“For too long pharmacy costs have been a black box. In the era of pharmacy value, organizations are grappling with how to dissect and visualize pharmacy data from multiple sources. The drive to value-based pharmacy is exacerbating this need and Initium Health has the experience and tools to assist.”
Quan Pho, PharmD, MBA, FACHE
Quan Pho is a pharmacy executive with nearly two decades of experience leading broad scale initiatives for health systems, health plans, physician groups and technology companies. Quan has led strategic, operational and change management initiatives at every level of pharmacy practice.
A New Paradigm
Pharmacy services have tremendous growth potential and ability to differentiate health systems within highly competitive healthcare markets. Our pharmacy solutions bring best-in-class clinical, operational, and technological support to your team, allowing them to excel as pharmacy professionals and yield measurable results. We’ll help you tackle hyper inflated drug costs, and we are willing to go at risk with you in order to produce savings. We customize our services based on each hospital’s needs, supporting our clients through comprehensive assessments, contract optimization, enhanced business development, and onsite or off-site leadership and operational support.
We conduct a comprehensive review of to align 340B-eligible facilities with overall health system strategy and transform your bottom line. We design all-inclusive 340B enrollment and contract pharmacy strategies to include TPA contract review, while ensuring program compliance.
Our team has the extensive operational knowledge needed to optimize the 340B program in every facet of the market: contract management, distribution, assistance, and retail. We help you negotiate contracts, create billing and dispensing infrastructure, and train staff on policies and procedures. Our in-depth review mirrors an HRSA audit to ensure that your system is compliant and ready in the event of a formal audit. We identify potential risks, provide corrective action plans, and detail key areas of improvement that will generate cost savings.
Beth Israel Lahey Health
Pharmacy Benefits Management and Plan Design
Initium identified an unmet opportunity in specialty pharmacy and employee benefits, and negotiated with the pharmacy benefits manager (PBM) to implement a copay assistance program with an external vendor, resulting in $5M in plan savings. Subsequently, Initium assisted the health system in creating the capacity to administer this program instead of outsourcing it, growing the savings to $7M. Initium also identified new areas of savings in plan design and negotiated additional value for the health system with its PBM.
Initium conducted a thorough review of all pharmacy contracts and service agreements to identify opportunities for optimization, negotiation, consolidation, and to leverage Beth Israel Lahey Health’s purchasing power. Initium Health facilitated the request for proposal process for a pharmacy wholesaler and negotiated $13M in savings along with growth opportunities including participation in the wholesaler specialty Pharmacy Services Administrative Organization (PSAO) for increased access to payer reimbursement as well as support for the health system to develop a central distribution center for pharmaceuticals. Additionally, Initium reviewed the health system’s group purchasing organization (GPO) service offering to maximize use of GPO services and tools. We facilitated implementation of savings opportunities including biosimilar conversions resulting in $5M in savings, and coordinated regular business reviews to bolster transparency between the GPO and health system.
340B Program Optimization
Initium Health developed a 340B expansion roadmap that generated an additional $25M in contribution margin for the health system. This initiative was the first pharmacy integration project following the health system merger and required a well-designed pathway and consistent engagement of stakeholders across business units and service lines. Initium successfully engaged leaders including hospital executives, physicians, nursing, operations, marketing and communications, facilities, legal, IT, and finance to execute this substantive project that resulted in a new level of collaboration and value for the health system and its communities.
340B Program Consulting
Whether you are implementing a 340B program, looking to optimize one, or looking to partner with FQHCs, our team can help you get there.
Wholesaler / GPO
Retail / Specialty Rx
Create or grow your retail network to improve employee access, drive in-network dispensing and align with population health priorities. We work with health systems to establish fully integrated specialty pharmacy and benefits strategies.
Pharmacy Benefits Management
We help health systems improve PBM margins and are willing to go at full risk with you to re-negotiate current PBM contracts, initiate a RFP for a new PBM, or establish your own PBM.
System P&T Committee
Establish the infrastructure you need to standardize your health system formulary, reducing costs and improving patient outcomes and safety. We work with you to optimize your P&T composition and function and secure the support needed to operate efficiently.
Deploy inventory strategies such as central self-distribution to leverage purchasing power, optimize contracting, and reduce costs. Our pharmacy experts help you implement best practices for pharmacy inventory reduction, streamline buying, and align corporate synergies across your health system.
We implement a proprietary analytics dashboard to show your savings and real time costs. View your data in an intuitive, easy-to-use interface with presentation-ready reports. Our expertise helps enhance patient care and improve financial performance. As a public benefit corporation, we leverage our deep healthcare expertise and industry affiliations to support health systems, FQHC’s, pharmaceutical, and technology companies with operational and technological innovation.
Infusion Line/ Specialty Rx
ACE certification is the industry standard to validate 340B knowledge expertise and Initium Health’s Senior Consultant & Lean Six Sigma Black Belt, Kate Bailey, MPH is ACE certified.
Case Study: Pharmacy Operations
A comprehensive review of pharmacy infrastructure revealed opportunities to streamline operations, fix billing, and improve processes to enhance revenue. GPO and wholesaler arrangements were renegotiated, and all pharmacy contracts were assessed for revenue potential.
We optimize retail pharmacy operations so that you can interact with more patients at discharge and between visits, resulting in better medication adherence, lower readmissions, reduce employee drug costs, and increased patient satisfaction.