The aggressive drive to generate more value from the $3.2 trillion health care delivery system in the U.S. is changing the way each stakeholder in the system provides services to patients. That push is altering the role retail pharmacies play in the system and nowhere is the shifting competitive landscape being felt more than at the local level by independent pharmacies.
McKesson asked Crystal Lennartz, Chief Pharmacist at Health Mart, a McKesson affiliate and independent pharmacy franchise with more than 4,700 stores, to identify trends that will affect the independent pharmacy market in 2017. Lennartz said the following five trends should help guide independent pharmacies in reworking their business models to remain competitive and optimize the value of the services they provide to patients, other providers and payers.
Trends Impacting Independent Pharmacies in 2017
1. Continued focus on performance measures to increase opportunities with health plans seeking to maintain or improve their star ratings from Medicare.
2. Expansion and diversification of clinical services and programs offered to patients.
3. Growing role of the community pharmacist as a health care provider.
4. Opportunity to foster more collaborative clinical and business partnerships with other providers and payers.
5. Making the voice of the patient the center of the community pharmacy experience.
Lennartz explained how independent pharmacies can act on those five trends to improve the health of patients as well as their own business.
What drug plan performance measures in Medicare’s star rating system for health plans should independent pharmacies focus on in 2017?
Lennartz: The focus should be on the measures that keep patients as healthy as possible and reduce their total cost of care by avoiding hospitalizations and physician office visits. Those measures that pharmacies have the most ability to impact include metrics that monitor adherence for diabetes, blood pressure and cholesterol medications, annual completion rate of comprehensive medication reviews, and identifying potential gaps in care like statin use in patients with diabetes.
What clinical services or programs should independent pharmacies offer or expand into in 2017?
Lennartz: At the top of my list is medication synchronization which aligns patient’s medications to a single pick-up each month. Med sync drives adherence, which improves the health of patients. It also raises refill rates, which improves the financial health of the pharmacy. Med sync also creates an opportunity for pharmacists to schedule one-on-one meetings with each patient who may need other clinical services like medication therapy management or disease-state specific education. Also on my list are immunization programs that go beyond flu vaccines to include other core vaccines like those to prevent shingles and pneumonia. Third on my list is medication therapy management. In all three cases, independent pharmacies are contributing to the health of their patients and to their bottom line by creating new revenue opportunities.
As pharmacists assume the provider role, what clinical services do you see them performing in 2017?
Lennartz: Other than expanded immunization programs and medication therapy management, I see independent pharmacists diversifying into disease-specific management, chronic care management and point-of-care testing. Point-of-care testing like a strep test for strep throat or an A1C test for blood sugar levels can lead to pharmacists prescribing medications under collaborative practice agreements in select states. Pharmacists can do many of those things now if they practice at the top of their license, but what will drive more activity in these clinical areas is reimbursement. Those types of services won’t become commonplace in pharmacies until pharmacists are reimbursed like traditional providers. For now, with services like point of care testing, it’s mostly a cash business.
If pharmacists perform many of those clinical services, how will that change the relationship between pharmacies and other providers and payers in 2017?
Lennartz: It can’t help but facilitate closer clinical collaborations and business relationships between independent pharmacies and other providers in their market and the payers serving their market. As community-care extenders, local pharmacies have an increasingly important role to play in determining whether hospitals, medical practices and payers are successful under value-based reimbursement models. Medication adherence is a great example. Two pain points for hospitals are readmissions and healthcare-acquired conditions. If independent pharmacies can help drive medication adherence by customers with chronic medical conditions or by patients recently discharged from the hospital, then they’re less likely to return to the hospital with an infection or any other acute medical condition. That’s also a win for payers, which would pay out less in medical claims. In a value-based reimbursement environment, independent pharmacies are an invaluable clinical and business partner for both providers and payers.
Why should independent pharmacies put the patient’s voice at the center of their operations?
Lennartz: We must consider the voice of the patient or the patient experience in everything we do in pharmacy. We need to continuously measure, analyze and act on patient-reported outcomes based on their experience with independent pharmacies. It’s not just whether a patient got a comprehensive medication review but whether that review was valuable to the patient and whether the patient was satisfied with the experience and had ideas to share on how to improve the process. Think of it as HCAHPS for pharmacies. Two pharmacy quality groups are piloting patient satisfaction measurement that could be used by pharmacies to improve the quality of the service they give to patients. That’s only going to become more important to the clinical and financial success of independent pharmacies in the future, and we’ll be hearing more about that in 2017.
As Lennartz’s outlook reveals, expanding clinical programs and improving the service given to patients will become critical success factors for independent pharmacies as they enter the new year and will strengthen their clinical and business ties with providers and payers in their communities.
Health Mart is an innovative franchise program designed to enhance an independent pharmacy's ability to compete with chains, mail-order programs, and other independents. Health Mart provides franchisees with services and programs that help them compete more effectively in today's retail pharmacy market.Related: Learn about McKesson’s solutions for independent pharmacies.