Sphinx Strategies: Helping Specialty Pharmacies Navigate the Accreditation Criteria

Vic Simianu, Founder and CEO Against the backdrop of the increasing incidence of chronic health conditions, specialty pharmacies have proven that they may be the most efficient conduit to provide specialized care to patients. In fact, many reports have revealed that the specialty pharmacy market in the U.S. is going to exceed $387 billion by 2026. Such immense growth predictions are driving many entrepreneurs to charter this specific territory. However, the complex compliance requirements and administration issues associated with specialty medications often deter these entities to effectively run their business. In parallel, accreditation has also emerged as an increasingly critical component for successful specialty pharmacy businesses. Key industry stakeholders such as payors, pharmaceutical manufacturers, and even providers consider accreditation a prerequisite while building their network or adding pharmacies to their network. Accrediting bodies closely conduct performance measurements, including drug interactions, call center performance, dispensing accuracy, distribution accuracy, and turnaround times for prescriptions. As a result, it becomes essential for specialty pharmacies to run a thorough gap analysis to confirm they are operating according to the policies and procedures and meeting the intent of the accreditation standards.

Additionally, accreditation standards are subject to frequent changes and become more rigorous over time. As such, specialty pharmacies are impelled to proactively review the appropriate accreditation standards and update their policies and procedures accordingly.

This is where Sphinx Strategies steps in!

Founded by Vic Simianu to become the nation’s most trusted independent specialty pharmacy consulting group, the Indianapolis-based consulting group thrives on the knowledge and experience that Simianu and his team endows. As an Accreditation Commission for Health Care (ACHC) Certified SP and DMEPOS Consultant and one of the first specialty pharmacy consultants to achieve URAC Specialty Pharmacy accreditations, he has a comprehensive knowledge of the nature and history of the accrediting bodies. Also, Simianu, who is currently donning the role of the Principal Consultant, CEO, and Founder at Sphinx Strategies, understands the rapid evolution of the accreditation standards themselves and the ever-expanding value behind engaging and maintaining accredited processes.

While Simianu’s expertise spans across the entire spectrum of specialty pharmacy, the field of Oncology has always remained his area of interest. In fact, this industry stalwart has managed acute, and outpatient purchasing supply chains and took part in planning and preparing operations for a state-of-the-art Proton Cancer Therapy Center. Recently, one of his clients became the first to achieve the newly released and highly sought-after Specialty Pharmacy Distinction in Oncology Accreditation through ACHC.


We target effectiveness and speediness of their approach by combining efforts in accreditations, operational excellence, and data analytics in each phase of their projects

Achieving Excellence with Expertise

Today, under Simianu’s strategic leadership, Sphinx Strategies focuses on developing and maintaining highly integrated and collaborative Specialty Pharmacy operations. “While Payors and PBMs continue to force adoption of enhanced competitive requirements, specialty pharmacies face the compounded effect of time constraints, regulatory hurdles, and constant reimbursement challenges. We target effectiveness and speediness of their approach by combining efforts in accreditations, operational excellence, and data analytics in each phase of their projects,” remarks Simianu. This enables clients—from independent pharmacies to large IDNs, ACOs, and publicly traded pharmacies and insurers—to achieve and surpass double and triple-digit ROIs per engagement.

Sphinx Strategies has architected AccrediGuard, a virtual compliance sentinel software that provides every stakeholder of its clients’ teams with access to crucial information for audit or accreditation verification. In this context, Simianu mentions that specialty pharmacies on a regular basis handle multiple documents, and unfortunately, a major portion of this task is conducted manually. That’s why, during an official audit visit, businesses become clueless about the location of the necessary files. This delays the entire accreditation process and often leads to severe financial loss.

Sphinx Strategies’ platform eliminates this quandary by allowing clients to upload all their crucial documentation and permits at one centralized location. And all the team members can access those without breaking a sweat. “We bring all the necessary documents at clients’ fingertips, eliminating the need to sift through multiple systems or locate a file in an old cabinet whenever an auditor shows up,” Simianu mentions. “It’s not a patient or workflow management software, but a task management tool that works as an interface between our consultants and clients and helps the latter stay prepared for audits and limit financial risks.”

Simianu recalls an incident where he, along with his team, prepared a client for an incoming audit within a seven-days-notice. “I cancelled my vacation and worked with them round the clock to rewrite all of their policies and procedures. Extracting all the data scattered across multiple systems, we created 200 pages of report,” he adds. The client leveraged this information to quickly get the accreditation. This enabled them to enjoy a 10x growth.

A Well-Built Network

Sphinx Strategies has also built three different sub-brands— SPRYNG, TEMPYL, and SYLTOS.
SPRYNG was built from the ground up with the idea of opening a network of the highest performing regional independent specialty pharmacies as a contracting and fulfillment option to industry partners, plans, and PBMs. There is no doubt that independent specialty pharmacies vary widely across the nation when it comes to disease class expertise and focus. However, they all struggle with the same reimbursement challenges and want to up the ante when it comes to patient care. That’s why several specialty pharmacies across the U.S. have joined the SPRYNG network to ease the pain for all the stakeholders while capitalizing on their respective footing in their current licensure, coverage, and drug access.

Second on the list is TEMPYL—specifically designed to help specialty pharmacies with management and operations. It helps businesses gain key insights from across the industry, including drug-pipeline reports, operational tools, and access to best practices and tactics. As such, pharmacies can build out their operations, monitor targets, and hit the bull’s eye—from both revenue and efficiency perspectives.

"We have our staff located across the nation and they are some of the industry’s greatest minds"

Lastly, SYLTOS is the analytics and informatics division of Sphinx Strategies. This splinter group focuses on generating disruptive technologies and developing informatics verticals for pharmacies, infusion centers, hospitals, and provider’s offices. By integrating Sphinx Strategies’ compliance tools and advanced analytics frameworks, the group enables clients to develop custom software for their unique requirements. This enables businesses to capitalize on their strengths and extract custom KPIs while implementing new innovations, fiscal tools, and informatics solutions.

What’s more? ACHC has also recognized the great strides that Sphinx Strategies has made in the specialty pharmacy consulting space. The accreditation body has rewarded the company for a stellar record of excellence in guiding a large number of pharmacies through the ACHC accreditation journey. In fact, it is one of the first three consulting companies to have ever been crowned with this acknowledgment.

A Continuous Endeavor to Achieve Excellence

To further up its ante in the specialty pharmacy space, Sphinx Strategies has shifted from Colorado to Indianapolis while bolstering its connections with universities. This will allow Sphinx Strategies to build a team of young and enthusiastic graduates to maintain its leadership position in the specialty pharmacy consulting space. The company has also planned to bring more innovative solutions to the table by making investments in R&D. Simianu believes that this will help them grow an extensive network of specialty pharmacies. “We have our staff located across the nation and they are some of the industry’s greatest minds. This team always strives to change the paradigm of the entire healthcare industry and help clients achieve success,” he mentions.

In a nutshell, with his expertise, experience, and strategic leadership, Simianu always guides Sphinx Strategies toward success. And this is the key driving force for the company to achieve the goal of “Carving Excellence in Specialty Pharmacy.”

Company
Sphinx Strategies

Headquarters
Boulder, CO(recently relocated to Indianapolis, IN)

Management
Vic Simianu, Founder and CEO

Description
Sphinx Strategies has architected AccrediGuard, a virtual compliance sentinel software that provides every stakeholder of its clients’ teams with access to crucial information for audit or accreditation verification. In this context, Simianu mentions that specialty pharmacies on a regular basis handle multiple documents, and unfortunately, a major portion of this task is conducted manually. That’s why, during an official audit visit, businesses become clueless about the location of the necessary files. This delays the entire accreditation process and often leads to severe financial loss

Sphinx Strategies