Physician Dispensing
Commitment to quality
How ACHC accreditation benefits Clearview Cancer Institute
Demonstrating best practices
What more can a specialty pharmacy do to compete effectively, while strengthening support among payers and pharmacy benefit managers (PBMs)? For Clearview Cancer Institute, the answer was obtaining accreditation from the Accreditation Commission for Health Care (ACHC).
“We looked at the payer landscape ahead and determined that becoming accredited would help us remain a strong choice for payers and pharmacy benefits managers,” said Todd Murphree, Pharm.D., Ambulatory Pharmacy Manager. The progressive strategy perfectly fit the practice’s vision, as northern Alabama’s leading cancer treatment facility.
The ACHC sets accreditation standards that reflect a specialty pharmacy’s commitment to high performance and patient care. Specialty pharmacies earn the distinction—considered to be the gold standard by payers and PBMs alike—by demonstrating best practices regarding organizational structure, policies and procedures and compliance with federal and state laws. ACHC surveyors visit the practice onsite every three years to review these best practices and maintain accreditation.
Clearview partnered with ACHC to gain accreditation on two levels: specialty pharmacy in general and oncology in particular. “Our goal was to package the two together and create new best practices that would be an industry model for other oncology specialists,” Murphree said.
A best practices approach to developing best practices
To prepare for the ACHC’s review, Murphree began by creating a master spreadsheet of the policies and procedures required to meet each ACHC standard and uploading it to a central server, so that each Clearview practice could access it.
Then, he asked for assistance by requesting relevant policies and procedures from each department—such as HR—that had already developed. Each department linked the applicable policies and procedures to the master spreadsheet. Murphree would review them—and if a particular policy or procedure didn’t meet ACHC current standards—he would let the appropriate department know, so that information could be updated.
“I also engaged with Clearview’s Compliance Officer to assist with the quality improvement section of the standards,” Murphree said. And to satisfy the patient record requirement, Murphree accessed the practice’s EMR. “A large part of the medical information you need is already there,” he said.
Gaining support along the way
Toward the end of the process—right before submitting its information to the ACHC for review—Clearview engaged a third-party consultant. “We wanted to do a gap analysis and mock survey, to determine if there were any areas that needed improvement, prior to our submission to the ACHC,” Murphree said. “As a result, we demonstrated that we were ready to proceed.”
The ACHC was very helpful as well, answering Clearview’s questions and offering guidance when needed. “The ACHC wants you to be accredited, so they’ll help you along the path,” he said. “You can also go online and see the questions—including checklists—that will be asked during your onsite survey.”
Gaining accreditation
The ACHC surveyor visited Clearview, and the review was a success. “No one gets a 100% on the onsite survey, so be prepared to need a corrective action plan,” Murphree said. “But if you’re prepared, your practice should pass.”
After the process was complete, Murphree created a scrub standard form for every policy and procedure developed. Today, individual Clearview practices can download and modify these forms, based on the specific needs of that practice. “We use these forms as basic guidelines, so each practice can see the policies and procedures that the ACHC has approved,” Murphree said.
Advice for the future
“We spent about a year developing the policies and procedures that we would need for accreditation,” Murphree said. “Because this initiative wasn’t urgent, we took our time—and other specialty pharmacies could likely do it faster. Above all, don’t overthink the process and get bogged down by doing more than the ACHC requires.”
The end benefits of ACHC accreditation are clear: demonstrating the commitment to quality and continuous improvement that payers and PBMs increasingly require—and that ultimately benefit the patients we all serve.