New Research Reveals Most Pharmacies Are Unprepared for Market Growth

, /PRNewswire/ -- As the infusion and specialty pharmacy markets face rising operational costs and increasing complexities in reimbursement, providers are under immense pressure to deliver exceptional patient care while maintaining profitability. Challenges like staffing shortages, rising payer scrutiny and a lack of streamlined revenue cycle processes have intensified the need for innovative solutions to navigate these obstacles. Recent market projections emphasize the urgency for pharmacies to adapt. Most analysts expect the home infusion market to grow at a compound annual growth rate (CAGR) of 7% to 8% over the next several years, while the specialty pharmacy market is projected to grow at an even faster rate of 10% through 2035. As a result, a strong revenue cycle management (RCM) strategy has become a necessity for securing long-term success and growth.

To further understand pharmacy provider needs and what drives an optimized RCM strategy, Prochant—a 25-year leader in the home-based care industry—released a research report detailing the evolving state of the infusion and specialty pharmacy market. Prochant's insights are based on a comprehensive survey from in90, an independent third-party consulting firm. The survey represented some of the largest pharmacy providers, with 43% of respondents from organizations generating more than $30 million in revenue. The report reveals critical pain points, emerging trends and the growing reliance on a trusted partner with deep expertise to drive efficiency and reduce costs.

Key findings include:

• 73% of providers surveyed are less than fully satisfied with their RCM approach, with common issues including high denial rates, aging accounts receivable (A/R) balances and increasing write-offs - all of which diminish profitability.
• 73% of respondents report revenue losses due to inefficient RCM processes as the reason for dissatisfaction. Other reasons reported include limited revenue growth (50%) and RCM staff frustration leading to high turnover rates (43%).
• 68% of pharmacies say reducing denials and appeals will be their biggest billing and RCM challenges over the next two years. Keeping up with complex payer rules follows closely behind as a top challenge (44%).

These challenges are prompting many pharmacy providers to turn to external RCM partners to bridge the gap. 82% of respondents have outsourced at least one RCM function, with 47% citing resource limitations or lack of expertise as the reason. According to the survey, the top three things pharmacy providers value in an RCM partner are revenue capture, visibility into metrics and expertise.

"Infusion pharmacy providers must adopt a proactive approach to RCM, leveraging a team with deep expertise and advanced tools like real-time analytics and intelligent workflow powered by AI and automation to stay ahead," said Joey Graham, CEO of Prochant. "Our goal is to empower pharmacies with the resources and technology they need to achieve financial stability while focusing on patient care."

For more detailed findings and actionable insights into the infusion pharmacy industry, stakeholders are encouraged to explore the full report, available here. 

For more info, visit prochant.com or email [email protected].

Contact

Greg Krantz
VP, Marketing
+1 (888) 349-9015
[email protected] 

About Prochant, LLC

Established in 1999, Prochant delivers focused revenue cycle management (RCM) solutions to healthcare providers for the home-based care industry. Our expertise lies in providing end-to-end RCM for home-based care, HME, infusion services, specialty pharmacies and home health and hospice, consistently delivering exceptional results to some of the leading healthcare providers in the country. We combine innovative technology in workflow and analytics and deep industry knowledge to streamline the time-consuming and expensive reimbursement process. As a result, we help healthcare providers accelerate their collections, increase revenue and reduce operational costs while managing risk.

SOURCE Prochant