MUSC Health is the clinical delivery arm of the Medical University of South Carolina [MUSC]. The $4B health system is comprised of a large academic medical center, seven regional community hospitals, a dedicated children’s hospital, an NCI designated cancer center, hundreds of ambulatory clinics, and numerous community hospital affiliations. MUSC’s $710M Pharmacy department spans the system with services supporting both inpatient and ambulatory settings – its Specialty Pharmacy division was the focus of our work.
MUSC Health’s Specialty Pharmacy [SP] supports patients with serious health conditions that require complex medications and therapies. The SP team had effectively managed the highly regulated area and grown revenues and contribution margin; however, they were only offering services in a limited number of clinics. While SP leaders believed there was an opportunity to grow further, they had insufficient resources to expand and needed help to creating a viable business plan.
KCG partnered with Pharmacy leadership to assess its SP operations, creating recommendations for optimization as well as a successful business plan that enabled SP to increase its investment and grow revenue >50% year-over-year in FY22.
Optimization of Current Clinics
- Staffing: Assessed clinic staffing to ensure # of pharmacists and technicians aligned with patient and SP prescription volumes
- Capture rate: Analyzed SP prescription orders vs dispensed metrics to develop clinic-specific action plans to increase capture rate
- System support: Recommended transitioning contract management and revenue cycle activities to health system operations
Growth / Expansion Opportunities
- New specialties: Developed priority list of specialties not currently covered by SP, considering # of SP prescriptions written, complexity of cases and potential margin
- Regional hospitals: Identified opportunity to expand operations to support smaller, regional hospitals, offering patients access to SP medication in the convenience of their local market
- Infrastructure: Developed a successful business case and ROI to secure 16 additional FTEs to staff additional clinics