The idea

Clear bagging is when a health system-owned specialty pharmacy dispenses medications for administration in the health system’s infusion centers. Clear bagging is an emerging strategy some health systems are using to offset the challenges that occur when payers require that infusion centers source medications from an external specialty pharmacy (a process called “white bagging”) instead of through the hospital’s typical distributors.

The promise

Clear bagging helps health systems respond to payer requirements while maintaining oversight of medication dispensing to ensure safe, high-quality patient care. It may also lessen logistical challenges and financial impact caused when prescriptions are sourced from external specialty pharmacies.

Why now

Payers are increasingly implementing policies to control medication use and spending, especially for high-cost specialty medications. These policies include dictating where providers can source medications they administer to patients. An Advisory Board survey found that 84% of health systems reported an increase in payer white bagging requirements from 2019 to 2020. Health system leaders are concerned that payer restrictions threaten patient safety and hinder their ability to oversee care quality and efficacy.

Reality check

While clear bagging seems straightforward, health systems implementing this strategy find that it is applicable only in a limited number of cases, unless a health system and health plan have made arrangements to clear bag medications for certain patients. Factors limiting health systems’ ability to use clear bagging include an inability to bill for medications under the medical benefit, limited pharmacy network access, and poor internal coordination.