Adherence: A New Strategy for New Times

Pharmacists can drive results related to adherence by offering patients new services and solutions.

Pharmacists are among the most trusted professionals in the country, but until the recent focus on adherence they haven’t been getting paid for it. Gallup regularly polls Americans on how they rate the honesty and ethical standards of people who work in various professions, and pharmacists consistently take one of the top 2 positions.

Pharmacists have long been patients’ trusted advisors, a virtual “information desk” on all matters related to drug therapies, nutrition, and wellness. They are easily accessible, don’t require an appointment, and patients know that they care about health outcomes. Yet pharmacists were conspicuously absent in shaping the Affordable Care Act (ACA) that is transforming how we do business in health care.

It is a dynamic we’ve seen before. Ten years ago, American politicians debated making drugs more affordable for consumers, and some encouraged patients to travel to Canada—even busing them across the border to get them to pharmacies there. Many patients brought home drugs with the same name as the one their doctor prescribed, but manufactured with different strengths or used to treat other conditions. American pharmacists picked up the pieces, counseling patients on drugs they didn’t dispense.

And pharmacists, for all their long hours and hard-won victories on the front lines of patient care, seemed to take all of this in stride. So as health care providers apply the provisions of the ACA and shift their focus to adherence as a key driver of patient health, it’s no surprise that people are turning, once again, to the trusted professionals in white coats behind the pharmacy counter to help make things better.

Independent pharmacists are uniquely positioned to drive results related to adherence. Their intense focus on personal relationships with patients comes naturally. It is their passion for helping people that inspired them to pursue pharmacy. That focus is also the key to driving patient outcomes with adherence programs.

When we founded Parata 12 years ago, our early customers were independent pharmacists who were eager to adopt technology that would change the way they did business and allow them to spend more time with patients. Today is no different, only now we work with thousands of pharmacies across all market segments—national and regional pharmacy chains, military, institutional, hospital, and community pharmacies.

So it hasn’t been surprising to us that independent pharmacists are the ones quickly stepping up to adopt technology that will enable them to impact adherence. As we work with them, we offer this advice for growing their businesses with adherence programs:

Look at your product and service offering. The health care game is changing. It’s time to develop a smart strategy. Independent pharmacists already provide great service; it’s their sweet spot. But when they turn a complex problem like a bag of prescription vials into a simple solution, like a strip package with a patient’ s daily medications collated by date, time, and dose—now that's a game changer.

Entrepreneur and author Seth Godin calls such a product the “purple cow in a field of brown cows.” It’s a product that can make a pharmacy stand out in a crowd of other excellent pharmacies because it’ s remarkable and worth talking about.

Another high-value offering is medication therapy management (MTM). Recent US House and Senate bills would increase the number of Medicare Part D beneficiaries who qualify for one-on-one counseling sessions with a licensed pharmacist to include any patient with a chronic condition. So MTM is about to get more profitable for pharmacies who have the time to provide it.

Secure your patient base. For most pharmacies, 10% of their patients account for about 50% of their revenue. They are the chronically ill patients who take more than 5 medications a day. They’re also the patients payers are targeting for fast savings. It’ s critical for independent pharmacists to retain those high-value patients with adherence products and services that make it harder for them to walk out of their pharmacy and into another one down the street.

Considering that almost half of consumers use more than 1 pharmacy, and strip packaging aggregates prescriptions, pharmacists who use it can grow their business and have a greater impact on patient wellness with increased visibility. They also can create a built-in refill program and pick up an extra fill a year, since most patients don’t refill on time.

Seek out strategic partnerships. Simply follow the money to identify the providers who make the best partners; they are the ones who have the most to lose on hospital readmissions. They are ACA’s target to bring health care costs under control. One in 5 Medicare patients are readmitted to the hospital within 30 days, costing taxpayers $17 billion a year. On average, half of those patients do not take their medications as prescribed.

Hospitals place high value on health care providers who help them prevent readmissions and bring costs down. Physicians started half of the Medicare-approved accountable care organizations (ACOs), which are provider partnerships that tie reimbursements to patient health outcomes and successful cost reduction measures.

Smart pharmacists are working with insurance companies, physicians, employers, and home health care agencies to target entire patient populations, like a virtual ACO. When a pharmacy provides a service or product that makes it easier for patients to adhere to medication regimens, the pharmacy becomes a valuable partner for other health care providers seeking to contain costs. We’ve heard from several of our customers who were delighted when insurance companies called them to report that their dispensing fees would increase because they were using strip packaging.

Measure outcomes. The pharmacies that can account for measurable impacts on patient health outcomes will emerge as industry leaders in the next 36 months. Many schools of pharmacy are interested in partnering with health care providers to measure the impact of medication therapy changes. Bob Lomenick, owner of Tyson Drug Company in Holly Springs, Mississippi, is a Parata customer who uses strip packaging as the cornerstone of his adherence program. He’s working with a research team at the University of Mississippi School of Pharmacy to track outcomes, with great results. Bob not only secured his patient base, he doubled his prescription volume within 1 year of offering the product. Now, he’s engaged with an insurance company to prove outcomes and capture thousands of patients.

Health care is changing fast. At Parata, we’ve seen these changes on the horizon and made big changes of our own to respond to them by preparing our team to become consultants to pharmacists who want to grow their businesses and succeed in the next generation of health care. We’ve brought on a team of industrial engineers who are Six Sigma Lean certified in health care to help pharmacies optimize their labor and work flow processes and get more for their automation investment. We’ve also raised the bar on technical support training, so we can help busy pharmacies resolve issues in minutes over the phone, for maximum uptime.

It’s our passion. We want to see pharmacists get paid for keeping patients healthy. It’s what has inspired them since pharmacy school. No wonder they are among the nation’s most trusted health care professionals.

Tom Rhoads is chief executive officer of Parata Systems, one of the nation’s leading pharmacy automation providers. For more information, visit www.parata.com. Parata has partnered with Pharmacy Times for the Next-Generation Pharmacist^TM awards program, now in its fourth year. For more information, visit www.nextgenerationpharmacist.com.