Medication synchronization and the appointment-based model (ABM) are gaining traction among independent pharmacies, and have the potential to deliver tangible benefits to both their patients and business.
Lack of adherence to prescribed medications is a well-known and costly problem. Nearly two-thirds of Americans don’t take their medications properly1 and lack of proper adherence costs the U.S. healthcare system almost $300 billion each year.2 Payers, PBMs, pharmaceutical manufacturers, physicians and pharmacists have all been trying to tackle the issue of non-compliance.
The Concepts of Med Sync and ABM
In 1995, an independent pharmacist in Long Beach, California conceived and implemented the appointment-based model, with prescription synchronization as “the engine that drives the ABM.”3
These two concepts work together:
1) Medication synchronization. All of a patient’s prescriptions are synchronized to be refilled on the exact same day of the month, eliminating the need for separate call-ins and pick-ups.
2) Appointment-based model. An appointment is scheduled for the patient to come into the pharmacy to pick up all of their medications at one time. Prior to this appointment, patients are contacted to confirm the prescriptions that are to be filled and to identify any changes in therapy. During the appointment, the pharmacist can review a patient’s health and medications, provide counseling or medication therapy management, and/or conduct a medication review.
In combination, med sync and ABM turn a reactive process where independent pharmacies have traditionally waited to hear from patients about refilling their prescriptions, resulting in high rates of non-adherence, into a proactive process of contacting patients, reviewing their medications, refilling prescriptions and educating patients.
Top Benefits of Program Adoption
There are several main advantages of medication synchronization and ABM to a pharmacy’s overall business, including the following:
1) Increased revenue. Med sync and ABM can lead to 2–3.5 additional prescription refills per participating patient over the course of a year. Also, the scheduled monthly appointments provide opportunities for medication reviews, medication therapy management, and counseling with participating patients, which are often billable services and can represent sources of revenue.
2) Operational efficiencies. Medication synchronization is a way to organize and streamline operations. It replaces chaos and stress with order, it is relatively easy and inexpensive to start, and it can help improve inventory management. It enables the pharmacy to transition from what is a primarily reactive and transactional mode of business, to a proactive, patient-focused workflow.
3) Stronger relationships. Both patients and providers are interested in the idea of med sync/ABM, providing yet another way for pharmacists to forge deeper relationships. For physicians that are migrating to ACO models, knowing that pharmacists are focused on adherence and are regularly reviewing and synchronizing medications is extremely valuable.
4) Improved clinical performance. Medication synchronization can improve clinical performance data on key Star Ratings quality measures, such as PDC scores, as a result of more adherent patients. With routine patient check-ins, pharmacies can identify gaps in care and ensure patient outcomes are positive.
Key Implementation Considerations
Implementing medication synchronization and ABM requires planning, decisions, and addressing several important considerations, such as:
1) Purpose and goals. Before undertaking med sync and ABM, a pharmacy should have clarity on exactly what it is trying to accomplish. Is the main goal operational efficiency? Increased revenue? Improving adherence? Improved inventory management? Freeing up pharmacist time for other clinical services? And, how will success in achieving these goals be measured?4
2) Staff training. Staff must be trained on the processes and technologies to implement med sync and ABM. Also, a good idea is to designate a technician or staff pharmacist to oversee the program.5 It’s important for your staff to understand your motivation for change, how it will impact their roles, and that while the results will not happen over night, they will see the benefits of this new model.
3) Business model. Along with the basic goals, it is important to think through the financial rationale for med sync/ABM. The model may be that increased operational efficiency on its own justifies med sync, or it may be that some payers will reimburse for medication synchronization and reviews. Pharmacies should have a clear financial plan before they start.
4) Patients to target. Med sync and ABM is not for everyone. The best candidates are individuals with chronic conditions who take multiple prescriptions. It is these individuals who often have adherence issues and for whom medication synchronization and ABM can have the greatest value. Pharmacies should understand how many of these patients make up their customer base, and what opportunities they have to attract new patients for whom a medication synchronization service would be appealing.
5) Technology. According to the APhA Foundation, “Technology can facilitate the implementation and scalability of the ABM.”6 Focused medication synchronization tools and technologies need to be integrated with a pharmacy’s existing pharmacy-management system. The pharmacy-management system might provide an automated data feed to a synchronization tool, which determines the best synchronization option for the patient.
6) Start small. Those who have implemented med sync and ABM programs suggest starting small, with just a few patients, and first conducting a pilot to work out processes and identify issues to be addressed.
Multiple studies have shown encouraging results which indicate that medication synchronization and ABM decrease gaps in getting prescriptions refilled and dramatically improve patient adherence. For independent pharmacies looking to grow in today’s competitive marketplace, it’s imperative to understand how these programs will benefit their business and what they need to consider before establishing these programs in their store.
Related: Learn about McKesson's medication adherence solutions for independent pharmacies