Maintaining a thriving independent pharmacy requires strategic thinking and innovative approaches to increase revenue. There are lots of ways to boost those numbers. Some are obvious like "expand your clinical service offerings" or "leverage technology" to up your med sync game, for instance, or even launch a mobile app to make it easier for patients. But thinking outside the proverbial box has never been more critical (or easier).
On the technology front, Raj Chhadua, PharmD, managing partner at ReNue Apothecary GP, PLLC, and Max Anderegg, PharmD, MS, head of clinical programs at DocStation, will cover how streamlining their medical billing processes optimized their revenue streams. How? In their session Medical Billing in Action: A Case Study on Maximizing Revenue (Tuesday, Oct. 17 at 10:30 a.m.) they will talk about why improving operational efficiency and enhancing patient care through effective medical billing practices and technological integration wasn't just easy for them. It was necessary. Common billing practices like data entry conversion and order management were not just taking up hours, they were taking up mental space, too, for two busy pharmacists trying to juggle 200 or more prescriptions each day.
Telehealth is a dimension of the revenue conversation. In their standing-room-only session, Telehealth, Pharmacist Billable Services, and Lessons Learned from a Project with a National Payer (pictured), Cindy Warriner of CPESN Virginia and Kristi Fowler of UnitedHealthcare presented an innovative CPESN pilot project with UnitedHealthcare, showing how pharmacies in Virginia are improving access to care for Medicaid patients and increasing sustainable revenue streams in the process. The pilot program, which could be a blueprint for national expansion, pays pharmacists for certain medical services such as patient evaluation and management and point-of-care services rendered. Pharmacies are also providing needed access to other members of the health care team via telehealth services available to UnitedHealthcare members.
"I think it's really important that the provider has the value of the clinical expertise of the pharmacist on site. We are seeing that in places where pharmacists are doing a comprehensive assessment and are able to provide information to providers, increasing collaboration and creating trust," says UnitedHealthcare's Fowler.
"This is an example of the next phase of care, so don't be afraid to make that change," says CPESN's Warriner. "Everyone knows workflow in a pharmacy can be a challenge, and there are a few places in the workflow that cannot be touched by a certain three-letter acronym fee, so that means this can be a sustainable structure for your pharmacy."
There are some less obvious ways to boost revenue, too, on tap at the 2023 NCPA Annual Convention. If you and your team are already educating patients with diabetes on managing the disease state and monitoring progress, billing can be a real nightmare when trying to tie provider-like services performed by a pharmacist to the billing identifiers of a pharmacy.
Travis Wolff, PharmD, BCACP, president of PharmFurther, has been helping hundreds of pharmacies troubleshoot billing issues and get paid for diabetes self-management education. In his session, Demystifying Payment for Diabetes Education to Go from Set Up to PAID UP (Tuesday, Oct. 17 at 1:45 p.m.), he will pull back the curtain on what DSME really is, the necessary logistics to get paid for your services, common hurdles experienced and how to avoid them, and how it can fit into your existing pharmacy workflow. Whether you want to start DSME or are stuck in claim rejections, this session is for you and your team to secure non-dispensing revenue.
Another less obvious way to improve revenue? Long-term care at home services. Lindsay Dymowski, cofounder and president of Centennial Pharmacy Services and LTC@Home Pharmacy Network, has been successfully providing medical-at-home services to her complex patient population for more than five years. It's an important revenue stream, she says, and it's made her profitable, too.
Saturday, in her session titled Your Step-by-Step Guide to Launching a Long-Term Care-at-Home Program Dymowski discussed how to qualify patients for LTC services, the differences in billing community versus long-term care, preventing audits, and how to avoid DIR fees while boosting the bottom line and helping serve the LTC community.
"Providing long-term care at home is essential for patients, enabling those dealing with chronic illnesses or aging in place to receive specialized pharmacy care in the comfort of their home," says Dymowski. "For pharmacies, diversifying into LTC-at-home services can be a profitable decision, allowing them to bill under an LTC NPI for qualified patients, which increases revenue opportunities."
No matter how inventive pharmacists become in securing new revenue streams, there will always be a standard set of concerns around revenue for their businesses (or any independent businesses). Lately, that's meant inflation, interest rates, and supply chain challenges, but in a broader and historical sense, that's always meant getting the dollars in the door—also known as cash flow—and getting the word out on the street—also known as marketing and visibility.
Still, pharmacy's future seems brighter than ever because it's easier than ever to tap into (and operationalize) a lot of the innovative ideas featured at the 2023 NCPA Annual Convention. All you have to do is attend with an open mind.
