Streamlining Pharmacy Benefits: The Role of BPO in Healthcare

Running a pharmacy can be complex, so it's important to ensure you have the right support for your business. One of those important support pillars is often pharmacy benefits management (PBM). 

PBM includes various tasks, including coordinating with insurance companies and tracking pharmacy orders. It's important to note these are not the only tasks that PBM encompasses, as it's a complicated and comprehensive area. 

When PBM is done right, pharmacies can function in a productive, streamlined manner, providing a better patient experience and completing tasks promptly. 

Because PBM is so complex, many people choose to outsource it. Managing PBM in-house can be overwhelming and lead to errors, so choosing to outsource this area can be a great way to get peace of mind and make sure that this aspect of your business is being taken care of by experienced professionals. 

Business process outsourcing (BPO) is an excellent way to streamline pharmacy benefits management and ensure your pharmacy runs smoothly. 

Benefits of BPO for Pharmacy Benefits Management 

There are a variety of different reasons why some choose to outsource PBM. Let’s go over some of the benefits that you may receive if you choose to outsource. 

Increased Efficiency and Productivity 

If your in-house staff's PBM productivity isn't reaching your goals, it may be time to outsource. When you choose to outsource, you can be sure that your expanded team will consist of experienced and seasoned professionals. Because of this, they'll be able to improve your business efficiency and ensure everything is done productively. 

When you improve productivity, you may also reduce costs… 

Reduced Costs 

Some people are surprised that outsourcing can reduce their costs. Choosing to outsource can save you money in a few different ways… 

• Faster tasks: Getting things done faster can save you money. It’s that simple. Your outsourced staff will be able to use their experience to get things done faster, which makes this a budget-friendly option.
• Free up your in-house staff: When you outsource, your in-house staff can focus on specialized tasks.
• Budget-friendly options: One of the great aspects of outsourcing is that you can choose the partner that makes the most sense for your budget.

Improved Compliance 

It’s no secret that compliance is an essential aspect of the pharmacy industry. Working with an experienced BPO provider will mean that their staff has a deep understanding of compliance and regulations that are in place. 

Patient Care 

Making sure that you have exceptional patient care is one of the best ways to ensure that your customers return to your business. Improving your patient care can build trust with your customer base and potentially increase loyalty. 

Flexibility and Scalability 

Getting flexibility and scalability is one of the biggest reasons some outsource. Let's dive into what exactly scalability means in this context… 

Let's say you start with a BPO team tasked with five things. Then a member of your in-house team finds another job and suddenly you need more help… You can simply reach out to your BPO partner and let them know about the adjustments that need to be made. 

This element of scalability can give you peace of mind and assurance that your business will have the support it needs. It’s not always possible to forecast how much support you’ll need, so mankind sure that you select the right partner is important. 

Choosing a BPO Partner 

There are a few different aspects to consider when looking for a BPO partner… 

• Scalability: We've already mentioned the importance of scalability, but it's not a benefit that all providers offer. Ensuring your potential partner prioritizes scalability is a great first step, so don't be afraid to ask about this aspect.
• Location: The location of your BPO partner and their staff can significantly impact your working relationship. If you’re looking for a high level of communication from your partner and its staff, then you may want to think about time zones and time differences.
• Budget: Saving money can be important, especially when selecting the right BPO partner. While selecting the cheapest BPO partner can be tempting, remember that sometimes you get what you pay for. Finding the right balance of affordability and quality is possible, so don't be afraid to keep shopping if you haven't found the right option yet.

How BPO Works for Pharmacy Benefits Management 

If you're new to the idea of outsourcing, then you may be wondering exactly how it works. Let's go over the three steps that are common when you start working with an outsourcing partner. 

Assigning Tasks 

The first thing to be done is deciding what tasks you will outsource. Once you've made that list, you can speak with potential partners about their abilities and if they can take over those tasks. 

The BPO partner will then take over all or some of the PBM functions, such as claims processing, formulary management, and utilization review. 

When you're deciding what tasks you're going to outsource, it's important to think about productivity. Just because your in-house staff can handle a certain task doesn't mean that's the most productive option. 

Completing Tasks 

Once the tasks have been assigned and you've solidified your relationship with the BPO partner, it's time for them to start working. At this stage, the BPO provider uses its expertise and resources to streamline operations, improve efficiency, and reduce costs. 

It’s important to think about ROI and what exactly you want to get from outsourcing. If you have a main goal, such as saving money or reducing costs, it’s important to be upfront with a potential BPO partner about that goal. 

Utilizing Expertise 

When you work with the right BPO provider, you’ll be able to rely on the expertise of your new staff. They’ll provide access to cutting-edge technology and analytics that can help to improve patient care and expenses. 

Outsourcing PBM 

If your business has been missing something lately or you want to improve your PBM, then outsourcing could be the right option for you. Outsourcing can be an excellent way to save money, get access to specialized expertise, and streamline your PBM processes. 

Taking some time to consider outsourcing PBM could be an excellent choice for your business, so think about if this could be the right decision for you.