Clinic Based Mixed-Model Charity Pharmacies

Saint Thomas Health (STH) operates several different types of charity pharmacy models. Two are located on metropolitan hospital campuses, while two others are located inside of STH primary care clinics. All models except one dispense medications to charity patients of either the hospital and/or clinic and STH associates. These pharmacies have the ability to process commercial insurance and Tennessee Medicaid (Tenncare) as well. 340B qualifying locations will also layer this program into existing charity pharmacy models to offer comprehensive service to its patients. Both a charity pharmacy model and 340B program can work in tandem to provide medication access to patients experiencing affordability issues. Of note, one pharmacy does not dispense to associates due to a non-STH owned pharmacy already contracted to provide this service prior to the introduction of the charity pharmacy to this campus.

Saint Thomas Health is a family of Tennessee hospitals and physician practices united by a single mission: to provide spiritually centered, holistic care that sustains and improves the health of the communities we serve. As a part of Ascension Health, the largest not-for-profit health care system in the United States, they are committed to healing and dedicated to service, especially to persons who are poor or needy, reflecting the spiritual core of our mission, vision, and values.

The Clinic Model (Mixed Model) is the preferred model for Saint Thomas Health now that campus-based charity models have been established.

  • Best suited to capture indigent/sliding scale clinic patients
  • Convenient to patients already onsite for appointment decreasing transportation issues
  • Onsite support for providers with patients expressing affordability issues, steer prescribers to charity formulary
  • Market to associates as an in-house pharmacy to capture revenue and also save health system dollars if self-insured
  • Capture retail business from the clinic to offset charity operational costs
  • Assist with hospital discharge prescriptions if close proximity to a hospital campus without an onsite outpatient/charity pharmacy
  • Is there space in clinic for a pharmacy? 
  • Is there a common lobby that can be shared decreasing square footage needs of pharmacy? Patients should be able to access pharmacy even if clinic is closed if hours differ.

Hickman Charitable Pharmacy

Ashley Bennett, Pharm D

Saint Thomas Health Outpatient Pharmacy Supervisor

Centerville, TN

  • Part of a $1 million-dollar Clinic expansion that included behavioral health services and a charity pharmacy 
  • Clinic model chosen as no space available on Hospital proper, Clinic shares a parking lot with Hospital
  • 340B reinvestment narrative helped make this happen (25 bed critical access hospital)
  • Needs assessment identified behavioral health/medication access as a focus area
  • Hickman County has one of the highest suicide rate in the state
  • Behavioral Health needs include medication access
  • Just started filling employee RX in February 2017

Hickman County Demographics

  • Rural community 
  • Population approximately 25,000
  • Median household income $31,013
  • Persons below poverty level 16.3%

Hickman County (Community Health Needs Assessment) See Local Factors for Community Charitable Pharmacy Implementation

  • Prioritized Need #3: Access to Care/ Care Coordination
  • Goal:Improve access to comprehensive, quality healthcare services through increasing availability and affordability of care while advocating for increased health insurance coverage.

Initial Marketing plan – See Marketing Where to start.

  • STH Campus providers
    • Saint Thomas Health Clinic staff
    • Hospitalists
    • Emergency Department
    • Care Management
    • Behavioral Health providers
    • Community resource counselor
  • Flyer distribution
    • Local medical & dentist practices
    • Local Health department
    • Local Churches
    • Helping Hands
    • Churches
    • Saint Thomas Health At Home Medical Mission
  • 211nationwide local resource listing 
  • Community Safety Net meeting
  • Community newspaper ad & local radio spot
  • Open House with Blessing/Ribbon Cutting Ceremony

Saint Louise Pharmacy

Rutherford County, TN

Rutherford County, Tennessee, population 308,251 in 2016 with 10.5% uninsured. Of note, Community Commons 45% uninsured rate for Hispanic and Latinos in the area (2015). Also, 24% of adults 19-25 years old are without health coverage.

  • Located in the Saint Louise Clinic in Rutherford County, a clinic that serves patients of all ages which includes pediatrics, obstetrics, adult primary care, and geriatrics.
  • Partners with medical residents and pharmacy students to provide learning opportunities 
  • Pharmacy dispenses to Saint Thomas Health associates and charity patients from Saint Louise Clinic and community at large
  • Saint Thomas Health first charity pharmacy site, operating 10+ years
  • 1 pharmacist, 2 technicians
  • Fiscal Year 2017, Pharmacy dispensed over 25,000 prescriptions to 6,149 patients qualifying for charity care.