- Most MCOs are charged with reducing Medicare or Medicaid program costs, managing utilization of health services, and improving health care quality and outcomes.
- SNFs who work with their pharmacy to align with these drivers can dramatically improve their success with managed care.
- Pharmacies can help SNFs support MCO expectations through medication management, continuity of medication regimens, more utilization of generic drugs, and better management of chronic conditions.
- Many SNFs seek to join Post-Acute Networks (PANs). If selected into the network, SNFs gain access to MCOs and other value-based payment models they may otherwise miss. Having an agile and reliable pharmacy helps SNFs clear the highly competitive selection criteria.
- Another strategy used by SNFs is to offer specialized clinical care for the MCO’s populations who need it. Examples include respiratory, head trauma, bariatric, or behavioral challenges. Pharmacy can assure availability of appropriate medications and processes necessary to support specialized care.
Managed care has reshaped the healthcare landscape. To succeed in this new environment, SNFs must adapt and deploy new strategies. Working closely with a full-service, solid pharmacy partner can help optimize those efforts…as well as the resulting clinical and operational outcomes.
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