The business question for health systems has moved beyond “Should we build a specialty pharmacy?” to “How can we take our program to the next level?” The specialty pharmacy service line has become standard—not just among the largest regional health systems, but among many smaller health systems as well1—and hospitals and health systems represent the fastest-growing category of ownership.2 Exceptional performance in specialty pharmacy is both clinically and financially necessary.
At Shields Health Solutions (ShieldsRx), the growth in health-system specialty pharmacies (HSSPs) has led to a new emphasis on elevating and accelerating existing specialty pharmacies. ShieldsRx is proud to have helped dozens of specialty pharmacies start from the ground up and get to the next level of performance.
Within the core areas of access, outcomes, and growth, ShieldsRx offers a platform of capabilities to meet the unique needs of each health care organization. Through ShieldsRx, HSSPs can tap into a full range of specialty pharmacy subject matter experts for a fraction of the cost of attempting to locate, hire and utilize that expertise on their own. This model allows for an accelerated time to value for HSSP programs at all stages.
The Shields Performance Platform encompasses a wide range of solutions and services to add value, elevate outcomes and accelerate growth and performance. These include staff augmentation, accreditation, payer contracting, and trade relations.
For example, through the expertise of approximately 40 accreditation specialists, ShieldsRx provides continuous compliance monitoring and other forms of assistance with accreditation, tasks that at many HSSPs fall on one person with numerous other responsibilities. At the highest level of engagement, ShieldsRx has the resources to take on full responsibility for managing accreditation and related designations, such as the URAC Rare Disease Designation and ACHC DMEPOS accreditation.
“Ensuring access to affordable medications and expanded treatment options for every patient we serve in Louisiana and Mississippi was at the heart of our decision to partner with Shields,” said Steven Gremillion, MD, FMOLHS executive vice president, and chief medical officer. “The comprehensive Shields model enabled growth of our core program while also accelerating our specialty pharmacy expansion into several additional therapeutic categories, including neurology, dermatology, and pediatric specialties, all supported by disease state specific clinical pharmacy teams and expanded patient support services.
One of the most urgent needs for HSSPs in the current environment is workforce augmentation. High turnover among pharmacy technicians was confirmed in recent surveys conducted by ASHP.3 Nearly 1 in 10 pharmacy administrators indicated turnover among pharmacy technicians of 41% or more in 2021. By utilizing ShieldsRx’s workflows and centralized support, HSSPs can continue to scale their program even during workforce shortages. All support is accretive or supplemental; Shields does not replace a health system’s own specialty pharmacy employees.
A Case Study: Workforce Augmentation Helps Put Patients First
Problem: When FMOLHS launched its partnership with Shields in 2021, the dual-accredited specialty pharmacy program at FMOLHS serviced a handful of disease states. Significant opportunity existed to service additional patients through enrollment and access to commercial payors and additional limited distribution drugs. The Louisiana-based health system, like many others nationwide, was still recovering from the aftermath of the COVID-19 pandemic and was hesitant to add additional resources without first showing financial value.
Solution: The Shields Performance Platform is a bespoke set of capabilities that can be activated and customized to meet health systems and their specialty programs “where they are” in addition to “where they are going.”
“The Shields model allowed us to rapidly expand and put boots on the ground where the greatest opportunity existed,” said Adria Kerr, RPh, Senior Director of Retail Pharmacy and 340B. This allowed FMOLHS to take advantage of Shields resources in the short term, such as clinical pharmacists and embedded pharmacy liaisons working with patients and providers.
Kerr added, “Once word got out about these additional resources, the floodgates opened and we integrated into more clinics than we could have on our own.” This workforce augmentation allowed expansion of the specialty pharmacy into critical disease states such as rheumatology, gastrointestinal and infectious diseases, and have an immediate impact on the cost and quality of care for these high utilization patients.
About Franciscan Missionaries of Our Lady Health System
The Franciscan Missionaries of Our Lady Health System is one of the largest healthcare systems based in Louisiana and is the leading healthcare provider for more than half the state’s population. The health system is a non-profit, Catholic organization sponsored by the Franciscan Missionaries of Our Lady. Headquartered in Baton Rouge, Louisiana, the ministry serves patients in Louisiana and Mississippi through a network of hospitals, clinics, physicians and integrated health systems.
The health system’s unified physician organization is comprised of more than 1,100 adult and pediatric primary care physicians and specialists. The system’s nine main campus hospitals include St. Francis Medical Center in Monroe, Our Lady of the Lake Regional Medical Center in Baton Rouge and Gonzales, Our Lady of the Lake Children’s Hospital in Baton Rouge, Our Lady of Lourdes Regional Medical Center, Heart Hospital, and Women's & Children's Hospital in Lafayette, Our Lady of the Angels in Bogalusa, and St. Dominic Hospital in Jackson, Mississippi. For more information, visit fmolhs.org.
In addition to adequate technician resources, sufficient clinical pharmacists working directly with patients and documenting their interactions is paramount to having a successful specialty pharmacy. ShieldsRx employs clinical pharmacists to supplement staff at our health system partners and to fill gaps as needed. For example, many HSSPs want to expand into additional clinics, disease states or markets.
Health system partners can seamlessly utilize Shields clinical pharmacists, on a fractional basis, for medication therapy management, allowing the HSSPs to expand more rapidly than if hiring, training and deploying their own resources. The clinical pharmacist model is flexible, with a combination of remote and in-clinic pharmacists, depending on the needs of the partner.
The landscape for HSSPs has changed dramatically since Shields was founded in 2012. Today, many HSSPs may have substantial infrastructure, one or more accreditations and a clinical documentation system in place.
In the areas of payer contracting and trade relations, ShieldsRx has dedicated resources to share expertise with and work in conjunction with the health system team, rather than leaving these tasks to one person. Through our health-system partners nationwide, ShieldsRx also provides drug manufacturers and payers with the ability to contract with many high-performing HSSPs through a single point of access.
No two partnerships between ShieldsRx and a health system look alike. The flexibility of the model allows for a bespoke approach tailored to the individual specialty pharmacy’s needs. As needs vary over time and are reassessed, different capabilities of the platform come into play; the relationship is not static. The ShieldsRx team works alongside the health system’s specialty pharmacy team, scaling resources and implementing the processes required to deliver more affordable care, optimize specialty pharmacy services, improve outcomes and retain more patients.
About Shields Health Solutions
At Shields, improving lives and elevating performance are at the heart of everything we do. That’s why more health system leaders trust Shields to help them elevate and scale clinical, operational, and ﬁnancial performance. Not just within specialty pharmacy, but throughout the entire health system. Working alongside your team, Shields leverages its proven collaborative care model; integrated care technologies; and dedicated teams to produce the superior outcomes your patients deserve and the ﬁnancial results your health system demands. Together, we elevate performance where it matters most — expanding payer and drug access; improving therapy management and care coordination; delivering unsurpassed patient experiences; and generating the net operating income you need to accelerate growth. Learn more about how Shields elevates outcomes and performance at www.shieldshealthsolutions.com.