacies can eliminate unnecessary phone calls and reduce transcription errors.  

Resource-Intensive Client Support and Consultations  

Hospices rely on pharmacies for guidance on medication selection, interactions, and compliance. While this support is necessary, it requires significant pharmacist time and resources. Streamlined communication tools and automated workflows help reduce unnecessary back-and-forth while ensuring medication management is accurate. 

High Costs of Marketing and Sales Efforts  

Building relationships with hospices requires ongoing sales and marketing efforts, which can be costly and time consuming. Independent pharmacies often struggle to compete with larger PBMs that offer extensive reporting and cost-control features. With access to real-time reporting and electronic refill request systems, pharmacies can better position themselves as valuable partners for hospices.  

Competition from PBMs  

PBMs offer services like EMR integrations, utilization reporting, and cost controls, making it harder for independent pharmacies to compete. Without access to similar tools, pharmacies risk losing contracts to PBMs.  

By equipping pharmacies with robust reporting, tracking, and ordering features, they can offer the same level of service as PBMs while maintaining independence. 

Contact BetterRX 

Navigating hospice pharmacy direct contracting can be complex, but BetterRX makes it easier. Our software simplifies contract management, improves compliance, and streamlines communication—saving your team time and reducing administrative burdens. Want to see how it works? Get in touch with one of our specialists today! 

About BetterRX

BetterRX's mission is to radically change patient care by ending medication delays that cause needless suffering. BetterRX offers efficient ordering technology, medication tracking, real-time PPD & cost alerts, and committed local pharmacies. Learn more about BetterRX, our CRX Platform, Better ePrescribe, and Pharmacy tools.