Once again, community pharmacy has been asked to stretch, bend, and flex as the healthcare industry continues to experience dramatic change. Just as it has done in years gone by, community pharmacy has responded. We’ve seen community pharmacy positively transform the status quo of healthcare across the nation by building healthier, more adherent patient communities. 

With 35 patient touches each year, community pharmacies are responsible through the services they provide for influencing patient behavior. Their adherence initiatives result in a more educated, more motivated patient that is more likely to exhibit compliant behavior and improved adherence to prescribed medication. 

And as their role continues to tilt toward the role of provider, we expect this trend of building healthier patient communities to continue.

Uncharted Territory

Community pharmacy is now entering uncharted territory with performance networks, accountable care organizations (ACOs), and PBMs that are more focused on outcomes than just finding the lowest cost provider. 

Health plans have to pay attention to the impact pharmacists have on the pharmacy measures that affect their star ratings. They will be looking to collaborate with networks that can deliver positive patient outcomes. The better a pharmacy’s performance metrics, the more likely a plan will want to contract with them.

With ACOs entering the equation, additional responsibilities and opportunities are surfacing for community pharmacy. They will be looking at pharmacies based on performance and expanded patient care services. Pharmacies that don’t advance patient care could fall out of consideration for ACOs seeking collaboration. 

There’s Good News

The contracts PBMs have with payers will now include performance clauses. Millions of dollars have already been lost due to poor performance. Millions more are at risk. We know the PBMs will shift that risk in new contracts with pharmacy services administrative organizations (PSAOs) and preferred networks. While on the surface it may seem to be simply another opportunity for PBMs to grab more share of the revenue, the opposite is true. This is good news for community pharmacy. PBMs now have to concern themselves with finding pharmacies that can deliver quality, not just pharmacies offering the lowest price. 

This year’s NCPA Convention was filled with meetings on star ratings, quality, pay-for-performance, and what it means to be a high performing pharmacy. One thing is clear: the shift from fee-for-services to performance-based incentives is undeniable. 

In this new, not too distant future where the focus on patient outcomes is king, the first step is to recognize that these quality measures are of utmost importance. The encouraging news is that there are affordable solutions that fit seamlessly into a pharmacy’s workflow and handle the hard stuff. With resources like these, a pharmacist can improve the adherence of every patient without adding additional staff. 

At PrescribeWellness, we are arming PSAOs, group purchasing organizations (GPOs), and community pharmacists with the tools to streamline patient engagement and deliver better outcomes. We believe that the community pharmacist delivers the best patient care and we are excited to provide the tools and analytics to prove it. PrescribeWellness has proudly served the community pharmacist for years and built innovative solutions that empower them to be profitable, successful business that are creating healthier, more adherent patient communities.

Al Babbington is President and CEO at PrescribeWellness. Learn more about PrescribeWellness.