Two experts shared best practices for operating a pharmacy convenience packaging service with attendees of the National Community Pharmacists Association (NCPA) 2019 Annual Convention in San Diego, California, on Sunday, October 27.

During the session, “Expanding the Market for Your Packaging Services,” Susan Rhodus, RPh, senior vice president for contract administration at Gerimed, talked about the opportunities for pharmacists in the at-home-care market, which is growing dramatically, because baby boomers do not want to go into long-term-care facilities. At-home care is part of long-term care (LTC).

These at-home-care patients “are underserved from a pharmacy aspect. They need your care,” Rhodus said.

Five million people are homebound, she said, and 10,000 people are turning age 65 years each day.

Those confined to their homes “are the ones who are going to the hospital the most. They’re falling the most. They’re the ones who need extra services, and they aren’t getting them,” Rhodus said.

By law, a nursing home has to be affiliated with a pharmacy to get Medicare or Medicaid, and 97.2% are affiliated with a pharmacy, she said, citing CDC data.

But just 4.9% of home health agencies are affiliated with pharmacies, creating a huge opportunity for pharmacists in that segment, Rhodus said.

One of the biggest issues with medical at-home care, however, is determining who qualifies, according to presenter Steve Adkins, PharmD, owner of Health Park Pharmacy in Raleigh, North Carolina.

If a patient cannot walk into a pharmacy and get medications and take them appropriately themselves, cannot walk into a pharmacy unassisted and get the services provided, or has a caregiver administering their medications, he or she should qualify for medical at-home care, Adkins said.

“Have a checklist to figure out whether your patients are qualified,” Adkins added.

In addition, the Centers for Medicare and Medicaid Services (CMS) has a list of 10 services required for Medicare Part D LTC qualification, so it is important to make sure that a pharmacy can meet these requirements to serve these patients. One of the 10 requirements is providing special packaging.

The National Council for Prescription Drug Programs has added a new Level of Service code to support pharmacies providing special services to medical at-home patients. This level of service,  07, for medical at-home with special pharmacy services is identical to LTC beneficiaries, with the exception of emergency kits. Pharmacy benefit managers (PBMs) have to agree to adding this designation and any changes in contract payments for this new level of service. PBMs pay at retail rates for patients served in their homes.

Medical at-home pharmacy services are important, because of adherence, better quality of life, compliance, a decrease in admissions to hospitals and visits to emergency departments, a decrease in admissions to assisted-living facilities and nursing homes, and lower health care costs for complex chronic care patients.

Better quality of life is a way to reach patients.

“When you’re doing motivational interviewing with patients, you need to hone in on this,” Adkins said, adding that it is important to use a life event to light a fire with patients, such as being able to attend a child’s wedding.

In terms of packaging, “medical reconciliation is key,” Adkins said. “Med [synchronization] is a must. If you aren’t doing synchronization, there’s no way you can do packaging. Sync is the cornerstone of all this.”

Adkins said that once a pharmacy starts to market the packaging, bring in providers and communicate with them.

In addition, “I would never recommend doing this on a large scale without some kind of quality assurance” related to packaging, Adkins said.

Finally, it is important to work with community partners and ask them questions, such as how many employees they have, and what their pain points are, he said.

Adkins said he strongly recommends doing ride-alongs with nurses and members of the sales teams, sit in on clinical meetings, and be accessible if they need to reach out.

“Make it as easy as possible for them to get those patients to you.” he said.


RELATED ARTICLES

REFERENCE

Adkins S, Rhodus S. Expanding the Market for Your Packaging Services. Presented at: National Community Pharmacists Association (NCPA) 2019 Annual Convention. San Diego, California; October 27, 2019.