Platform Features
Custom Formulary
Generic formularies either drive up costs or restrict clinicians when comfort changes fast. Prescribers get mixed signals.
Hospice impact overview
Your hospice formulary, your rules, complete control
Build a formulary that matches how your hospice practices. Wise lets your team define preferred agents, therapeutic classes, and exceptions, and align coverage rules to those standards. When an order falls outside coverage or policy, it’s easier to see and address, instead of finding out only when a claim rejects.
For clinical and operations leaders, the same rules drive consistent handling of exceptions and clearer reporting. That means fewer orders turn into after-hours calls, manual overrides, or one-off decisions that are hard to explain later.
Key Outcomes
- Executives: Standardized formulary rules reduce non-covered selections and variation in prescribing, so pharmacy operations stay closer to plan.
- Clinical leaders: Clear, hospice-defined preferred medications and exception policies reduce gray areas and cut down on one-off “can we do this?” decisions.
- Finance teams: Better alignment between coverage rules and prescribing patterns leads to fewer preventable write-offs and a more predictable pharmacy spend profile over time.
Strategic Impact
Standardize what you can, stay flexible where you should.
For hospice executive leaders
Governance, standardization, and measurable cost control
Wise Hospice Options gives leaders the structure and visibility needed to run predictable medication operations across sites. The formulary rules you define translate directly into ordering behavior, which reduces variation and lowers operational risk.
Key Outcomes
- Hospice-specific rules and preferred alternatives reduce preventable non-covered orders.
- Clear formulary standards promote more consistent ordering and reduce callbacks.
- Policy notes and scoped exceptions shorten training time for new and rotating staff.
Executive Strategic Impact
A well-governed formulary is one of the most reliable levers for pharmacy cost control. Organizations that maintain a tailored formulary and drive consistent use can materially reduce pharmacy spend over time while maintaining flexibility for complex clinical situations.
For hospice clinical leaders
Clarity of process, consistency in care
On a busy day, prescribing variation rarely looks like a policy problem. It shows up as callbacks, exceptions, and “can we do this?” messages. A formulary only helps if it’s usable at the moment decisions are made.
Our customized formulary process turns your hospice’s medication standards into clear, documented rules instead of unwritten preferences. It defines preferred choices by class, clarifies which orders may require additional steps, and documents what counts as an appropriate exception, so symptom management doesn’t depend on who’s on call or how much time they have.
Key Outcomes
- Hospice-defined set of preferred agents by class, with site-level variation where needed.
- Clear ordering rules and documentation expectations that reduce gray areas and informal workarounds.
- Ongoing PA flexibility at the patient level: when a prior auth is approved, you can mark it as one-time or ongoing for that patient and medication, so repeat orders don’t keep getting blocked for the same reason.
Clinical Strategic Impact
Clinical teams feel the impact when ordering is more predictable. Fewer orders bounce for clarification. Fewer “this is how we do it on weekends” substitutions. Cleaner handoffs between admitting, on-call, and pharmacy teams. Over time, a well-run formulary reduces unwritten rules and protects consistency in symptom management, especially when staffing changes or census spikes.
For hospice financial leaders
Predictable pharmacy spend, fewer avoidable write-offs
Medication cost control works best when it starts upstream, before orders turn into rework, denials, or write-offs. A hospice-defined formulary reduces variation in what gets prescribed, makes coverage expectations clear, and creates a clean exception path. That translates into fewer surprises at month end and a steadier spend profile you can forecast against.
Wise Hospice Options supports financial predictability by aligning prescribing behavior with coverage rules and documented standards. It helps reduce preventable non-covered selections, limits manual intervention, and strengthens audit readiness without relying on case-by-case oversight.
Key Outcomes
- Hospice-defined preferred agents and policy alignment reduce avoidable medication cost variation
- Fewer non-covered selections lead to a reduction in write-offs and fewer downstream corrections
- See the cost of exceptions, not just the count: Reporting shows where non-preferred or exception meds are driving spend, so finance can focus conversations on the areas with real dollar impact.
Financial Strategic Impact
A well-managed formulary lowers pharmacy cost over time by reducing preventable variation and tightening exception management. It also improves forecasting accuracy by making utilization patterns more consistent across prescribers, sites, and time periods. Finance gains clearer accountability for changes, cleaner audit trails, and fewer coverage-driven reversals.
FAQ
Common Questions
Complex workflows shouldn’t require guesswork. We’re committed to explaining how our solutions work—and why they matter—in terms that help leaders make decisions with confidence. When you need clarity, we’re here, no friction and no fluff.
The Custom Formulary can be configured with both organization-wide standards and site-specific variations where clinically or operationally necessary. This allows you to maintain consistency while accommodating legitimate regional differences in patient populations or pharmacy relationships.
We recommend quarterly reviews of formulary performance and updates to medication listings. However, the system also accommodates urgent updates when new medications become available or coverage policies change. Our clinical pharmacists proactively monitor industry changes that might impact your formulary.
Successful implementation typically requires involvement from clinical leadership (5-10 hours), and finance teams (3-5 hours) spread over the implementation period. We also recommend identifying 2-3 "super users" who receive additional training to support their colleagues during rollout.
Many organizations begin seeing signs of cost improvement once the formulary is live and actively used in prescribing decisions. As patterns adjust and the formulary is refined based on utilization data, pharmacy spend typically becomes more predictable and avoidable variation decreases over the following months.
Absolutely. The Custom Formulary is designed to guide rather than restrict. When clinicians need to prescribe outside formulary guidelines for patient-specific reasons, the system captures clinical rationale and provides a streamlined exception process. This preserves clinical autonomy while ensuring thoughtful consideration of alternatives.
Unlike standard PBM formularies that focus primarily on cost and are often felt only when a claim rejects, our Custom Formulary is designed with hospice workflows in mind. It incorporates your organization’s clinical philosophy, allows for exceptions with documented rationale, and makes coverage expectations clearer up front so fewer issues show up as surprises later.
Platform Spotlight
Explore Even More
Related insights
Hospice Pharmacist's Brief
Expert insights from our clinical team.
Now that you're here...
Let’s talk through your workflow.
We’ll map your current process and show where we can reduce rework, risk, and spend.