Effective and efficient pharmacy utilization is a crucial aspect of hospice operations, impacting patient outcomes, medication costs, and regulatory compliance. However, for hospice interdisciplinary teams, it can be hard to connect care for individual patients to larger trends that influence the long-term sustainability and success of their organizations. Enclara Pharmacia’s account management and clinical support professionals work with hospice leaders to ensure that nurses and prescribers at every level of the organization understand the key factors driving their hospice’s pharmacy utilization. These include care setting, diagnoses, prescribing behaviors, and overlooked operational inefficiencies like medication waste. By examining each of these areas, Enclara helps hospices identify and implement actionable strategies to deliver both high-quality care and financial sustainability.
Understanding Demographic Factors in Hospice Pharmacy
Multiple demographic factors influence medication utilization in hospice, and individual hospice offices may have very different patient populations. Enclara considers each of these factors when assembling benchmarking data in order to help hospices set achievable goals for their organizations.
Recognizing the unique demands of each care setting allows hospice teams to tailor their medication management strategies. For example, patients in long-term care facilities often experience steady, lower-acuity treatment plans, resulting in consistent, predictable medication needs. By contrast, services in private homes can involve greater variations in acuity, medication adherence and social determinants of health.
Hospices may also see significant variation in the diagnosis mix of their overall patient populations due to regional variations, different referral sources and other factors. This in turn affects per-patient-day of service medication costs. For instance, hospices in states with higher incidence of cancer or with a strong reputation among oncologists will likely have a higher proportion of patients with cancer, and in turn see higher medication costs, than a hospice that serves more patients with dementia. Enclara provides a variety of business intelligence tools to help hospices analyze their patient mix and compare it to regional or national benchmarks. This helps hospice leaders better anticipate trends and adjust their operational and financial strategies accordingly.
Ensuring Consistent Prescribing Patterns
Prescribing patterns are often shaped by a mix of factors, including individual clinician preferences, patient or caregiver expectations, and historical habits within a hospice organization. When prescribing diverges from best practices, hospices may incur unnecessary costs or provide suboptimal care.
For example, prescribing maintenance medications like statins or diabetes treatments, which provide long-term benefits but little relevance for end-of-life care, can unnecessarily drive up costs and increase the burden on patients. This is where deprescribing comes into play. Deprescribing involves re-evaluating and discontinuing medications that no longer align with a patient’s goals or prognosis. Enclara pharmacists provide valuable guidance around deprescribing, empowering hospice staff to handle both the clinical aspect of medication discontinuation and the emotionally sensitive conversations with families about deprescribing maintenance medications.
Palliative prescribing patterns may also differ significantly. Enclara helps hospices identify potential overreliance higher-cost medications and suggests equally effective lower-cost options. Cost profiles of different medications can vary over time, making this an ongoing process. Enclara also monitors for duplicative therapies and helps simplify medication profiles to provide safer, more effective symptom management at lower cost.
Limiting Medication Waste
Medication waste refers to unused doses that remain after a patient’s passing. Not only does this inflate hospice pharmacy costs, but it may also lead to safety risks such as potential drug diversion. Medications prescribed as needed can often accumulate when refills are ordered without checking existing supplies. Disease progression can also lead to new medication needs such as a need for liquid or sublingual dosing, leaving a supply of unused tablets. In some cases, it makes sense to adjust quantities ordered when death appears imminent. Enclara’s EnclarityTM business intelligence platform includes real-time dashboards that enable providers to pinpoint inefficiencies, while clinical and account management professionals help hospices adopt prescribing methods that align with patient care needs while minimizing waste.
Addressing Ancillary Spending
Fees such as courier charges, STAT dispensing and compounding costs often fly under the radar but can add up quickly. Enclarity dashboards make it easy to regularly review ancillary spending reports to identify patterns and opportunities for cost reduction. Available mail-order services for routine shipments and ComfortPakTM offerings can yield substantial savings while improving patient care and satisfaction.
Encouraging a Culture of Collaboration
Optimizing pharmacy utilization is not a siloed effort. It requires collaboration across every level of the hospice team—from executive leadership setting strategic priorities to prescribers, nurses, and support staff implementing changes on the front lines. Education is the backbone of this collaboration. Providing tools like deprescribing decision trees or templated questions for nursing staff to use with patients and families reinforces the consistency of care. Similarly, offering targeted training sessions on prescribing optimization ensures every team member understands their role in achieving broader organizational goals. Enclara provides clients with a robust library of educational programming and reference resources, as well as regular utilization reviews to explore strategies for improvement, and celebrate successes.
Enclara Can Help Identify and Address Your Hospice Pharmacy Utilization
Ultimately, optimizing prescribing patterns is about more than cost-cutting. The goal is to position your hospice as a leader in delivering compassionate, resource-conscious care that meets the needs of patients and families in tangible, meaningful ways. By focusing on key factors that drive pharmacy costs, from care settings to prescribing habits, individuals at every level of your organization can contribute to smarter, more sustainable practices.
Whether you’re beginning medication management optimization efforts or refining an already-effective approach, revisiting these principles provides a strong foundation for progress. With the right mix of data insights, collaboration, and education, hospices can overcome today’s challenges and lead the way into a future of excellence in end-of-life care. Reach out to Enclara today to learn more about how we can help.
