Paige Clark, RPh

Seeing more cash-paying customers at your counter? This scenario may be on the uptick as more employers offer high-deductible health plans (HDHPs). As patients continue to look for savvy ways to save money on their prescriptions, community pharmacists need to be ready with a cash-price solution that keeps price-sensitive customers happy without hurting the bottom line. Here’s what to look for in a cash-pricing solution.

HDHPs are on the rise and customers are looking for alternative payment methods.

 found a 13% increase in people on HDHPs in recent years. That means more pharmacy customers are paying attention to cash prices of their medications. An HDHP is treated as a distinct health plan in which more costs are paid out-of-pocket (the deductible) before the plan starts to cover eligible costs. The IRS sets minimum deductibles to define an HDHP; 

 in 2022 is $1400 for an individual and $2800 for a family.

And yet studies have shown that actual deductibles can 

regularly be more than $4500 for a family

—significantly exceeding those minimums.

The rise of HDHPs could increase the need for a solution for cash-paying customers. A recent survey on consumer attitudes toward prescription medication found that 

 had asked for the cash price at the pharmacy counter—even though they had insurance. And even with that insurance, 

66% of respondents thought they paid too much

. Clearly, customers are likely looking for ways to save money, and that could mean paying with cash or popular savings cards.

Cash cards and coupons can hurt the pharmacy bottom line.

Many patients have likely turned to popular prescription savings cards, such as GoodRx, to offset the high cost of drugs and their deductibles. But as so many pharmacists know, these cards can hurt business.

Many cash card programs charge a processing fee, which can take a big bite out of pharmacy profits, particularly for smaller, independent shops. And as some pharmacists and pharmacy owners 

, when Surescripts and GoodRx announced a partnership, coupon programs “

allow PBMs (pharmacy benefit managers) to enter the cash-paying market

,” working within a system that has been accused of obscuring the real cost of drugs.

Taking the guesswork out of cash pricing will help pharmacies succeed.

But how to find a solution that works for you and your customers? Look for the following attributes:

, below $1 per transaction/claim, charged only for paid claims with no additional reversal or hidden costs for the pharmacist.

 that provides competitive pricing for patients while 

 for patient data through technologies such as blockchain.

As consumers continue to look for ways to save money on their prescriptions and shop for alternative ways to pay, it’s essential that pharmacists have a cash-pricing solution. It’s just one more way that pharmacies can engage customers, win over new ones, stay profitable, and continue to provide the essential community support that only trusted pharmacists can offer.

Paige Clark, RPh, is the VP of Pharmacy Programs and Policy at 

, overseeing the company’s policy work to drive awareness, utilization, and scope of trusted independent pharmacists nationally. Prior to Prescryptive, Paige spent 11 years at Oregon State University's College of Pharmacy, driving policy initiatives for the state’s licensed pharmacists, including the prescribing of birth control and tobacco cessation services. Paige also worked as the Staff Pharmacist Consultant for the Oregon Board of Pharmacy, managing rule writing, legislative endeavors, and regional and national policy work. She is a frequent speaker and presenter at national industry conferences and a multi-award winner, including several Pharmacist of the Year recognitions.

High-Deductible Health Plans Continue to Grow in Popularity, but Are They Right for You?

, Value Penguin by Lending Tree, accessed March 17, 2022.

 Healthcare.gov, accessed March 17, 2022.

High-Deductible Health Plans and Access to Prescription Medications

, PAN Foundation, accessed March 17, 2022.

Consumers in Pain Over High Prescription Prices, Ready to Take Action and in Need of Better Tools, According to Survey by Scripta Insights

, PRNewswire.com, accessed March 17, 2022.

Independent pharmacists sound the alarm on Surescripts, GoodRx partnership

, mobihealthnews.com, accessed March 17, 2022.

Copy of letter to Surescripts Boardmembers

, medcitynews.com, accessed March 17, 2022.

Articles

Customers are looking for ways to save money on prescriptions, but cash cards and coupons could hurt your bottom line. Here’s how to find a sustainable cash-pricing solution that works for you and your customers.

High-Deductible Health Plans Mean More Cash-Paying Customers for Prescriptions: Here’s How to Find a Cash Solution That Works

It may seem like folly to try to predict the future; however, if the COVID-19 era has taught us anything, it’s that things can rapidly change. But it’s always a good idea to be prepared for whatever may come next. If I had some kind of “Magic 8 ball” for pharmacists in 2022, here’s what it would say.

1. Prepare for the continuing expansion of scope to meet public health outcomes

Nobody can argue that pharmacists are among the most 

 medical professionals. And with 90% of Americans living within 5 miles of a pharmacy, we are also some of the most accessible, supporting underserved and rural areas.

That accessibility makes us key players in public health outcomes. COVID-19 changed our role in this arena, and in 2022, the trend should continue, with the expansion of clinical services to patient populations seeking more convenient and timely access to acute care services, such as 

In both cases, some states already allow pharmacists to prescribe these services, and that may expand in 2022 as more legislators recognize the power of trusted community pharmacists who regularly see patients, perhaps even more often than their primary care providers. And if we can connect 

 into the process, the outcomes for public health will be tremendous.

No matter what, the drumbeat of pharmacists pushing to work “

” will continue, with various testing, prevention, and treatment of acute minor ailments coming live. We pharmacists have to be ready with 

2. Keep up COVID-19 clinical services—uncertainty will continue

No 2022 forecast would be complete without COVID-19 in the mix. Pharmacists will continue to play a key role in testing and vaccinations, with additional complexities with 

. And with possible variants and waves still coming, there’s no clear view on how COVID-19 will continue to impact public health.

One opportunity for pharmacists is COVID-19 treatment. Unvaccinated rates 

, and COVID-19 contraction is still a reality throughout the country. Pharmacists can help fill the void to treat it.

, licensed pharmacists can administer monoclonal antibody treatment, and pharmacists should prepare for the opportunity now with 

. With the possibility to help patients on 3 fronts in the COVID-19 pandemic—prevention, testing, and treatment—pharmacists will continue to prove their impact in communities nationwide in 2022.

3. Look for Artificial Intelligence (AI)-driven technologies to change the pricing landscape

What connects the expanding role of pharmacists and our immense expertise? Technology. With digital solutions that streamline our business and help us connect with patients, the opportunities for pharmacists become almost limitless.

One such technology is AI. Hearing the term may conjure images of robots in a scene from a science fiction movie, but the technology is real and its implications are powerful, especially when applied to prescription drug pricing.

AI can ingest enormous amounts of information, analyzing for trends based on any number of inputs, including location, demographics, seasonality, and, in the case of prescription drugs, therapeutic type and usage. Applying intelligence to the guesswork of drug pricing can increase profitability and efficiency for America’s pharmacists while still balancing what patients want and need.

In 2022, I think we’ll see more talk of how technologies such as AI can help usher in a new era for community pharmacists.

As always, patient care is at the center of everything we do.

No matter what the new year brings, patient engagement and care will be top-of-mind for all community pharmacists. And though it may sound counterintuitive, technology can help here, too.

Digital solutions are available to connect pharmacists and patients in meaningful ways, offering new opportunities to help new patients, which is always the goal.

Public Views Pharmacists as Trusted Professionals with High Levels of Virtue, 

Pharmacists Are Needed to Provide Birth Control, 

US Senate Joins House in Sponsoring Legislation Expanding Medicare Access to Pharmacy Services, 

Why Pharmacists Need to Practice at the Top of Their Licensure, 

Pharmacists Must Digitize Business Now to Keep Up With Changing Patient Needs, 

For Pharmacists, COVID-19 Holiday Safety Preparation Has Already Begun, 

Federal Mandates for COVID-19 Mean Enhanced Inventory, Scheduling: What Pharmacists Need to Know, 

States ranked by percentage of population fully vaccinated, 

PREP Act: Pharmacists Can Administer COVID-19 Therapeutics, 

Administering COVID-19 monoclonal antibodies, 

Technology, COVID-19, and scope expansion—here’s how pharmacists can capitalize on opportunities coming in the new year.

Three Big Opportunities for Pharmacists in 2022

The holiday season is upon us and this year, pharmacists will play a key role in helping patients prepare for COVID-safe travel and celebrations. This is a good time for pharmacists to do some initial checks and pre-holiday planning to make sure you are ready for the coming weeks.

With the CDC’s announcement on the availability of the Pfizer-BioNTech COVID-191 vaccine for children 5 to 11 years of age, pharmacists have a new patient demographic. For many pharmacists, this is the first time that they will be actively treating this age group and there are some easy steps to take to make the transition easier:

: Make the treatment space both private and child-friendly. Posters, art, and other eye distractions can help with the experience.

: Given the nature of the pandemic, children are better versed in COVID-19 and how it is treated. They will likely have questions about the vaccine and its effects, and time spent answering these questions will lead to a good connection and a more comfortable patient.

: Children like a marker to show an achievement and the COVID-19 vaccine is a big one. A sticker or other item that shows their participation will lift spirits and underscore the message that vaccines are important.

Get the vaccination and other scheduling lanes ready

The children’s vaccinations add 2 more “lanes” for scheduling appointments in the form of first and second vaccine doses for children 5 to 11 years of age to the pharmacy offerings. This group requires both the specialized vaccine dose and smaller needles for children.

They join adults and older children getting first and second vaccines, those receiving booster shots, and those who have special doses due to health conditions. Pharmacies should plan to add these new scheduling lanes to those already in place, tracking for dosages and timing.

The new offerings are a good time to check for all supplies, such as tests, personal protective equipment supplies, as well as review reporting and documentation strategies. Do you have a seamless means to track upcoming appointments, show which vaccines that have been given, and produce records for patients?

Technology can help streamline these records and reporting, and now is a good time to look at your system with a view to upgrade to more features. Patients are looking for vaccine records to be made available electronically, ideally stored on their phones. A good record-keeping system will allow this option.

Prepare for an increased demand in rapid testing

The CDC’s recommendations for this year’s holiday season include avoiding gatherings if you might be ill, especially given the presence of people who are not fully vaccinated.

Pharmacists should anticipate customer demand for rapid testing to make sure that no one in their party is at risk. Making patients aware that these tests are available is another good step for informed, safe health.

Spread the holiday cheer and the information

Similar to the booster availability, the new vaccines will require explanation. Pharmacists should prepare for these scenarios and get ahead of the process by assembling FAQs and other material available at the counter or online. Some areas to consider for information:

When will my children be fully vaccinated?

Do we need masks if everyone is vaccinated?

Are there plans for children’s boosters?

Do we still need to social distance in public?

2021 will be remembered as the year that pharmacists came into their own nationally dispensing certain therapies and treatments, including tests, vaccines, and monoclonal antibody therapies. COVID-19 treatment is expected to continue through the next year, at least, and pharmacists should be ready to keep the communication and connections with their pharmacists active. Holidays are a good time to connect with patients in a way that keeps the COVID-19 health conversation going into 2022.

 overseeing the company’s policy work to drive awareness, utilization, and scope of trusted independent pharmacists nationally. Prior to Prescryptive, Paige spent 11 years at Oregon State University's College of Pharmacy, driving policy initiatives for the state’s licensed pharmacists, including the prescribing of birth control and tobacco cessation services. Paige also worked as the Staff Pharmacist Consultant for the Oregon Board of Pharmacy, managing rule writing, legislative endeavors, and regional and national policy work. She is a frequent speaker and presenter at national industry conferences and a multi-award winner, including several Pharmacist of the Year recognitions.

COVID-19 Vaccination for Children 5 through 11 Years Old. CDC. 

https://www.cdc.gov/vaccines/covid-19/planning/children.html

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays/celebrations.html

The time is now for pharmacists to do some initial checks and pre-holiday planning to make sure they are ready for the coming weeks. 

 For Pharmacists, COVID-19 Holiday Safety Preparation Has Already Begun

Remember the big, boxy, snail-slow computers from the early days? If you had told me back then that someday, the processing power on those computers would fit into the palm of my hand, I probably wouldn’t have believed you.

But as modern pharmacists, we know that our patients and their needs have changed. Now they do everything on their phones and if we want to keep up—if we want to keep new patients coming through our doors—we must adapt our business to the new reality.

Any change can feel overwhelming, particularly when community pharmacists are overworked by the challenges of COVID-19. But there’s never been a better time to harness the power of digital technology.

Our scope of practice is expanding. That opportunity comes with complexity.

The COVID-19 pandemic has changed the role of the community pharmacist. More people are seeing their local pharmacy as a destination for essential care. Through the 

, long-standing restrictions on the ability of pharmacists to order and administer diagnostic tests and treatments have been lifted.

Pharmacists have filled the void in this public health crisis, distributing tests, vaccines, boosters, and in many cases, 

, to help chart a path out of this pandemic.

And there’s evidence that this expanded scope may be here to stay. Additional legislation has been introduced in Congress that would give 

, especially in critically underserved areas.

The opportunities for pharmacists to step into new areas are immense. And every opportunity comes with complexity—to a pharmacist’s schedule, logistics, and working system.

The benefit of digital workstreams is that they are seamless and secure—perfect for the complex system of vaccines, tests, and treatment scheduling that community pharmacists will continue to face as scope expands.

With an all-in-one system, patient generation, scheduling, operations, and logistics get easier. Including automatic billing and payment completes the workflow. When paperwork and patient records are digitized on a secure system, work happens faster. A digitized system allows pharmacists to truly work top of license.

And it helps pharmacists be paid appropriately for their work. As the scope of work expands, pharmacists can use best practices from 

 to streamline complicated procedures and maximize profitability to ensure that pharmacist-provided clinical services thrive and expand.

It is also worth considering that reporting requirements are expanding. As the COVID-19 pandemic goes on, reporting of test results to relevant agencies will remain a priority. Rather than doing this complicated step by hand, the right all-in-one system will handle the reporting digitally, further freeing up pharmacists to focus not on paperwork, but on what matters: patient care.

Patients will go where they can find secure digital solutions.

 a smartphone, it’s undeniable that handheld technology is fully integrated into our society. Patients want to conduct their pharmacy business on their phone, just like they order take-out or a taxi. Mobile solutions for patient engagement are the future for pharmacists and the future is here, now.

But patients want security in their solutions. 

Half of Americans have decided not to use a product or service because of privacy concerns

. When adapting patient engagement efforts to the digital age, a system that’s not just HIPAA-compliant but also secure is essential to maintaining patient trust.

The complexities of COVID-19 remain, and new legislation may bring new opportunities for pharmacists. The time is now to upgrade to a digital workflow solution that brings in new customers while making the day-to-day work more efficient.

Just as we couldn’t know that the power of a bulky desktop computer would one day be eclipsed by a more powerful yet smaller device, we can’t know what the future holds for our patients and for our business. But we can prepare now, with digital solutions, more streamlined work, and more ways to serve more patients in mind. To harness the power of that opportunity, we must digitize our business.

1. Pew Research Center, “Mobile Fact Sheet,” survey of U.S. adults conducted Jan. 25-Feb. 8, 2021. Accessed Sept. 28, 2021. https://www.pewresearch.org/internet/fact-sheet/mobile/

2. Pew Research Center, “Half of Americans have decided not to use a product or service because of privacy concerns,” 2020. Accessed Sept. 28, 2021. https://www.pewresearch.org/fact-tank/2020/04/14/half-of-americans-have-decided-not-to-use-a-product-or-service-because-of-privacy-concerns/

The COVID-19 pandemic and the rapid digital adoption of mobile devices have changed the role of the community pharmacist.   

Pharmacists Must Digitize Business Now to Keep Up With Changing Patient Needs

announcement of the most comprehensive, mandated COVID-19 vaccine

 and testing program to date has the health care community taking notice and starting to plan. For pharmacists, these directives offer both challenges and opportunities for their practices.

The challenges lie in offering added COVID-19 services—should the FDA eventually approve 

Pfizer and Moderna booster shots for the general population

—as well as third shots for immunocompromised during the traditionally busy flu season. However, the added activity also offers opportunities for pharmacists to engage with their communities for better health as well as realize additional revenue from these services.

The pathway to success lies in having robust inventory, scheduling, reporting, and community communications systems in place.

Inventory planning may bring back memories of spring 2021, when the different vaccines first became available and the need for testing waned in many places. This time, the inventory needs are more complex.

Pharmacists will need to know the exact amounts of Pfizer and Moderna booster dosages if they are eventually approved, as well as track third shots for those eligible. They will also need to monitor the stock of COVID-19 tests for the expected demand from consumers and to meet Biden’s requirements for employers.

Pharmacists will also need to make sure they have the necessary personal protective equipment in place to meet increased clinic activity and should do this while keeping an eye on levels of flu vaccines and tests, which will also be in demand. The best bet is to determine what you have, put in measures to get the supplies that you need, and be vigilant in monitoring.

In a nutshell, scheduling will be more difficult because different people will need boosters or third shots of different medications at different times. You will also need to account for on-demand and planned COVID-19 tests. For most pharmacists, the solution will come from extending your current scheduling system to include booster/testing information and instructions on how to make appointments.

Ideally, the system will allow you to send electronic results/receipts directly to the patient for their records, having scheduling and results in one system. Scheduling could also bring opportunity to provide group services given the broadening of vaccine and test requirements.

Pharmacists can and should look to partner with schools and employers with more than 100 people to offer services in a convenient setting.

Similar to scheduling, reporting will have added complexities because of the different doses and the need to report greater numbers of test results. Pharmacists should be used to more intensive reporting, given the guidelines issued on June 4 by the US Department of Health and Human Services (HHS) for COVID-19 testing. The HHS asked for pharmacists to capture complete demographic information and report test results daily.

Ideally, pharmacists will be able to extend their current reporting capabilities to absorb the increased activity and additional tracking. Pharmacists can include more intensive questionnaires to help with patient monitoring and reporting.

In addition, pharmacists may be able to use their reporting systems to help employers, who will be required to submit test results to the federal government. Smaller employers, especially, may not have adequate reporting systems in place and would benefit from a pharmacist partner.

 poll, people in the United State rank pharmacists among the most honest and ethical professionals. The general public, in addition to having a high level of trust and comfort with pharmacists, also have more contact with pharmacists than with other health care professionals.

Pharmacists should expect and prepare for an influx of patient queries regarding third shots, including which dose they should get and when, whether there are efficacy differences, and what are any possible adverse effects. These patients will also want to know the best way to show employers and others that they are in compliance with the vaccine doses and/or show the results of COVID-19 tests.

Being prepared for these questions with materials that provide answers is one way to meet the demand. Having patient data included in their scheduling communications is another.

For example, the messaging to the patient could inform them that they are eligible for a third shot at this time, and the plan is to give the same booster as the first 2 shots for added efficacy.

Having a quick “what you should know” leaflet—either electronic or printed—to review prior to the service will also help.

Meeting the increased activity with the confluence of flu season and the ongoing pandemic will require planning, patience, and a commitment to productivity. The good news is that pharmacists are trained for situations such as these and have the ability to adapt to complexity.

COVID-19 requires pharmacists to practice at the top of their license, which the community has proven they are enthusiastically able to do.

, is the VP of Pharmacy Programs and Policy at Prescryptive, overseeing the company’s policy work to drive awareness, utilization, and scope of trusted independent pharmacists nationally. Prior to Prescryptive, Paige spent 11 years at Oregon State University's College of Pharmacy, driving policy initiatives for the state’s licensed pharmacists, including the prescribing of birth control and tobacco cessation services. Paige also worked as the Staff Pharmacist Consultant for the Oregon Board of Pharmacy, managing rule writing, legislative endeavors, and regional and national policy work. She is a frequent speaker and presenter at national industry conferences and a multi-award winner, including several Pharmacist of the Year recognitions.

President Biden's COVID-19 Plan | The White House

Pharmacists Remain Among Most Trusted and Ethical Professionals (pharmacytimes.com)

Booster Shots and Third Doses for COVID-19 Vaccines: What You Need to Know | Johns Hopkins Medicine

Pharmacists will need to make sure they have the necessary personal protective equipment in place to meet increased clinic activity and while keeping an eye on levels of flu vaccines and tests.

Federal Mandates for COVID-19 Mean Enhanced Inventory, Scheduling: What Pharmacists Need to Know 

Biden administration for booster shots to combat COVID-19 

follows an earlier recommendation of a third shot for the immunocompromised and is a call to action for pharmacists to get ready for the upcoming flurry of activity.

Keep these organizations in your back pocket

The FDA and the CDC are both great go-to sources for what is actually happening health-wise, especially in terms of COVID-19 developments. Similarly, the National Community Pharmacists Association and the American Pharmacists Association are excellent sources for pharmacist-specific news. At the same time, keep an eye on the general news because this is what your customers are watching or reading.

 that the COVID-19 vaccine efficacy weakens in 3 months under Delta. For people without a health care background, this news could serve as a signal to jump ahead and try to get their booster shots.

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, has done associated 

 appearances recommending that 8 months after the second short is the proper time to get a booster to augment coverage. You can reference Fauci’s comments while explaining the complexities of immune response to your customers, as well as how the general media may unintentionally generalize situations (for those who are especially eager).

We know that as pharmacists, we are among the most trusted health care providers. This is the time to think about how to market your services to your customer base so they know that you are an option for these services.

Letting your customers know how they should plan for a booster shot is a good starting point. You should also be prepared for questions such as timing, whether they need to stick with the same vaccine, and any known adverse effects to keep the important flow of communication going.

This is also the time to check on your stock of vaccine doses, testing supplies, and personal protective equipment. The amounts you used in the spring with an eye toward expanded volume of immunizations of both flu and COVID-19 vaccines should provide a good indication of what you may need in the coming weeks.

Given the different levels of reporting required with COVID-19 and the flu, this is an excellent opportunity to make sure your scheduling and tracking systems are doing what you need them to do. Expect your COVID-19 vaccine scheduling solution to accommodate multiple doses.

Perhaps we will see a smaller dose for younger patients or potentially a booster dose that varies from the original dosing at the same time you continue to give first and second shots to patients just getting immunized. Things may become more complex to manage, especially when this all coincides with a booster dose for certain immunocompromised people.

How you track each appointment will play into how you later report the activity. Also, can your system work well for you and the community? Expect groups to want to schedule booster shots in tandem, so look to ensure that you have a system that can handle this. 

Throughout the COVID-19 crisis, pharmacists have been the shining stars in keeping communities informed and healthy. This next phase is an excellent chance to cement that relationship with your patients and your community. 

, is the VP of Pharmacy Programs and Policy at Prescryptive, overseeing the company’s policy work to drive awareness, utilization, and scope of trusted independent pharmacists nationally. Prior to Prescryptive, Paige spent 11 years at Oregon State University's College of Pharmacy, driving policy initiatives for the state’s licensed pharmacists, including the prescribing of birth control and tobacco cessation services. Paige also worked as the Staff Pharmacist Consultant for the Oregon Board of Pharmacy, managing rule writing, legislative endeavors, and regional and national policy work. She is a frequent speaker and presenter at national industry conferences and a multi-award winner, including several Pharmacist of the Year recognitions.

Biden Announces COVID Vaccine Booster Shots for All Americans | Voice of America - English (voanews.com)

British study shows COVID-19 vaccine efficacy wanes under Delta (msn.com)

COVID-19 booster shots, hospitals being overrun addressed by Dr. Anthony Fauci (msnbc.com)

As variants swirl, document what you do and why you do it | NCPA

This week’s recommendation by the Biden administration for booster shots to combat COVID-19 is a call to action for pharmacists to get ready for the upcoming flurry of activity. 