A Model for Modern Pharmacy Billing and Payments in Long-Term Care Centers

Nearly 80% of consumers think of their pharmacists as a trusted source of care, and in long-term care (LTC) centers, where patients’ health needs are often complex, pharmacists spend time developing relationships, making them a vital resource.1 For this reason, it’s critically important that the billing and payment experience complement this relationship, providing an easy and simple way to pay one time or monthly, depending on the type of care.

But too often, the final aspect of patient billing—payment—comes about in a clunky and disjointed fashion, which can ruin the overall patient experience. It’s a challenge that can’t be solved simply by making the switch to a digital-first form of payment, like text-based notifications that payment is due. Instead, a beneficial approach takes into account the look and feel of communications, how and when messages are delivered, and the ease of setting up an automatic payment or simply pushing a button if the card is already in the system.

Understanding the Role of Pharmacy in LTCs

Most pharmacy providers that service an LTC aren’t owned by the LTC. Instead, they have a business relationship with the facility that allows them to deliver and dispense medications, review medication history and care regimens, and provide specialized services such as infusion therapy. Often, pharmacists will also help patients select the plan that best meets their needs and will work with insurance companies, Medicare, and physicians to ensure medications are covered.

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But patients in LTCs often associate these pharmacists with the facilities they serve. So, when a bill arrives with the name of the company they represent—say, XYZ Pharmacy—this often causes confusion for patients or family members paying the bills, who are left wondering, “Who is this?” That’s especially true when the company doesn’t have a storefront presence, making the brand name much more unfamiliar.

Pharmacy providers that cater to LTCs can lessen confusion for patients by ensuring the design of billing statements makes it immediately clear, that the pharmacy partners with the LTC to deliver services. They can also work with the organization’s leaders to determine: What are the administrative pain points that the pharmacy can help solve? And, how can they support better experiences for patients and families through back-end education and service?

It's an important question as the need for LTC pharmacies rises, and as seniors or their children who are paying the bills become more open to digital communications and mobile account management.²

Adopting a More Modern Approach

Just as pharmacies that service LTCs lean into smart technologies for syncing and packaging prescriptions and automating medication administration, so, too, must they adopt technology-enabled tools for patient financial care. Here are 4 places to start:

1. Look for ways to surround the entire payment experience with automated support. For instance, patients might need to sign a consent form to participate in electronic billing notifications from an LTC business partner. Rather than sending a PDF via email and requiring the patient to print it out and sign it, consider establishing a mobile-first process that guides patients through an easy-to-complete, digital form that encompasses all the permissions needed to connect with patients once insurance has paid its portion.
2. Ensure text-to-payment or email communications are co-branded with logos for the pharmacy and the LTC. This helps eliminate confusion regarding who sent the bill—and that strengthens pharmacies’ ability to capture timely payment.
3. Make it easy for patients to view their bill—not just their balance—and pay. The best electronic platforms send patients a secure link that automatically takes them to their bill, without the need to log onto a patient portal or remember their username and password.They also provide the ability to set up autopay or keep an active card on file for one time purchases.
4. Demonstrate an understanding of your audience in developing your communications approach. For example, what is the patient’s past history of medical payment? Which patients are most likely to respond to digital payment—and how quickly do they tend to do so? These data will inform how you communicate with specific populations. For instance, if there is a high likelihood that a patient will not pay the amount owed after insurance, a pharmacy may choose not to send multiple communications.

By elevating patient billing and payment to match the quality of one-to-one pharmacy care, LTC pharmacies can elevate the pharmacy’s brand and establish a feeling of trust at each point of the patient encounter.

About the Author

Pete Heydt is president of PatientPay.

REFERENCES

1. Wolters Kluwer. The evolving role of pharmacists: Bridging the gap in healthcare access and patient care. October 20, 2023. https://www.wolterskluwer.com/en/expert-insights/evolving-role-pharmacists-bridging-gap-healthcare-access-patient-care

2. Pharmacy in Long-Term Care 2024-2025 Report. AM Intelligence. 2024. https://accessmarketintell.com/product/pharmacy-in-long-term-care-2024-2025-report/