Q1. When did Tabula Rasa HealthCare (TRHC) acquire Pharmastar?
Pharmastar is now a wholly-owned subsidiary of TRHC as of Monday, October 5, 2020.
Q2. Is Pharmastar now part of CareVention HealthCare?
While Pharmastar services will be offered in conjunction with CareVention HealthCare, Pharmastar will operate independently of CareVention HealthCare as a subsidiary of TRHC.
Q3. What does this mean for our Pharmastar services and contract?
There will be no change to your services or contract. We expect to conduct technology and reporting along with other PACE-focused enhancements over time.
Q4. What is the role of the PBM when it comes to a pharmacy?
A PBM’s role is to ensure pharmacy alignment with PACE’s Part D policies and contract pricing. Contract pricing is managed through electronic adjudication through a third-party adjudicator, in Pharmastar’s case, ProCare. The PBM in general provides oversight and enhancement of pharmacy services.
Q5. Will pharmacy oversight by the PBM, Pharmastar, be sacrificed now that TRHC owns both CareKinesis and Pharmastar?
No. The services provided under your Pharmastar contract will be the same. The parameters underlying PBM auditing and accountability are set by CMS.
Q6. How can a PBM provide oversight of a pharmacy if they are part of the same company?
It is common for PBMs and pharmacies to have the same corporate parent. In fact, nearly 100% of PBMs in the U.S. also own a pharmacy or are owned by the same corporation as a pharmacy. Indeed, Pharmastar has owned a PACE-focused pharmacy, PersonifilRx, since 2015. Pharmastar, CareKinesis and PersonifilRx are entirely separate entities, with significant firewalls in place to ensure separate operations. Pharmastar has always audited its own pharmacy with even more scrutiny than an outside pharmacy and has never had a finding during a CMS 1/3 financial audit. As was the policy prior to its
acquisition, Pharmastar will ensure that staff do not cross over in any way that could be perceived as a conflict of interest. Audits are tracked and reported to plans in the same way, regardless of which pharmacy is being audited. Pharmastar will continue to provide this independent oversight to its clients including those that use CareKinesis.
Q7. We were told that if we used CareKinesis, we did not need to use a PBM; CareKinesis would provide the same services. What has changed?
CMS has changed their perspective on whether a PBM is warranted in PACE. We find this in the new
PACE start-up process in particular as it relates to the need for multiple pharmacies that provide services to long-term care and other facilities. In addition, CMS continues to expand its Part D Audit program for PACE to be more and more similar to non-PACE plans. Tabula Rasa HealthCare wants to assure regulatory compliance to avoid the possibility of sanctions on PACE organizations.
Q8. How will Pharmastar clients benefit from this change in ownership?
While Pharmastar operations will remain completely separate from CareKinesis and TRHC’s other business lines, as a technology company TRHC will be able to provide significant advances and upgrades to Pharmastar’s reporting and client-facing tools over time. This will bring greater efficiencies and insights to our PACE clients.
Q9. Will organizations using both Pharmastar and CareKinesis benefit?
Pharmastar clients using CareKinesis will benefit from a higher-level of scrutiny and the resulting assured compliance. Additionally, using both services will provide more meaningful data analytics which will be available from the forthcoming CareVention HealthCare data platform.
Q10. How exactly do Pharmastar’s and CareKinesis’ service differ?
Pharmastar is a pharmacy benefits manager (PBM). CareKinesis provides medication risk mitigation
and PACE-specific pharmacy services that improve clinical outcomes, PACE efficiency, and workflow and reduce total costs. CareKinesis integrates MedWise™ medication decision support tools into the prescribing and medication review process, real-time, to reduce the risk of preventable adverse drug events (ADEs).
Q11: Will Tabula Rasa be adding service options to Pharmastar in the future?
The goal for Pharmastar is to become more PACE-focused and also more personalized from a medication benefits standpoint. We see this as an opportunity to reduce medication risk even further for PACE Organizations. In the short-term, Tabula Rasa HealthCare will provide its Tabula Rasa HealthCare
University’s Learning Management system continuing education (CE) programs for Pharmastar clients who may need CE due to the lack of conference programs in 2020. Pharmastar online training will be available in this system in the future as well.
Q12: Will I be able to keep my customer service liaison at Pharmastar?
Yes, nothing will change related to the support and customer service you are receiving
Q13: Is there a way to learn more about the purpose of PBMs, the audit function, and what’s coming for future Part D Audits?
Yes, in conjunction with NPA, Pharmastar will host quarterly education events, starting before the end of the year.
Q14: Where can I find more information about this?
The link to the press release is here: PharmaStar Press Release.