Pharmacists and owners know about DIR fees and the dangers it means for retail pharmacies. But for most of the world, the term “DIR fees” sounds like another industry buzzword. One of our PDS members, Traci Shell from Corner Drug Store in North Carolina sent us a summary that was so spot-on and well written, we had to share it.
BONUS: Look below for an easy download of this summary and a breakdown of DIR fees per PBM.
You can share this with…
- The team at your next team meeting (that’s what Traci did!), so they can stay current with the issues your pharmacy faces and understand that the goals you set are around combating these fees. Read below to learn how pharmacies like you are making them irrelevant.
- Elected officials so they can begin to comprehend the plight of the independent. The more they understand the gravity, the greater the chances to spur legislation that drives real change in the industry.
What are DIR Fees?
DIR stands for Direct and Indirect Remuneration. In a nutshell, these are fees paid back to the PBM (pharmacy benefit manager) after the point of sale transaction or time of adjudication. Fees are typically collected at the time of third-party payment. However, some are taken far past that date. The fees discussed below and detailed on the second page only apply to Medicare Drug Plans.
What Does this Mean for Independent Pharmacies?
What makes DIR fees so “dangerous” is the fact that they are not easily identifiable at the time a claim is processed. This pain point is exaggerated by the fact that these fees vary by not only the PBM, but by the drug, the pharmacy, and by performance.
It’s not expected for EVERYONE to know EVERYTHING about these fees. However, it is crucial that their existence is acknowledged. Each day we encounter low or below-cost reimbursement by PBMs. We are forced to determine how little we are making on that claim or how much we are losing.
The Problem with PBMs
Many times, a prescription is sent through under the assumption that we’re “only losing $2,” or, “at least we’re making $1.” The problem with this thought process is a failure to calculate in the DIR fee the PBM will expect to be paid. Often after assessing the estimated DIR fee, that small “profit,” is now a loss.
Up until this point, most were completely unaware of these fees. While DIR fees have been around since 2006, it wasn’t until 2013 when they began to show up in PBM’s pharmacy contracts. Since that time, DIR fees have gradually grown, evolved, and become the monster we can no longer hide in the closet.
How Independent Pharmacies Can Combat DIR Fees
While this summary may seem dark, there is hope! Pharmacies just like you around the country are discovering ways to undermine the cost of these fees on their business. It's not luck that makes a pharmacy successful. It's not even one single strategy, applied well. It is a combination of unique variables that sparks the development and profitability of your pharmacy while providing a system to sustain the growth.
After 20 years, and through a relentless mission to help pharmacies maximize their potential, PDS has identified these 4 "it" factors for pharmacy success.
Your business is nothing without a high-performance team to align with your vision as a leader. Too often, owners are mired in the chase for more profits that they forget the bedrock of their business: their people. A successful owner sets forth a plan to hire and train the right people and focuses on culture to engage their team. You will be unstoppable with an empowered staff that is powering on all cylinders. Keep in mind, people work harder when they know they are valued, appreciated, and set up for success.
Pharmacy owners too often think that the variable to achieve pharmacy profitability is volume. They would be mistaken. Long gone are the days when pharmacies have to settle for every prescription that walks through the door. It is vital for owners to shift their mindset on what will move the needle in their business. For example, ask yourself which prescriptions are making the most money? The least? It’s critical to identify where you are making money - and doing more of that - and where you are losing money - and doing less of that. Your success should not be measured by script volume, but rather, profit per script. Would you rather fill 100 $4 prescriptions or four prescriptions with a $100 profit each? Which requires more effort?
This is only one of the many ways to impact your profitability. PDS has identified many ways to increase your profits. Find out more here.
Resting on your past successes is a prescription for failure. Doing something because you've always done it will cost you valuable time, money and resources. Ask yourself: is every corner of your business operating at peak performance? Auditing how your pharmacy works, from your workflows to your inventory will show you the changes you need to make to maximize efficiencies in your pharmacy. Do your employees adhere to structured systems and processes that set them up for success and smooths operations? Do you have a handle on your inventory so you're not allowing any stockpiling? Are you managing your will-call bins? Do you have expired or dead products? These are all questions to ask yourself as you look around your pharmacy.
Every corner of your business can benefit from a good audit. The key is to audit consistently and implement process change swiftly before you lose any more valuable resources.
Pearson's Law: Everything measured improves, and everything measured and reported on improves exponentially.
This factor in pharmacy success is all about numbers. Understanding your numbers will help you identify and set your goals and listen to what the data is saying to make informed decisions. It's how you measure whether or not your pharmacy is on the right track towards achieving your goals. Are you financially literate? Do you know how to read, understand and interpret your financial statements along with other pharmacy data to help you make better management decisions, course-correct and seize opportunities? If this is an area in your pharmacy you are falling behind on, it's vital for you to secure the right tools and resources to help you become literate in your business so you can measure profitability and growth in your pharmacy. (Hint: PDS can help!)
Download the DIR Fee Summary and Estimate Cost per PBM
Fill out the form below to download the summary and don't forget to share it with your team and your elected officials!
Success doesn’t just happen; it is something that you must work towards daily. PDS has been serving independent pharmacy industry for 20 years this May. In this time, we have consistently recognized four business principles adopted by the most successful pharmacy owners. These principles have also helped to define PDS' success over two decades of business. Whether you're celebrating 20 years in business or opening your first pharmacy here are the four essential pieces of the puzzle you should keep in mind on your journey.
Commitment to Adapt
Running a successful pharmacy business means making (and keeping) commitments to not only yourself but the employees, patients, and customers that rely on you. Saying "I want to improve" is easy. Keeping the commitment to learn and adapt is tough. Don't just download the eBooks or attend training; invest time every day to put new knowledge into practice.
Pharmacy Development Services has been working with independent pharmacy owners for 20 years. One of our most impactful revelations is when we identified our brand promise.
1. Earn your investment back as quickly as possible.
2. Multiply that return as often as possible.
3. Make your life easier.
4. Make your business better and more valuable.
This isn’t just a motto; it became our driver in everything we do. Every day we come to work with the purpose of delivering with each member interaction.
A competitive edge in the market isn't a given, and we've already talked about the commitment to adaptability. Relying on the program you implemented two years ago to keep you relevant won't work. Pharmacy entrepreneurs need to understand and anticipate the needs of their community. The ability to innovate and solve problems creatively is what will determine the collective success of our industry.
The core of our commitment is innovation. In 2016, we introduced the RxAnalytics
dashboard. The first of its kind, this service helped members to track and optimize their prescription profit margins from month to month. This February at PDS2018, we unveiled the next generation of RxAnalytics. Our program now boasts real-time data function and identifies opportunities with granular specificity. At PDS, innovation is about empowering owners to improve their business without sacrificing exceptional patient care.
Be Humble (Don’t be the smartest person in the room)
It is easy to think that you have all the answers after a few wins, but it is also dangerously short-sighted. Top-performers in any industry realize that there is always more to learn. The big question should always be "What can we collectively do to keep moving forward?"
How to Avoid 'The Smartest Person' Mentality
Once you are a part of the PDS community, you’re among friends. We are a network of entrepreneurs with a laser focus on finding what works for our industry. From RxAnalytics to the PDSadvantage, our goal is to connect and empower pharmacy owners. Sharing knowledge, providing support and encouraging conversations are mainstays of PDS culture.
Leading a Strong Team
Effective leadership is one of the most elusive aspects of running a business because people are complicated. There is a formula to building and keeping a strong team aligned to your pharmacy's mission. Business is the ultimate team sport. You'll find a plethora of advice on leadership, but we believe it can all be distilled into the three points below.
Key Elements of Leading Your Best Team
In the next 20 years, the only thing that matters, regardless of industry, is how people felt when they were with you. Whether it is securing the long-term viability of your pharmacy or building a stronger industry, your legacy is defined by the position your people are in when you aren't around. Are you leading a team of mission-aligned doers or will it all crumble if you're not there to guide them? The mission at PDS is to create something meaningful for OUR industry to reminds us that independent doesn't mean alone.
Pharmacy Owners: Adapt or Go Home
This is the critical mindset that we write about in our 2018 Pharmacy Industry White Paper. This free download will show you what you should be doing NOW to make sure your pharmacy not only survives but thrives.
Read this state of the industry as soon as you’re able so you can learn how to:
In early April, the Wall Street Journal published an article that featured PDS member and multi-store owner, Cliff Holt of Hurricane Family Pharmacy. Cliff’s is one of the many companies taking advantage of the new tax deduction for pass-through businesses. These companies make up the majority of U.S. businesses and include entities like sole proprietorships, partnerships, and S-corporations. Pass-throughs are aptly named because profits essentially “pass through” to owners and are taxed at the individual level, instead of paying corporate taxes plus individual taxes on top of that after money is distributed to owners.
We’ll get into how pharmacy owners are using this new deduction below. Let’s unpack this a bit more.
What is the New Tax Code?
This new deduction effectively lowers the maximum individual income tax rate for millions of business owners from 37% to 29.6%. One of the caveats that come with this break is that it is not available for higher income professional services. There is a taxable income threshold of $157,000 in individual income or $315,000 for those filing jointly.
How are Businesses Using It?
Many businesses who have reached the income threshold have been getting crafty with how they make their business qualify for this deduction, outside of increasing their charitable and retirement-plan contributions thereby reducing their taxable income. A new method has emerged that will allow these businesses to expand the reach of the new tax code.
This new method is often referred to as the “Crack and Pack,” and involves separating their business into different entities to be able to claim the deduction on one part of their business that does not reach the threshold, thereby effectively benefiting from the break. If businesses can restructure themselves that disrupts their operations in a relatively minor way, this 20% tax break would be a powerful benefit.
What Does This Mean For Pharmacy Owners?
Showing the ingenuity and willingness to jump on opportunities that is common among high-performing PDS members, Cliff Holt has joined those businesses who have taken on restructuring to leverage this deduction. Cliff owns four pharmacies that get more than 90% of their revenue from selling medicines, nutritional supplements, gifts and other retail products. However, his pharmacies provide exempt health services (flu shots and vaccinations) and also employs two registered nurses, so his business would miss out on the 20% deduction. Unwilling to take the all-or-nothing approach, Cliff was able to restructure his business into two companies so he can continue providing health services and enjoy the benefits of the new tax code.
Cliff’s tax advisor, Tom Wheelwright of WealthAbility LLC in Tempe, AZ and featured repeat PDS Super-Conference speaker, is optimistic that the IRS will allow pass-through businesses to claim the deduction even while a small amount of their revenue comes from health or other excluded services. Tom, himself, has recently split his own CPA business from his education business to take advantage of the new 20% deduction.
It must be noted that this method isn’t for all pass-through businesses. Some find that the cost of restructuring alone outweighs or marginalizes the tax benefit. Also, this deduction expires in 2025 but could be exposed to legislation that will aim to reduce or eliminate this gain.
You can find the original Wall Street Journal article here.
Adapt or Go Home
As a pharmacy owner, Cliff has adapted to the changing pharmacy landscape and leveraged his opportunities to take back of his business what others would give away.
This is the critical mindset that we write about in our 2018 Pharmacy Industry White Paper. This free download will show you what you should be doing NOW to make sure your pharmacy not only survives but thrives. Read this state of the industry as soon as you’re able so you can learn how to:
- Offer better patient care
- Have more professional fulfillment
- Obtain higher profits
- And, increase the valuation of your business.
Click here to access the Pharmacy Industry White Paper Immediately.
Operating a successful pharmacy takes more than the mastery of a single clinical or business skill. The complexity and evolution of the industry have made it so extended hours or higher prescription volume are not enough to drive impactful pharmacy growth. Between declining reimbursements, ambiguous DIR fees, and a competitive pricing environment owners are faced with unique roadblocks not found in other industries. The surest approach to staying competitive is to hone skills that make you and your business better. So, where do you start? Which business skills are the most relevant to successful pharmacy ownership? We’ve got that answer!
Below are the four business skills we frequently see in the most successful independent pharmacy owners.
Business Skill #1 – Facing Failure
Pharmacy Owners: Learn to Fail
Failure may not seem like an indicator of success or a business skill but accepting unexpected outcomes with grace forges resilience. What matters the most is your reaction and next steps when the disappointment from a loss still stings. Do you throw your hands up and move on or do you analyze what went wrong and try to figure out how to improve the situation? Experiencing failure makes you a more resourceful, flexible and empathetic leader. The most successful pharmacy leaders respond with an open mind; choosing to see the moment as an opportunity for growth.
Business Skill #2 – Grit
Build a Thriving Pharmacy Business in the Face of Adversity
Regardless of industry; the top performers have grit. Though often intangible, it is an easy trait to recognize when someone possesses it. Passion, determination, and motivation to achieve is a unique and undeniable combination. With the state of the industry and the challenges pharmacy entrepreneurs face, grit is a requisite for creating sustainable growth in your pharmacy. Unfortunately, over time and in the face of industry roadblocks — it can fade. Surrounding yourself with passionate and like-minded colleagues while building an empowered and mission-aligned pharmacy team can make all the difference when the going gets tough.
Business Skill #3 – Develop Meaningful Mentorships
Pharmacy Mentors: Independent Doesn’t Mean Alone
Experience is a pricey and critical asset when it comes to running a pharmacy. Clinical skills aside, becoming an entrepreneur requires a business education that most pharmacy schools don’t have in their curriculum. Forward-thinking pharmacy owners must be proactive about gaining this knowledge.
With the pharmacy industry in constant flux, the concept of mentorship is ever more critical for success.
At PDS, we believe that when independents share insight into what works and what doesn’t with a trusted network — our collective strength to influence change and affect the future of our industry increases exponentially. Learning to grow and leverage a trusted network is a business skill that cannot be overlooked.
The Value of Mentor Relationships
New pharmacy owners benefit from the wealth of knowledge that only comes with years of running a business. Long-time owners benefit from new information and different perspective of a younger generation. Mentorship a two-way street and both parties need to keep a few things in mind to create a mutually beneficial dynamic.
- Be Clear. Define and refine your goals, whether you’re writing a call agenda or setting quarterly objectives.
- Give As Much As You Get. Bring enthusiasm and energy to your sessions.
- Stay Mindful. The advice you give will be taken to heart. If you’re venturing into unknown territory; don’t pretend to be an expert.
- Drop the B.S. Embrace candor within your mentorship. Honest feedback leads to real improvement.
Business Skill #4 – Maintain an Innovator’s Mindset
Meet Challenges with Innovation
Identifying areas to innovate should be a regular part of your business strategy. These opportunities can manifest in many ways. The employee that oversees your medication synchronization program may have ideas on how to add more patients to the program. A vendor you work closely with can introduce you to a new technology that changes everything. Keeping an “innovators mindset” is a critical business skill.We are all familiar with the saying,
“If you are the smartest person in the room, you’re in the wrong room.”
As a business leader, you must see and nurture the value that your network brings to the table. Including your pharmacy team and trusted colleagues in this process will amplify your success.
We can’t buy Aetna; we can’t merge with Target. But if we unite on a few key fronts, you are going to see an entirely different industry, ripe with opportunities. Read our latest white paper that outlines a Strategy for Independent Pharmacy to save itself. For 20 years, Pharmacy Development Services (PDS) has been helping thousands of owners across the country shift their business into high gear. We know firsthand what it takes to keep you operating at the top of your license.
As we near the end of the first quarter, it’s time to pick your head up from the trenches and take a moment to look around your pharmacy. Take inventory of your four walls and everything in it. What do you see?
Look at your team. Do you see a team that bickers with each other, or do you see a team who works together to accomplish a singular mission? Do they have a purpose in their everyday duties with measurable goals and milestones, or are they running through the motions of daily operation?
Now look in your store. Take inventory of your endcaps, your checkout counters, carpets, uniforms… Are they clean and orderly?
What you see right now is what your patients see when they walk through that door. Making small, incremental changes throughout the year to address cosmetic, structural or operational issues will compound to large wins by the end of the year.
The idea is not to be consistently perfect, but to be consistently better.
Instead of making unattainable promises to yourself, your business, your employees, and your patients resolve instead to do small, minor adjustments to your everyday routine that will become powerful catalyst for lasting growth.
That’s why, instead of making grand resolutions this first quarter, make a simple commitment: “I am going to do something every day to make my pharmacy better.”
Below are four simple habits you can implement to upgrade your 2018:
Detox Your Workplace Culture
If you want to make this the best year yet, you can’t do it alone. You need to rely on your team to help your patients, fill prescriptions and rise above the petty bickering that can often bring teams down.
While complete culture change is often a long, tough road, the process must start at the top with simple first steps.
Catch your employees doing something right. As owners and managers, we are too often fixated on recognizing everything employees do wrong. Before we realize it, only negativity comes out. To reverse this, aim to create a culture of positivity by recognizing an employee for a positive action every day. Let an employee know in a simple handwritten note that she did a good job with a patient that day or say thank you for covering for her sick coworker. You can spread positivity and encouragement in just two minutes every day. Just one action a day can have a long-lasting effect.
Spring Clean Your Pharmacy
Every day, countless feet walk around your pharmacy. The look and smell become background white noise that you and your team no longer notice. However, that isn’t the case for your patients! Trust us; they notice the stain on the ceiling or the faded sign on the front door and, yes, your worn-out carpets.
While a full remodel may not be possible or even needed, you can do some spring cleaning! Some examples of fast, easy improvements can be:
- Moving OTC products around to new locations
- Purchasing new waiting area chairs
- Placing fresh daily hours stickers on the front door
Small and inexpensive changes like these can give a whole new look to your pharmacy and a new appreciation by your patients.
The role of pharmacy owner is stressful and tiring. It is often too easy to ruminate on only the challenges and roadblocks you experience. Gratitude, as simple as that sounds, can rewire you to become a more positive person. Taking a moment to appreciate something each day can boost your happiness and productivity. You can do this on your own, by thinking of 3 things you are thankful for every night before bed. You can also include your team and share positive stories at the end of the day, instead of just focusing on daily frustrations.
Set SMART Pharmacy Goals
Most of us familiar with goal-setting realize that broad goal statements don’t translate into accomplishments without some heavy lifting and correcting course at least once. Specificity is critical when it comes to getting goals across the finish line. SMART goals are:
Instead of saying I want a better year, you should say “I want to make $50,000 more in profit in 2018,“ or “I want to attend all of my son’s football games this season.“
When you have a clear vision of your goal, you are more likely to achieve it. Encourage your employees to do the same for themselves, both personally, and professionally. If you’re not sure what is achievable in your pharmacy, we invite you to speak with one of our account executives that can share with you what other pharmacy owners have achieved in a single year.
Applying incremental and impactful changes will add up to major wins by the end of the year. Regardless of the changes you implement; the point is to keep moving, consistently aim to improve and take quarterly reviews of your pharmacy.
Launch Your Pharmacy to Amazing Heights in 2018
Want to learn more about what you should be focusing on in 2018? Watch the PDS 2018 Super-Conference recap video below for the 5 Key Takeaways from the conference and the strategies you should set your sights on to make this year the best your pharmacy has seen yet.
Here at PDS, we take pride in highlighting some of our incredible solutions partners. We know these companies have the potential to revolutionize pharmacies just like yours through their products and services. We’re excited to introduce RxSafe; read on for their sponsored blog post about a new approach towards inventory management.
Inventory is typically the largest asset in a pharmacy. Bottles on the shelf and vials in the refrigerator represent real money, cash just sitting there. For that reason, keeping inventory at an optimal level—not too much, not too little—is one of the best ways to ensure that your investment is being managed in the most efficient manner. If you can reduce your inventory without affecting customer service, it can free up cash that can be used for other money generating activities.
Reaching the Benchmark
One measure of a pharmacy’s inventory efficiency is to track how often the business ‘turns’ its inventory. According to America’s Pharmacist, May 2016, twelve inventory turns per year is often the benchmark for a well-run pharmacy. Inventory turns can be calculated by dividing the total annual cost of goods by average inventory value. But, capturing a current, accurate snapshot of this information is a moving target due to constant price changes and the need for frequent cycle counting which is tedious and often neglected.
Consider the case of Paw Paw Pharmacy in Paw Paw, Michigan. In 2016 they had a $50,000 decrease in inventory levels which totaled $80,000 in savings and their inventory turns increased by 6+ turns per year. What happened? Perpetual inventory management with accurate, automatic cycle counting—made possible by installing an RxSafe 1800.
Imagine a future where, on a daily basis, you could capture cost information for every NDC in your pharmacy, and track it to each bottle. On top of that, you could have item-level forecasting and item-level tracking, including historical cost data available on demand, 24/7. How much could you reduce your on-hand inventory, improving inventory turns and free up excess cash without the burden of frequent cycle counting? Wouldn’t that be a level of inventory management unheard of in the industry?
Welcome to the World of RxCloud Analytics
The latest innovation in RxSafe’s line of pharmacy automation technology is RxCloud Analytics™. Powered by Datarithm, it provides pharmacy owners using the RxSafe 1800 system with 24/7 cloud-based analytics. With RxCloud Analytics, your pharmacy can spend time and money on something other than inventory management.
This type of item-level cost tracking provides extremely accurate cost of inventory, as well as granularity about inventory valuation, which has never been possible before. Some RxSafe customers are already taking advantage of the data made available by the RxSafe/Datarithm partnership.
At Chris’ Pharmacy and Gifts, an independent pharmacy in Maruepas, La., owner Chris Williams, RPh, says, “RxSafe’s solution has been very valuable, especially for multiple stores. The program’s non-usage report will effectively indicate what medications we should send to our other locations or what medications to return to the wholesaler — as opposed to letting the medications sit on the shelf just waiting to expire.”
“When we began this partnership, our goal was to combine Datarithm’s sophisticated inventory modeling with RxSafe’s proven automated perpetual inventory accuracy, to eliminate cycle-counting, free up cash, and allow pharmacies to focus on their core business,” said William Holmes, President & CEO at RxSafe. “With RxCloud Analytics, we’ve done just that. What’s more, the combination of these two technologies has created a game-changing model that improves service delivery and profitability in pharmacy.”
RxCloud Analytics is available exclusively to customers that have qualifying pharmacy management systems. Currently, that includes ComputerRx, PioneerRx, and Rx30, and will soon include Liberty.
RxCloud Analytics is included with the purchase of an RxSafe 1800. We will be happy to set up an in-person or online demonstration of the RxSafe 1800. You can also check out the details here for more information and to view video testimonials from independent pharmacy owners currently using the RxSafe 1800 in their retail stores.
About the Author:
RxSafe is the leader in automated, high-density robotic storage and retrieval technologies for independent pharmacies. Our flagship RxSafe system enables pharmacies to take control of their inventory management, enhance patient safety, increase narcotics security, and improve profitability. RxSafe’s RapidPakRx adherence packaging technology enables pharmacies to custom package patient medications on demand. RapidPakRx produces multi-med pouches with unprecedented throughput, accuracy, and efficiency, as well as the lowest consumables cost in the industry. For more information, visit www.rxsafe.com. To stay connected, follow RxSafe on Twitter, LinkedIn, and Facebook.
Our friends at NCPA are making great progress in their never-ending efforts to advocate for the independent pharmacy industry. In this newsletter from NCPA’s CEO, Doug Hoey, they are highlighting some great work done with the Arkansas Pharmacists Association (APA) in the battle against Pharmacy Benefit Managers (PBMs). Great job, Arkansas!
Sometimes it’s hard to believe your own eyes.
That had to be the reaction from many in the room at a press conference held by the Arkansas Pharmacists Association this week when they heard of a $484 difference between what a Caremark-administered plan paid a community pharmacy for a 30-day supply of aripiprazole versus what it paid itself!
For years, community pharmacists have suspected that chains, especially CVS/Caremark (since it is a price giver and a price taker as a PBM and drugstore chain), are reimbursed more for prescriptions than community pharmacies are. The example shared with Arkansas legislators, patients, and pharmacies this week was eye-popping even as it verified our suspicions, and mind-boggling for the legislators and patients in the room who, directly or indirectly, are paying that whopping difference.
The aripiprazole example wasn’t an outlier, either. Scott Pace, the APA Executive Vice-President, and CEO held up a folder with 270 more examples of self-dealing. On average, he said, those examples showed a difference of over $60 more per prescription being paid to CVS than was being paid to community pharmacies!
So far, there is no word from Caremark on these payment discrepancies. And, no word from other mega-PBMs so far suggesting that they don’t follow the same practices.
Arkansas has an active state association, very active pharmacist members, and has historically been very politically active, making sure to sustain relationships with their local legislators. Couple those strengths with the extreme payment cuts to local pharmacies and this new information about inflated payments to out-of-state competitors, and you have a firestorm.
Local news stations covered the press conference, and the entire event was posted on Facebook. The governor has called a special session, and Arkansas Attorney General Leslie Rutledge is investigating the low reimbursement rates:
“The change in reimbursement rates by the Pharmacy Benefit Managers has hurt Arkansans in every community across the state,” said Attorney General Rutledge. “Local pharmacists are critical members of Arkansas’s communities. Due to these changes, pharmacists are facing tough decisions because the reimbursements do not cover the actual cost of the medications. When public health is threatened, all Arkansans suffer.”
Even before these latest examples, evidence has been piling up indicating that PBMs are contributing to the increasing costs of prescription drugs rather than saving their customers (employers and local, state, and federal governments) money. I’ve written here about this issue a couple of times already this year (Jan. 19, “A Coincidence That May Not Be a Coincidence,” and Feb. 9, “Let the Sun Shine In”). These revelations coming out of Arkansas show a proverbial henhouse that is being raided rather than guarded.
The payment discrepancy information revealed at this week’s press conference will reverberate through many state houses. It looks to any reasonable person that local pharmacies are being forced to subsidize higher payments to CVS pharmacies. Couple that with solicitations from CVS to buy the same pharmacies they are reimbursing below the cost of the drug, and it paints an ugly picture that should be of great interest to federal and state legislators and regulators.
Arkansas isn’t the only state where pharmacies—at least community pharmacies—are seeing extreme cuts in prescription reimbursements and are responding with legislative action. In fact, almost every state has introduced PBM legislation this year. The new, specific information about the yawning gaps between payments to community pharmacies and to CVS should make those statehouse debates even more compelling.
Pharmacists in Arkansas have joined hands and raised their voices. If you have been quietly rooting your own state on, now is the time to stand up, take part, and open the eyes of your state officials.
Pharmacy Owners: You can join the conversation and connect with like-minded independent pharmacy owners in our industry only message board. Click and be a part of the elite knowledge-sharing culture that has become synonymous with Pharmacy Development Services.
If you’re a pharmacy owner and you missed the 2018 PDS Super-Conference, you left vast opportunities to grow your pharmacy on the table. That is the truth, plain and simple.
There were over 2,000 in attendance including the most progressive owners and professionals in the independent pharmacy industry. All of them piqued and ready to engage in the knowledge-sharing culture that has become synonymous with Pharmacy Development Services. Let’s break down PDS 2018.
Who Attends PDS’ Premier Pharmacy Business Conference?
To sum it up, they are life-long learners. Registering for a conference is easy, showing up is the next step, but it doesn’t guarantee value for your investment. Pharmacy owners that leave with new business insight and a clear understanding of what needs to be done once back at the grindstone have a singular quality that makes the difference between being in attendance and being truly present and engaged.
In the words of our leadership keynote speaker; they are ‘Learn-It-Alls.’ Our most engaged attendees and successful members understand that…
- There is hope and opportunity to grow in the independent pharmacy industry. Owners get frustrated by challenges facing their pharmacies such as DIR fees, below-cost reimbursements, and PBM abuses. Through thoughtful and active participation, the learners quickly realize that there is a way to make those issues irrelevant. Opening up to a new way of thinking allowed them to leave the show understanding that opportunity is right around the corner (and ready for the taking) when they focus on the factors within their control.
- They are not the smartest person in the room. As Dan Benamoz is fond of saying, if he thinks he is the smartest person in the room, he’s in the wrong room! The people who attend are the top-performing owners in pharmacy who continue to climb because they know that they discover more growth by learning from each other. The PDS Learners ask questions, try new things, and empower their teams. The result is a thriving culture with an inspired pharmacy team operating at the top of their pharmacy license.
- There is no competition among independents. We have a culture within the PDS membership that no independent competes with another. The heart of our mission is the idea that we lift each other up to reach new heights of success. After all, the more we help others, the greater our success will be. This credo is palpable at the conference, with so many of our attendees connecting and fostering beneficial relationships with each other.
Who Was on the Stage at The PDS Super-Conference?
We’re just bursting at the seams with pride on the caliber of presentations that graced the big stage on all three days. We can’t go through all of them here, but check out some of the highlights of the show:
- John Maxwell | #1 New York Times bestselling author, coach and world-renowned leadership expert treated us to the Five Levels of Leadership. He was a huge crowd-pleaser and captivated the audience with crucial leadership principles every pharmacy owner should understand as they aim to grow into a better leader.
- J.R. Martinez | “We all grow up with goals for ourselves…but sometimes we can’t take the most direct path to our dreams.” J.R. Martinez talked about how to adapt and overcome anything that life throws your way with resiliency, determination, and a sense of humor.
- Earvin “Magic” Johnson | Wow, his presentation was “magic!” The attendees were riveted by his presentation on “The Winning Way,” where he taught us how to build and empower high-performance teams that support the vision of their pharmacies.
- Steve Gutzler | One of the nation’s top thought leaders on emotional intelligence, personal transformation, and leadership development. This interactive and engaging keynote walked our PDS learners through the ‘How-To’ of tapping into their full potential and performing at the top of their game under pressure.
- Jeff Philipp and Josh McJilton | Unveiling PDS’ new version of proprietary software, RxAnalytcs, Jeff and Josh revealed our show-stopper on stage. This new software will enable PDS members to truly get behind their business analytics to discover the clear path to profitable scripts. But you’ll have to be a member to test drive!
Don’t Just Listen to Us
The reviews are in! We’ve been fortunate to have a flood of positive feedback about PDS2018. Instead of us going on about it; we’ll let them tell you what they thought:
“You get so much out of being there and taking time to focus on yourself and your business. It is also great for networking and meeting like-minded people within our industry and learning new growth opportunities.”
“It is a no brainer. My mistake is that I watched the free webinars for 5-6 years and didn’t join sooner. The cost scared me off for years. I didn’t think it could be ‘worth it.’ I was wrong. PDS helps your financials tremendously, but it changes your culture and your quality of life even more. As pharmacists, we all make a bunch of money no matter what. It isn’t about the money, it is about seeing the change in you, your staff, your patients and your family. Just do it. You will thank me later.”
“Every independent pharmacy owner is leaving money on the table, and I believe the programs PDS has in place addresses that. “
“Don’t wait around any longer and expect opportunity and success to trip and fall into your lap — get up, surround yourself with the best, and go find it.”
Special Edition Pharmacy Podcast featuring Highlights from PDS2018
Conference Guest Todd Eury, with Pharmacy Podcast, interviewed conference attendees and PDS Founder, Dan Benamoz, CEO, Jeff Phillip, and featured exhibitor Wellgistics.
- Hear more about why Bill Henning, Pharmacist and Owner of Giant Genie Pharmacy continues to not only invest in the PDS Super-Conference but has also started bringing key staff to attend as well.
- Cliff Holt of Hurricane Family Pharmacy has been attending for ten years, in spite of his initial plans to sign up for only one year. Once locked into PDS value, he realized that membership is a key investment he couldn’t afford NOT to make.
- Learn about the goal that PDS has to become THE catalyst for independent industry growth and how we will leverage the extensive network of independents and industry exhibitors to make 2018 the best year for independent pharmacy.
Watch it For Yourself!
Now you don’t have to leave profitability, stronger leadership skills, and an upshift on culture on the table. You can still watch the 2018 PDS Super-Conference from the comfort of your own home. We have the Livestream available for those who wish to purchase at a special price… and you can watch it with your team! But hurry, access to the Livestream ends on March 31st.
We’ll be the first to admit that the cards are stacked against pharmacy owners. Pharmacies are faced with fees, clawbacks and dwindling reimbursements at every turn. It’s no wonder many are trying creative methods to squeeze extra profit from any source they can find in order to avoid shrinking margins. Your PBM could make matters far worse. Optum users, we’re looking at you. Read on to find out more.
The creative method we’re referring to is the practice of choosing smaller wholesalers in order to save a few bucks. Generally, this makes sense. You pay less for a drug on the wholesale level to increase margins on the retail side. But this is a slippery slope, especially if your wholesaler is not compliant.
What Does Compliance Have to Do With Profit?
For pharmacies that contract with Optum, everything.
If you’re reading this blog, you probably know that Optum is one of the “Big Three” PBMs responsible for 80% of all insurance claims. Starting April 1, 2018, Optum is requiring all wholesalers and suppliers to be VAWD Certified and if they’re not, the pharmacy dispensing the drug can expect audits, clawbacks and possibly even loss of the contract.
This is why it’s so imperative that you do not unsuspectingly fall into this hole while you’re chasing a marginal increase. Is a 2% bump worth an audit or a loss of contract?
What is a VAWD Certification Anyways?
VAWD stands for Verified-Accredited Wholesale Distributor.
This credential is in addition to the standard operating procedures that are required to get licensed in each individual state. In the United States, each state has their own set of guidelines required to become a wholesaler. What is required by one state, may not be in another and can cause potential misfires when doing business across state lines. The VAWD certification is important because in some states, it is very easy to get a wholesale license and the standards for where the drugs can be sourced from is more relaxed.
VAWD ensures that not only is the wholesaler meeting the qualifications and standards of their home state, but they’re also meeting the qualifications of all 50 states, the FDA, and more.
While this certification is raising the drug chain standards, stopping gray market drugs and is safer for the patients, it does create an extra layer of headaches for pharmacy owners.
Find Out More in Our Crucial Latest eBook
In our latest eBook, the Pharmacy Wholesaler Buyer Beware Guide we’ll show you what those extra layers of headaches look like for owners and how to ensure you’re properly protecting your pharmacy.
In this FREE eBook, you’ll also learn…
- What it means to be VAWD certified
- How to identify wholesalers that could be harming your standing with Optum
- Why sourcing the cheapest drugs isn’t always worth the risk
- The 3 questions to ask your new and existing suppliers
- The impact reputable wholesalers can have on your bottom line and patients’ lives (We’re talking $3,000 in additional profits per week!)
Download the eBook now and save yourself or a fellow pharmacy owner from the dreaded clawback, audit or lost contract.
Launch Your Profitability the Right Way
Why make an extra 1–8% in profits and risk your Optum contract by saving pennies on a wholesaler, when you can earn thousands towards your bottom line by doing what the most successful pharmacies do?
Come see for yourself why we are so confident in our ability to change your life and improve the profitability of your pharmacy that we have a conference guarantee. If you don’t see the value of the PDS Super-Conference after the first day, we’ll reimburse your travel up to $500 and give you an additional $300 — no questions asked.
Still Not Convinced?
If attending a career-changing event is not for you at this time, you can join the discussion on topics just like this one, with other owners on PDSadvantage. It’s free to join and allows you to access the pharmacy owner forum and participate in these trending topics. Click here to create your free account on PDSadvantage,
Here at PDS, we take pride in highlighting some of our incredible solutions partners. We know these companies have the potential to revolutionize pharmacies just like yours through their products and services. We’re excited to introduce Liberty Software; read on for their sponsored blog post about the benefits improving patient care and profitability through strategic efficiency.
Independent pharmacy is no stranger to competition. The industry becomes tighter by the day and owners have to look for innovative ways to stay above the curve. We can all agree we’re in the business of helping others, but we also need to make a profit to stay in business.
One solution many owners ignore lies behind the pharmacy counter. Improving the workflows behind the pharmacy counter will drive your business into better productivity, better patient care, and better profitability.
Below, we’ve included five significant steps that you can take to improve your pharmacy’s workflows – in turn improving both the care you provide your patients and your profit margins.
Examine the Status Quo.
Examine the current state of your business. How are technicians and pharmacists operating now? Are there pain points or bottlenecks in existing workflows? Speaking with technicians and pharmacists who do the work every day is one of the best ways to identify areas for improvement.
If you don’t measure where you are now, how will you measure whether changes are positively impacting your business? Scripts filled per hour is a good starting point. Consider using software to track data entry errors. Customize your metrics to your company’s unique practices and needs.
Improve the Use of Space.
You want to physically minimize the amount of movement involved in filling a script, as well as make sure technicians and pharmacists aren’t vying for the use of the same space at the same time. Small slowdowns can add up to big drops in productivity, so focusing on your most-used spaces and heavy-traffic areas, both for employees and customers, can make a big difference in your pharmacy’s productivity.
Your employees need to be operating at the top of their licensed capabilities to provide the best service to your customers. Pharmacists shouldn’t have to spend time doing the work of technicians, and technicians don’t need to spend time on processes that could be automated. From automatic prescription processing to software that minimizes time spent on data entry, automating repetitive pharmacy workflow operations can have a measurable impact on your bottom line.
Focus on Strategy.
Strategic decision-making shouldn’t be limited to upper-management, back-office meetings. Get your staff on board with the company’s big-picture plan, and you’ll be aligning your entire operation around the same goals. Don’t hand down mandates – ask those in the trenches for their considerable expertise and input.
As you implement changes based on these steps, remember to periodically step back and measure the effects of those changes. Move slowly – don’t implement 20 new initiatives at once, or you’ll have a hard time determining what caused the changes you’ve measured. Deliberate, strategic moves in collaboration with your highly qualified staff will help your business maximize pharmacy workflow and profits in a challenging market.
About the Author:
Pharmacy software for pharmacy success. Liberty Software helps pharmacies improve profitability, increase patient safety, and enhance patient care. Here at Liberty, we believe that we have designed a revolutionary pharmacy management software platform. Why do we say that? It’s not just the technology, although it is built on Microsoft’s newest technology platform. It’s not just the feature list, although it is impressive. More than anything, we believe that it is the user experience. Prescriptions can be filled quickly and accurately while protecting patient safety. Many pharmacists say that it is the easiest software they have ever used.