PITTSBURGH KNOWS A THING OR TWO about comebacks. The Rust Belt capital suffered big losses when the steel industry collapsed in the 1980s, but returned to prosperity with a diversified economy. The West Penn Hospital also faced its own budgetary crisis a few years ago, after peaking in patient volume in 2008.
In 2010, we were forced to significantly downsize and reduce patient care services due to the financial difficulties of our parent organization. After an acquisition and two years of rebuilding and revitalization, we have turned things around with the reopening of a transformed emergency department, an increase in patient beds, technology upgrades, and the biggest transformation yet: the opening of a “new concept” health and wellness clinic in downtown Pittsburgh.
The West Penn Hospital Health and Wellness Clinic, which opened in February 2013, helped us to re-establish our reputation as a cornerstone of medical care in Pittsburgh and the surrounding Bloomfield-Garfield community. Funded 100 percent by proceeds from the hospital’s 340B drug discount program, the clinic provides critical medical services to underinsured and otherwise underserved patients.
Since its inception, the pharmacy services department has been a driving force behind West Penn’s 340B program. As the system director for outpatient pharmacy services, I’ve taken the lead in the overall operations of the new clinic. We run the clinic as efficiently as possible, saving time and resources by using existing space and personnel, including on-staff physicians. The funds generated by our 340B program pay for medications that patients might not otherwise be able to afford and for the cost of staffing the clinic.
As a 340B-covered entity, West Penn Hospital contracts with local pharmacies to fill prescriptions using inventory purchased by the hospital at the 340B price. Through this contract pharmacy network, we provide discounted medications to uninsured patients and generate much-needed supplemental revenue from prescriptions covered by insurance. The revenue, in turn, is used to cover the cost of the downtown Health and Wellness Clinic as well as costs associated with other uncompensated care.
Clinic Grows, Hospital Readmission Shrinks
Physicians at the clinic see uninsured and underserved patients weekly, and we expect to see more patients as word spreads. With funding generated by the 340B program, we help patients offset the costs of their medications. They literally benefit twice from the same 340B savings—patients now have increased access to care and their prescription costs are lower.
As with most hospitals today, readmission is a hot topic at West Penn. Pharmacists at the clinic help keep patients from using the hospital’s emergency department by providing disease management, medicine adjustments, and lab monitoring services. In addition, we receive prescription compliance data from our 340B program administrator to help clinicians monitor the patients who use the program. In February alone, the clinic saw 52 patients. We were also able to hire a full-time receptionist. By year’s end, the clinic hopes to see 800 patients.
Transitioning to Better Care
At the clinic, we are strong advocates for the “transition of care” program, which helps patients use the wellness clinic and Allegheny General Hospital (AGH) Apothecary (one of the hospital’s 340B contract pharmacies) and other local contract pharmacies. This program helps to ensure the coordination and continuity of care as patients transfer between different locations or different levels of care within the same location.
Another service we offer at the clinic is bedside medication counseling at discharge and seeing these patients at the clinic for medication management. AGH Apothecary fills prescriptions as needed. Pharmacists also provide post- hospitalization follow-up for patients who are unable to see their regular doctor.
Key Partners in Setting up the Clinic
With the health and wellness clinic, we have made the best possible use of the hospital’s 340B savings. Starting the clinic, however, took planning, resourcefulness, hard work, and a partnership with a contact pharmacy administrator, Wellpartner, to manage the program.
Wellpartner has expertise in creating custom 340B retail pharmacy networks that include both chains and independents. Our network is well balanced with the right geographical coverage, which helps increase 340B program utilization.
The hospital first implemented its 340B contract pharmacy program in 2011, after a local pharmacist noted that uninsured and underinsured patients from the hospital’s Joslin Diabetes Center could no longer pay for their medications. Currently, West Penn’s 340B program uses 29 contract pharmacies, filling more than 8,800 prescriptions in 2012.
I also credit the hospital’s C-suite for helping to get the clinic started. They were huge champions for us, and I believe that with strong C-suite support any hospital can implement such a program.
The economy has caused plenty of setbacks for us and for people in need throughout our service area. But the West Penn Hospital Health and Wellness Clinic proves that with hard work and ingenuity, positive results are possible, even in the worst of times.
–By Jennifer Davis, Pharm.D., Director of Outpatient Pharmacy Services, West Penn Health System, Pittsburgh