5 Questions to Ask Any Hospice Pharmacy Vendor (Including Us)

The demo went well. Too well. A hospice leadership team spends ninety minutes watching a pharmacy vendor walk through screens that anticipate every concern, and the room leaves impressed. It is only afterward, in the hallway, that the administrator realizes nobody asked a single question the vendor had not rehearsed. The demo showed what the vendor wanted to show. What the team needed to learn was what the vendor's model would do to them over three years, and demos are not built to answer that.

The model shows itself under a handful of specific questions. We published a short screening version of this list on our hospice PBM explainer; these five go deeper. For each one: why it matters, what a strong answer sounds like, the red flag to listen for, and, because we think the people who write the test should also have to take it, our own answer on the record.

1. Do you own a pharmacy, or share a parent company with one?

Why it matters. When the company applying your benefit rules also profits from where the fills go, every decision it makes about your formulary, your network, and your fill rules carries a second incentive. None of it requires bad faith; the incentives do the work.

A strong answer is a plain no, or a full disclosure of the relationship with safeguards you can independently verify.

The red flag is warmth without disclosure: "our pharmacy partnerships help us serve you better," with no answer to who owns whom and where the margin sits.

2. Will my invoice show what the pharmacy was actually paid?

Why it matters. The gap between what you pay and what the pharmacy receives is where spread pricing lives, and an invoice that shows only your side of the transaction is built to keep it invisible.

A strong answer commits to pass-through pricing with the pharmacy's rate visible and auditable, line by line.

The red flag is "competitive rates" or "aggressive discounts" with no commitment to show the other side of the transaction. The test is simple: if the pharmacy told you what it was actually paid, would it match your invoice? If those two numbers are allowed to differ, the spread lives in the gap.

3. When does my team learn about coverage, price, and prior authorizations?

Why it matters. This single question separates the reactive model from the proactive one. If answers arrive after the claim, your team inherits the rejection at the counter, the prior authorization discovered after the fact, and the telephone game that follows. If answers surface before the order is signed, most of that work never exists.

A strong answer is specific: coverage, price, and PA requirements on the prescriber's screen at the moment of ordering, with the claim processing cleanly at the counter as the result.

The red flag is any answer that begins after the claim, where your team learns about a problem only if the pharmacy calls about the rejection. Pride in how efficiently rejections get handled is the same flag in different clothes: handling rejections well is what a vendor offers when it cannot prevent them.

4. What will you measure before go-live, and show me every month after?

Why it matters. Impact only exists against a baseline. A vendor that never recorded where you started can report activity forever, claims processed, fills dispensed, calls answered, without ever proving anything got better. We wrote about the difference between activity and impact last week; this question is how you apply it in an evaluation.

A strong answer names the numbers: a baseline recorded before go-live, the same numbers measured the same way monthly, delivered without being asked, judged by you.

The red flag is no measured baseline before go-live and no tracking of the vendor's own performance, just sample monthly reports full of motion metrics. Motion is not improvement.

5. How difficult is it to leave or terminate the contract?

Why it matters. Measurement only means something if you are free to act on it, and your pharmacy relationships and your data should not be hostages to a contract. How a vendor answers this question tells you how it plans to keep you: by results, or by lock-in.

A strong answer is simple: you can leave at any time and make the best decision for your hospice, with your data exported in a usable form and your pharmacy relationships intact.

The red flag is the lock-in apparatus: long initial terms, narrow notification windows you must hit to escape an auto-renewal, and legal strong-arming when you try. If the product is that good, the contract does not need to do the holding.

A vendor that flinches at these questions is telling you something. So is a vendor willing to publish them with its own answers attached. Either way, you learn more in five questions than in ninety minutes of demo, because questions reach the model, and the model is what you actually live with.

Bring all five to every evaluation. Including ours.

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