Specialty Accreditation and the Independent Pharmacy
Updated: Apr 9, 2021
With the continued boom of the specialty drug market, independent pharmacies can now have an option to enter the space by obtaining specialty accreditation – all while enjoying the benefits of this emerging market. After all, where revenue is concerned, specialty is the future of the pharmacy industry. In 2018, specialty drug spending accounted for about 45.4% of the pharmacy industry’s $482 billion revenue. This is an increase from 2012’s 30% share of $318 billion.
Specialty accreditation will help distinguish a true specialty pharmacy from those which are not, and clear a widespread confusion that has been created between the two over the years. Becoming accredited is often the first step to establishing your pharmacy as a specialty pharmacy.
It will also increase consumer confidence, considering that a member pharmacy must obtain one or more accreditation certifications before they can be accredited as a specialty pharmacy. A seal of approval from an accreditation agency ensures your patients are receiving the highest quality care available, while setting you apart from other competition. With all other factors static, patients will likely choose an accredited pharmacy that has been deemed competent by an independent third party.
Currently, there are three most commonly seen specialty pharmacy accreditation programs which are from the Accreditation Commission for Health Care (ACHC), the Center for Pharmacy Practice Accreditation, and the Utilization Review Accreditation Commission.
Benefits of Specialty Accreditation
Improve service quality and standards
Specialty accreditations are based on standards for quality coordinated care, management strategies, and proper utilization of services that translate to better patient and consumer care and handling, something that people want and expect from pharmacies. Better patient care improves quality outcomes which can be shown as tangible, measurable data. It will be effortless to gain business from providers and patients with this information.
On the other end of the spectrum, specialty accreditation helps pharmacies improve the products they sell and the services they offer. When applying for certain insurance contracts or even access to limited distribution drugs, often one of the questions asked is “Which accreditation does your pharmacy hold?” Many times, an accreditation may be required to submit an application for these.
For contractors or those providing specialty pharmacy services, there also accreditation standards specific to them. For example, VAWD accreditation for wholesalers which stands for Verified-Accredited Wholesale Distributors administered through the National Association of Boards of Pharmacy (NABP) or even Health Call Center or TeleHealth accreditations which are both facilitated through URAC.
Accreditation agencies will hold its accredited members accountable on many levels to ensure they meet the standards set. Re-accreditation normally occurs approximately three years after initial accreditation and sometimes the renewal process is more rigorous than the first time around because of what’s known as the “look back period.”
As the industry evolves and new policies and procedures are implemented, the accreditation will force member pharmacies to review their own policies and procedures and implement the new ones. It is suggested that a pharmacy is extremely thorough when going through their existing policies and procedures and perhaps perform a gap analysis on current business operations.
The accreditation will provide a pharmacy or an organization a guide to improve its operations, helping them become a leader in specific products or services that they provide. This spells good news for patients and consumers, while possibly increasing revenue and profit margins on new products offered. Time spent on revamping your policies and procedures will translate into a more streamlined operation at your pharmacy.
Getting a specialty accreditation from either ACHC or URAC will get members recognized by key decision makers that will prove advantageous should they want to push a request for proposals with the desire to have access to limited distribution products. Like previously mentioned, one of the first questions asked on these proposals is regarding accreditations held by the pharmacy.
Specialty pharmacy accreditation will also increase the chances of accredited pharmacies to become part of managed care health plans that mandate specialty pharmacies to have the appropriate accreditation. Accreditation is strongly recommended by these health plans currently, but there is evidence out there suggesting that accreditation could become mandatory to enter into the network. Some may require dual accreditation from at least two specialty pharmacy accreditation agencies.
URAC (Specialty Pharmacy Program) – accreditation guidance including policy and procedure development, document procurement and training specific to your pharmacy operations as well as preparation for on-site surveys
ACHC (Specialty Pharmacy and Community Retail Pharmacy Programs) – accreditation guidance including policy and procedure development, document procurement and training specific to your pharmacy operations as well as preparation for on-site surveys.
For more information, visit HVRS Solutions or call toll-free 800-962-8760 x 113.