For retail pharmacy owners and managers, growth and increasing revenue are always top of mind. Retail is a fickle business, and in pharmacy you are at the mercy and whim of consumers’ needs and wants. Though the transaction of filling prescriptions is part and parcel of a thriving pharmacy business, pharmacies are put into the precarious position of striking a balance between increasing prescriptions and expanding their portfolio of patient care and other value-based offerings. Here are 3 trends and challenges in retail pharmacy management:
1) Value of “All-in-One” Pharmacy
You cannot downplay the increasing value of the ability of retail pharmacies, especially local ones, to really get to know their patients. Not only does this provide them the upper hand in improving medication non-adherence which translates to higher payer performance, but it also allows for clinical upsell opportunities, such as point-of-care testing, vaccines, telehealth, wellness screenings, and both medication therapy and chronic care management. As Rich Bukovinsky, executive vice president of business development at Fort Worth, Texas-based FDS says, “As the industry continues to evolve towards a focus on patient care and clinical outcomes, leveraging solutions that helps improve financial growth while delivering exceptional care at lower costs is a prerequisite.”
2) Med-Sync is a Mega-Opportunity
Med-sync (medication synchronization) has dominated the pharmacy marketplace, especially with the mega-pharmacy conglomerates, including CVS/Aetna and Amazon. However, there are small pharmacies that are taking this same cue in order to improve medication adherence and to increase revenue. For example, Love Oak Pharmacy based in Eastland, Texas, has grown their small-town business by offering a med-sync program through a presorted pill box that consolidates and packages medications and OTC products into one box for one simple pick-up. This has been made possible by medication synchronization software that captures all medication and dosage data for each patient in one place. This offering rivals Amazon’s Pillpack and other similar partnerships between PBMs (Pharmacy Benefit Managers), insurance providers, and pharmacy chains, and it’s an example of a key area that smaller pharmacies need to embrace in order to compete with the mega-pharmacies.
3) The Race for Star Ratings and a “Preferred” Label
It is a stark reality that pharmacies are beholden to Star ratings and preferred pharmacy network status. While preferred network status is directly tied to reimbursements, it also affects a pharmacy’s access to a larger customer base. The recent statistics are almost mind-boggling—over the last 7 years, the quantity of Medicare Part D plans that included preferred pharmacy networks went from 7% to a staggering 98%. As a result, the criteria for participating in these networks have become more rigorous for retail pharmacies to attain, especially in the area of Star ratings. This is why it’s increasingly critical for pharmacies to consider partnering with a pharmacy services administrative organization (PSAO). This type of service will identify additional reimbursement opportunities, reduce DIR (direct and indirect remuneration fees), and expand your access to preferred pharmacy networks.
FDS – VP, Business Development and Population Health
Data is power in today’s pharmacy marketplace. Patient data, prescription transaction data, clinical data, insurance data, financial data, adherence data … so much data in so many places – your pharmacy system, POS, claims processor, etc. Trying to gather all these data points from different programs and sources can be like herding cats for a pharmacy and even more difficult for multi-store pharmacy operators. Privacy and security concerns further complicate the process.
Business Intelligence (BI) is necessary to compete in today’s data-driven marketplace. BI can provide you with meaningful reporting and actionable data that can help your pharmacies grow, improve efficiency, and deliver better patient outcomes, as well as positively impacting your bottom line. Identifying and prioritizing key opportunities is necessary to maximize your financial goals and positively impacting patient health.
Pharmacy management systems have offered reports for decades for sales, regulatory requirements, dispensing history, and more. These legacy reports remain essential to operating your business. As the role of the pharmacist continues to evolve, more data is available in more places. New reporting and analysis is typically a requirement as with Star Rating measures. Star Ratings are an example of ancillary information that is vital to your pharmacy practice but often maintained in various systems and locations.
The goal for a successful BI service is locating, collecting, securely storing and aggregating the necessary data elements in a central location, typically the ‘cloud’ today, and then performing analytics to provide reporting promptly to meet changing marketplace dynamics and patient care needs.
What can BI do for your pharmacy business?
BI can give pharmacies the ability to simultaneously address poor patient medication adherence, Star Rating measures, med sync enrollment which in turn may boost profitability, prescription volume and so much more. The ability to provide Trending Analysis of Key Performance measures including Refills On Time, Gross Profit Margins, New Patients and, PDC Measures are just a few examples of meaningful reporting that can assist you in managing your business. Trending KPIs can provide a clear picture of your business health.
Patient Behavior Identifying refills that are overdue or missed has become somewhat common. But what about the impact of Early or Late Refills on staffing, inventory and refill volume? BI reports these events for immediate action by your staff which can have a direct impact on adherence, drive refill volume and produces more revenue.
Measure Success “If you can’t measure it, you can’t improve it.”, is a famous quote of Peter Drucker, considered one of the founders of modern business management. With BI, you can readily measure almost any variable you have the data elements for tailored to your specific needs. For example, identifying and tracking New Patients is essential to the growth of your business. Marketing and advertising get them in the door but understanding who they are and what they want is important to retain their patronage.
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From medication synchronization and medication therapy management (MTM) to a robust immunization program that includes yellow fever vaccinations, Balls Food Stores (BFS) has maximized clinical services and outcomes with the help of ENGAGE from FDS, Inc. On the operations side, FDS’s MYDATAMART enables BFS to monitor and measure pharmacy performance to ensure each of its 21 locations is operating at peak efficiency for maximum profitability.
“Data drives pharmacy services in today’s patient-centric healthcare environment. But there is little value to even the most robust database if pharmacists cannot act upon the information promptly,” said Mike Halliwell, Director of Pharmacy & Whole Health, Balls Food Stores. “By integrating ENGAGE directly into the clinical workflow, pharmacists can access the real-time data needed to identify and close medication gaps and determine patients who would benefit from medication synchronization or other patient-focused services, thereby optimizing patient engagement and clinical outcomes.”
ENGAGE is an interactive platform for pharmacists and technicians to manage patient-focused activities and to meet the growing demands of Star Ratings, adherence, and pay-for-performance measures while strengthening patient relationships. With ENGAGE, pharmacists are empowered to create and manage medication synchronization plans easily, take advantage of additional revenue from MTM and immunization opportunities, and extend patient relationships with automated patient messaging by phone and text. The patient management platform also streamlines Star rating management.
BFS also utilizes MYDATAMART, a comprehensive business intelligence tool that enables a deeper understanding of performance across the chain and delivers insights to increase profits and enhance patient care. It features interactive dashboards and easy-to-use, customizable reports for monitoring a variety of performance metrics, including the most frequently dispensed medications and the best National Drug Codes (NDCs) for dispensing. Other metrics include the overall financial impact of each NDC on the pharmacy and fills returned to stock by patient or drug. MYDATAMART also tracks patients and helps identify questionable claims, and features compliance reports to identify Star Ratings and non-adherent patients.
“We expend a tremendous amount of energy and talent to help build non-dispensing functions to differentiate ourselves, such as our travel clinics and pharmacogenomics programs. As we integrate these programs with the dispensing side of the house, it is imperative that data not be siloed. That’s why it has been so important to have ENGAGE and MYDATAMART, to enable us to continue to evolve with the industry and our patient populations while maintaining our high standards of care,” said Halliwell.
To learn more about ENGAGE and MYDATAMART …
FORT WORTH, TX – (NewMediaWire) – January 09, 2018 – American Associated Pharmacies (AAP) has selected FDS, Inc. to provide third-party claims reconciliation services to its growing network of independent retail pharmacies.
With the FDS partnership, AAP members will be able to manage their prescription claims for all third-party plans and monitor their receivables balance.
FDS Expands its Portfolio of Patient Care Offerings in Support of Care Coordination and Enhanced Pharmacy Services
FORT WORTH, TX–(Marketwired – Oct 11, 2017) – FDS, the pharmacy-centric healthcare technology company dedicated to helping customers succeed in today’s complex and multi-faceted healthcare ecosystem, announced today that it has successfully achieved Pharmacy eCare Plan “Level 1 capability” from Community Care of North Carolina (CCNC). The goal of this initiative is to empower community pharmacies to improve care coordination and health outcomes with use of electronic care plans.