How forward-thinking pharmacies are preparing to win in the new marketplace
By Crystal Lennartz, PharmD, MBA
Health Mart’s Chief Pharmacist
- The shift to value-based reimbursement is expanding from Medicare to other payers.
- With prescription margins falling, pharmacies must focus on revenue opportunities they can control.
- Innovative pharmacies are finding new ways to generate revenue and be paid for the services provided.
The speed of change in healthcare has greatly accelerated over the past four years since I joined Health Mart®, and the pressure is mounting to evolve the independent pharmacy business model. Monetary incentives around improving quality and decreasing cost are driving a lot of the momentum behind the change. Undeniably, prescription gross margins have been impacted and there is an increased focus on pharmacy performance around key quality and operational measures. AccessHealth® reported 41% of Medicare Part D claims now have some type of performance-related payment associated with them, and the impacts have started to expand into Medicaid and commercial claims.1
There has also been an increasing number of independent pharmacies looking to impact their gross margin, gain incremental scripts and improve adherence by implementing med sync and enrolling a majority of their patients who are on multiple chronic meds. The biggest challenge across the board has been the change management required with people, processes and technology — engaging the whole pharmacy team, changing workflow-related processes and implementing new technology. Millions of community pharmacy patients are now benefiting from med sync, but that’s not where the change needs to end.2, 3, 4
It expands beyond that to leverage our strong relationships and engaging the patient during pickup, offering additional revenue-generating services and partnering with local providers. The good news is you don’t have to navigate all these changes alone.
Health Mart’s new Pathway to Better Pharmacy Performance and Profit℠ is a five-step approach to help independent pharmacies make the necessary shifts to evolve your core business model.
- Understanding the challenges and opportunities is critical to planning. Overall, healthcare reimbursement is shifting from a transactional, pay-for-products or services model to value-based reimbursement. We have started to see that in Medicare, and it’s expanding into commercial, state Medicaid and other payers.
We began talking about this shift in the industry and key pharmacy quality ratings in Town Hall meetings three years ago, and we’re continuing to help pharmacies improve clinical performance through the Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP™), courses on Health Mart University℠, and more. Today over 40% of Health Marts are Top 20% performers in one or more pharmacy quality measures, which is important for ensuring access to lives and improving revenue.
When you understand the issues, you can set short- and long-term goals to grow your business.
- Monitoring clinical and financial performance allows you to identify trends and take action. To make that easier, myHealthMart℠ is a new online portal that enables owners to easily see your data, programs and insights in one place, as well as access Health Mart resources.
- Adopting a med sync program is an area where some pharmacies have made a shift, in their pharmacy operations as well as clinically and financially. Most pharmacies have implemented med sync, and reaching a higher number of patients makes a difference in improving efficiency, quality measures and profits. (Visit the Medication Synchronization Education Center.)
- Engaging patients during pickup requires identifying patient- and community-specific needs for products and services, and optimizing the front end. That brings additional revenue beyond the increased refills of med sync. We’re adding support for these efforts.
For example, our Vaccine Starter Kit and collaborative practice agreements help owners easily add vaccine services. In almost every state where a collaborative practice agreement is required, we provide a template agreement and a physician for signature, as sometimes finding a local physician can be a barrier to getting started.
- Building deeper partnerships with providers and payers requires pharmacies to demonstrate your value.
That’s what Towncrest Pharmacy in Iowa did, as the first pharmacy in a pilot with Wellmark. Now it is among hundreds of pharmacies, including other independents, that are paid both for the prescriptions they fill and for a higher level of services. (Read about Towncrest in “Be a Top-Performing Pharmacy on Star Ratings Measures: Make Every Encounter Count.”)
Health Mart and you — better together
For more than 30 years Health Mart has been dedicated to helping progressive, entrepreneurial pharmacists build a name for themselves in their communities. Today, we’re America’s largest network of independent pharmacies with more than 4,700 locally owned community pharmacies across all 50 states.
As we look at the future of independent pharmacy, know that you don’t have to go it alone. Our team of experts shares almost 400 years of collective experience in the areas of pharmacy operations, clinical performance, managed care and marketing. Together, we help our members navigate the complexities of a rapidly changing healthcare market. Building on the strength of McKesson’s distribution services, we enable independent pharmacies to grow their business and realize a more successful future.
Meet Crystal Lennartz
Crystal Lennartz is the chief pharmacist for Health Mart, McKesson’s independent pharmacy franchise of more than 4,700 stores. She has over 16 years’ experience working in or on behalf of community pharmacy, the last four in clinical and operational development roles with Health Mart.
“Health Mart has grown by over 50% in the past three years, and I’ve had an opportunity to grow with it,” Lennartz said.
While earning her PharmD and MBA degrees from Drake University, she had an opportunity to shadow an independent pharmacist. “That was my first time seeing the important role independent pharmacies play, working with individual patients and in communities,” Lennartz said.
“It seemed like no matter who came in, the pharmacists and staff knew their name and their family medication history. The pharmacy was engrained in the community and they gave back,” she said.
After graduation, Lennartz completed a community pharmacy residency program looking at how to integrate patient care services into the pharmacy.
When joining Health Mart, Lennartz was attracted to the entrepreneurial spirit. “I liked that Health Mart had a national strategy, but each individual pharmacy decides what to implement, so they can move a lot quicker.”