McKesson Introduces McKesson Reimbursement Advantage Solution to Help Independent Pharmacies Maximize Profits

“Independent pharmacies are known for the high quality, personalized service they provide their patients — this is where independents stand out and where they will continue to win,” said Tim Canning, Senior Vice President, Independent Segment, McKesson U.S. Pharmaceutical. “However, in order to remain competitive, independents must gain an equal footing when it comes to capturing top dollar for the drugs they dispense and the patient care services they provide. McKesson is committed to helping independents achieve this critical goal, which is why we’re delivering McKesson Reimbursement Advantage and the McKesson Patient Outreach Network — two key offerings that are part of the next wave of McKesson programs created to advance the future of independent pharmacy.”

McKesson Reimbursement Advantage: Helping independents capture maximum reimbursement

Amidst continued pressure on reimbursement rates due to AMP legislation and other industry forces, pharmacies of all types must be focused on capturing maximum reimbursement for the drugs they dispense to patients. Recognizing the critical importance of addressing underadjudicated, unpaid, and underpaid claims, chain pharmacies perform real-time validation and processing of pharmacy claim submission data to optimize claim reimbursement and minimize reimbursement errors. Independent pharmacies, on the other hand, typically lack the time and resources required to perform edits and reconcile their claims. They may also lack the time to follow up with third-party payors to get the money they deserve.

Anticipated to launch in November — first to Health Mart pharmacies and then to all McKesson independent pharmacy customers — McKesson Reimbursement Advantage will provide independents with a powerful solution to overcome these challenges and maximize their reimbursement dollars. More than a simple collection of edits, MRA offers the industry’s most comprehensive reimbursement optimization package for independent pharmacy, comprising financial services (automated claims resubmission to capture AWP updates and A/R reconciliation), analytic services, customer care, and market-leading pre and post edits (PPE). Pilot data has demonstrated that a pharmacy can increase its net profit by $150–$1,250 per month with MRA.

Additionally, Health Mart Preferred PatientRx™, a component of McKesson Reimbursement Advantage for Health Mart pharmacies, helps franchisees attract and retain cash-paying customers, which can lead to increased store revenue. With Health Mart Preferred PatientRx, Health Mart pharmacies can offer the most competitive pricing for cash customers without impacting overall reimbursement rates.

“McKesson Reimbursement Advantage encompasses much more than simple claims reimbursement,” said Tim Davis, RPh and owner, Beaver Health Mart Pharmacy. “With its service model approach, it provides robust revenue enhancement opportunities, helps us retain our customer base, and directs us toward greater profits. It’s almost like an adjudication special forces unit for independent pharmacies.”

Unlike first-generation edit packages that required pharmacists to comb through claims reports for inaccurate payments, MRA is a service offering that provides independent pharmacies with chain-like infrastructure and support. With MRA, independents have a solution to help them capture higher reimbursement without devoting hours to reconciling reports, reversing and resubmitting claims, and calling third-party payors’ service centers. MRA is powered by RelayHealth® (formerly Per-Se/NDCHealth), the industry’s leading connectivity platform. RelayHealth’s Intelligent Network connects more than 90% of the nation’s pharmacies and supports 8.5 billion transactions annually.

The McKesson Patient Outreach Network: A new revenue source, a new opportunity to deepen patient relationships

According to a report recently released by the National Council on Patient Information and Education (NCPIE), “Poor medicine adherence has reached crisis proportions in the U.S. and around the world, leading to unnecessary disease progression, disease complications, reduced functional abilities, a lower quality of life, and even death.” The report also found that only 50 percent of American patients typically take their medicines as prescribed, resulting in approximately $177 billion in annual costs to the U.S. economy.¹

To address the mounting problem of poor medication adherence — as well as provide pharmacies with the opportunity to tap into a new revenue source — McKesson introduced the McKesson Patient Outreach Network in July 2007. A national pharmacy network promoting medication adherence and pharmaceutical care, the McKesson Patient Outreach Network helps independent pharmacies strengthen relationships with patients, while reimbursing them for their medication adherence services.

Since the McKesson Patient Outreach Network was announced only three months ago, it has grown to 1,250 participating pharmacies. This strong growth underscores independent pharmacies’ increasing interest in providing new, revenue-building patient care services.

The McKesson Patient Outreach Network is operated by the new McKesson Patient Relationship Solutions (MPRS) business unit. MPRS provides the industry’s most comprehensive, integrated portfolio of medication adherence programs and solutions, helping pharmaceutical manufacturers, pharmacists, and other healthcare providers increase patient adherence to prescribed drug regimens and improve overall patient health outcomes.

About McKesson’s Solutions for Independent Retail Pharmacy

McKesson connects independent pharmacies to the broadest and deepest suite of programs and services, providing a one-stop shop for everything independents need to help manage their business and grow their bottom line. McKesson offers the industry’s leading generics purchasing program (McKesson OneStop Generics^SM), the fastest-growing pharmacy franchise program (Health Mart®), best-in-class automation and pharmacy management systems, and innovative front-end programs.

As the leading provider of connectivity solutions, McKesson also creates new opportunities for independent pharmacies by connecting them to payors, manufacturers, consumers, and other key healthcare players in new, more meaningful ways. These connections empower independents to maximize reimbursement and tap into additional revenue sources by offering new, revenue-generating patient care services.

About McKesson Corporation

McKesson Corporation, currently ranked 18th on the FORTUNE 500, is a healthcare services and information technology company dedicated to helping its customers deliver high-quality healthcare by reducing costs, streamlining processes, and improving the quality and safety of patient care. McKesson is the longest-operating company in healthcare today, and will mark 175 years of continuous operations in 2008. Over the course of its history, McKesson has grown by providing pharmaceutical and medical-surgical supply management across the spectrum of care; healthcare information technology for hospitals, physicians, homecare and payors; hospital and retail pharmacy automation; and services for manufacturers and payors designed to improve outcomes for patients. For more information, visit www.mckesson.com.

¹ National Council on Patient Information and Education, Enhancing Prescription Medicine Adherence: A National Action Plan, August 2007