Pharmacy Owners, Managers Turning to Outside Help to Boost Profits

MARCH 14, 2018
Bruce Kneeland, Community Pharmacy Specialist
Richard and Tripp Logan, both pharmacists, are a father and son team that own 2 pharmacies in southeast Missouri. 

Like most community pharmacies, one problem the Logans face is dwindling margins from third-party payers. Richard said that a few years ago they received some help from Monty Rogers, RPh, founder of Pharm Assess.  He credits this consulting firm with helping them evaluate, negotiate, and profitably service 2 340B entities in their service area. 

Richard said that he tells his interning pharmacy students, “as a pharmacist, your first priority is to provide good care, but, you can’t do that unless you make a profit.”  Richard added, he feels the practice of pharmacy has become so complicated that most pharmacies would benefit from working with experts to insure they generate the profit they need.  

When third-party reimbursement issues started causing them problems they once again reached out to Pharm Assess for help.     

First, Tripp said, Pharm Assess has worked for scores of pharmacies for several years. In the process, they have developed custom algorithms that provide reports that show the Logans how they can make changes that improve profitability. These reports come from data in their pharmacy system on patients, prescribers, prescriptions, and third-party plans. The various reports, charts, and graphs show them exactly where they are making or losing money. Second, Richard noted, while having this information is helpful, the real benefit comes when they talk with their account manager. During these conversations they review the reports, discuss options, prioritize, and then implement changes that improve profits. 

Another area that has benefited from this relationship, according to Tripp, is in managing direct and indirect remuneration (DIR) fees. He noted that by knowing which plans and patients have a negative impact on reimbursement, they can work with patients to improve adherence or make other adjustments after collaborating with prescribers or family caregivers. 

Pam and Jonathan Marquess are a husband and wife team that own 10 pharmacies in Georgia. Their first pharmacy, East Marietta Drugs is in the town of East Marietta, a suburb of Atlanta. Pam and Jonathan are both PharmDs and have placed a high priority on providing exceptional care. They even help other pharmacists do the same by way of another business they own, The Institute For Wellness Education, which credentials and provides APCE continuing education programs.  

Despite their professional expertise and managerial skills, they, like the Logans, realize that bringing in outside help can be a good idea. To help their small chain meet their profit goals they have adopted some hi-tech, high-touch services provided by PrescribeWellness. 

Jonathan said he believes that helping keep patients’ adherent is not only an important professional obligation, but he points out that adherence is also a critical component of a pharmacy’s STAR rating. To effectively improve adherence for thousands of patients, Jonathan explained, you need to know exactly who is and who isn’t adherent and have cost effective and patient friendly ways to encourage nonadherent patients to pick-up their refills. 

The Marquess’ were early subscribers to PrescribeWellness. Jonathan said the service interfaces with their pharmacy management system and carefully analyzes a patient’s prescription profile and identifies people with prescriptions ready to be refilled but that have not yet requested them. 

The service then provides a report that can be reviewed, modified, and approved by the pharmacist or key staff member. When approved, the system makes automated calls to the selected patients. The service tells the patient, in a HIPAA compliant manner, that a person at this number has a prescription eligible to be refilled.  The message, recorded in the voice of the pharmacists, allows the patient to request the refill right then, or to dial 1, and be automatically connected with the pharmacy to talk with a staff member.   

Jonathan noted that the system provides a dashboard showing how many calls went out and how many people responded by requesting and then picking up their refills. This makes it easy to know if the service is generating enough extra revenue to offset its cost. 

The Marquess’ are advocates of medication synchronization and use the PrescribeWellness platform to more effectively manage this service. They say Medsync helps improve productivity, which provides them with time to interact with patients. Additionally, Jonathan said, the combination of their refill reminder, MTM, medsync program and other professional services improves adherence which, in-turn improves their STAR Ratings. 

In mentioning STAR Rating, Jonathan noted, “Some PBM’s have DIR fees, and your STAR rating determines your DIR fee. The better the rating the lower your DIR fees.”  

As I talk with pharmacy owners and managers, I am struck by how often they mention the problems they face with third-party prescription plans, egregious audits, and the negative effects of DIR fees. Yet, when queried, they have no plan for moving forward other than hoping legislation will be passed that corrals the PBMs.  The good news is I also meet owners who are working with innovative companies that have new products, effective programs or innovative services that address these issues, and when implemented make it possible to their pharmacy to be profitable.   

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