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Physician Dispensing

Building closer bonds

How physician dispensing helps Central Ohio Urology Group improve patient care.

Case study

Central Ohio Urology Group

In response to the mounting pressures of healthcare reform, what can specialty practices do to improve patient care and lower costs at the same time? For Central Ohio Urology Group, one proven strategy is the physician dispensing of oral oncolytic medications.

This approach addresses the evolution in healthcare from fee-for-service to value-based payments in two ways.

“First, it improves compliance, which lowers costs by improving outcomes,” said Michael Gambla, M.D. of Central Ohio Urology Group. “A lot of money is wasted on office visits when patients don’t comply with the prescribed therapies. And that leads me to the second benefit of physician dispensing: patient tracking. We can more closely monitor patient adherence, which can lead to better outcomes and keeping patients out of the hospital.” In effect, dispensing medications in-house enables an even closer bond with patients.

This is the underlying philosophy of Central Ohio Urology Group—providing a comprehensive range of services that improves the continuity of care, enhances outcomes and lowers costs. “Our focus on creating a one-stop shop is really the same concept as value-based services,” said Tino Valentino, Chief Financial Officer of Central Ohio Urology Group. “Add in the patient convenience, and we have a winning combination.”

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Choosing the right physician dispensing program

After a thorough search for the best fit, Central Ohio Urology Group chose VitalSource™ GPO, the group purchasing organization of Cardinal Health Specialty Solutions.

“We want to work with who provides the most value,” Valentino said. “A lot of companies are competing for our business, but VitalSource™ GPO is always right there when I need them. They get an A+ for responsiveness — an established company with a lot of resources to help us succeed,” he said.

The approach strongly supports Central Ohio Urology Group’s patient-centric, personalized model of care. The practice also sees value in having its distributor, GPO and dispensing program all connected—for example, making sure drug pricing is synchronized and having a simple way to resolve any issues

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The complete solution for your patients, physicians and practice

Benefiting patients
The foundation of physician dispensing is improving patient care, which it accomplishes on several levels. “For patients taking generics, the expected benefit is to provide better pricing than the name brand drug,” Dr. Gambla said.

“The unexpected benefit is that, by being able to provide this medication, we’re able to stay closely connected with our patients and monitor adherence.” If patients don’t pick up their prescriptions at the pharmacy, the practice will know and can call them to follow up.

“It’s a great patient convenience—they love it,” Valentino added. “They don’t have to visit another pharmacy; they can just grab their medications and go while they’re here.” At the same time, patients can get all of their medication questions answered from familiar faces who already know them well.

The physician dispensing program also helps fill the ‘donut hole’ gap in Medicare coverage, which can be a significant barrier to ensuring patients can afford their medications. When patients use an outside pharmacy, that barrier can lead to non-adherence. And the physician might not know about the delay in therapy until the next appointment.

In-practice dispensing avoids this issue altogether by accessing the patient’s eligibility for financial assistance immediately and coordinating with patient assistance networks, so patients can begin treatment as prescribed.

Why choose physician dispensing?

  • Improve adherence
  • Ensure patients and caregivers receive thorough counseling on medication use, side effects and potential risks
  • Serve patients longer in-practice
  • Improve convenience for patients
  • Provide a greater comfort level and enhance patient satisfaction
  • Help control costs to patients, while creating a new revenue stream for the practice
  • Assist patients with insurance claims and co-pay assistance

Benefiting physicians
Dr. Gambla sees a wide range of advantages that helps physicians improve patient care. With physician dispensing, the practice is better able to ensure that patients understand the medications they’re taking, including potential side effects. Physicians see a level of patient care data and feedback that would not be available otherwise. Plus, they can monitor patients to reduce abandonment rates. “Overall, physician dispensing ups the quality of care we deliver, and payers like to see the increased compliance and potential for improved outcomes,” Dr. Gambla said.

Physicians are very excited to have the program, because they know they’re providing a stronger level of care. The physician dispensing program helps Central Ohio Urology Group take care of the ‘whole patient’—not just the clinical, including the emotional needs of both patients and caregivers. The practice is able to answer their questions and monitor how they feel from month to month.

Benefiting practice
The most obvious advantage of physician dispensing is adding a new source of revenue in a time when costs are rising and reimbursement rates are declining. But there’s more to this story. “While physician dispensing helps our practice capture new revenue, the hidden gem is that it enables us to monitor our patients more closely, which helps improve patient care,” Dr. Gambla said.

The program is flexible as well, enabling the practice to grow at its own pace. “We can add new drugs as we go, which is key as we continue to expand our pharmacy offering,” Valentino said.

In short, physician dispensing benefits patients, physicians and the practice alike. “It’s a tremendous positive for the physicians,” said Greg Sieg, Manager of the Physician Dispensing Program at VitalSource™ GPO. “Patients are very receptive as well. There’s a smooth continuity of care that helps forge and maintain patient relationships over the long term.”

Onboarding better care

Through a proven onboarding process, VitalSource™ GPO helped ensure a smooth implementation that streamlined the introduction of physician dispensing. “Because our team has years of in-practice dispensing experience ourselves, we understand the challenges of operating a specialty practice and can tailor our physician dispensing program to meet the specific needs of each customer,” said Sieg.

“Just as Central Ohio Urology Group provides a complete care solution to patients, we provide a complete physician dispensing solution to the practice that produces immediate and ongoing results,” said Jeff Andrews, Sales Director—Urology at Cardinal Health Specialty Solutions.

“The introduction went great,” Valentino said. “The practice began with a few generic products on a cash basis, to get the physician dispensing processes in place—and then moved on to the oral oncolytics. Even after the training was completed, VitalSource™ GPO continues to provide resources to help us expand the program."

Just getting started

The physician dispensing program has been growing in volume every month since its introduction. For example, Central Ohio Urology Group now writes approximately 170 prescriptions per month for erectile dysfunction, with about 70% filled by patients (roughly 120 prescriptions). Refills are steady at 220 scripts per month.

Vision for the future

“Our vision is to operate a full pharmacy,” Dr. Gambla said. Whatever a patient needs, including antibiotics, over-the-counter medications, gauze, tape—you name it—the practice plans to have it available. So the practice can improve the likelihood that it will be the patients’ first choice for care, even if it’s for something as simple as a urinary tract infection.

The physician dispensing program of Central Ohio Urology Group is proving to be a model for other practices around the country. “We’ve had visits from practices in Chicago, Cleveland, Virginia and Minnesota who want to see how a successful dispensing program works,” Valentino said. “They want to know if it’s really possible. And once they’re here, the question answers itself.”

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Physician dispensing is part of a comprehensive solution for specialty practices that can help improve business operations. Other VitalSource™ GPO services include a sophisticated suite of data analytics tools— including Advanced Practice Analytics—plus a highly competitive contract portfolio and innovative strategies for creating new revenue.

About Cardinal Health Specialty Solutions

Cardinal Health Specialty Solutions partners with healthcare providers and pharmaceutical manufacturers to ensure patients have access to the therapies they need. From supporting manufacturers on the path to successful drug commercialization, to delivering the products providers need and the efficiencies they want, we use our expertise to improve specialty care.

About Central Ohio Urology Group

Central Ohio Urology Group is one of the largest urology practices in Ohio, with 27 urologists in multiple offices collaborating with major hospital systems throughout the region. Physicians are respected experts in their subspecialties and provide a widerange of services, from general urology to robotic surgery—and from male infertility to radiation therapy.