Innovations-Magazine-April-2023 - 8

Will Integrated
Networks Raise
New Regulatory
Challenges?
As
6 | APRIL 2023
more hospitals integrate with medical practices, infusion centers, and home care to
create coordinated ways of delivering comprehensive patient care, such networks have
created both benefits and challenges in the areas of patient education, clinical workflow,
systems integration, and standards across care settings. The increasing complexity and growth of these
integrated delivery networks (IDNs), or health systems, have also complicated contractual obligations
with group purchasing organizations, payers, suppliers, and various other vendors.
The hospitals, medical centers, and other organizations comprising
IDNs all share a mission of improving patient care and satisfaction,
putting the patient at the center of care. Though two main delivery
models for drug distribution today are pharmacy benefits managers
(PBMs) and centralized delivery (central fill), IDNs have begun building
their own distribution networks and are increasingly creating their
own specialty pharmacies. Some of the largest IDNs today are HCA
Healthcare, CommonSpirit Health, and Ascension.
As these health systems get involved in specialty drug delivery, they are
partnering with manufacturers on drug availability and pricing on behalf
of patients and have built processes to meet manufacturers' specific
clinical requirements. However, regulatory and other challenges
have been arising related to how specialty pharmacies deliver drugs
to patients, and such challenges likely will affect both IDNs and
PBMs in the future.
IDN Pharmacies: Inside the Network
There are many benefits for IDNs that own and operate specialty
pharmacies, including greater efficiencies in patient care and control over
drug selection, prescriptions, and costs. Specialty pharmacies are also
potentially lucrative for IDNs because their limited distribution network
allows health systems to more effectively manage their costs.
Innovations-Magazine-April-2023

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