Care delivery key to next-gen pharmacy success

January 10, 2016

Start by thinking of yourself as an investment, not a cost center.

Community pharmacies focus on providing value through convenience, service, and price. Value, that is, for the customer and the customer alone. Who’s left out? Physicians and health plans. Traditionally, community pharmacists haven’t had to worry much about them beyond deciphering prescriptions and asking for reimbursement. From the perspective of a doctor or insurer, a pharmacy is a pharmacy is a pharmacy, right? Not anymore.

Troy TrygstadToday things are changing at a head-spinning pace. In this new era, alert independent pharmacies realize that to survive, they’ll have to do more than dispense drugs, diapers, and deodorant. They’ll also have to show that they have more to offer than the competition does, and that comes down to serving as much more than sophisticated pill dispensers.

The new mantra

Troy Trygstad, PharmD, MBA, PhD, has a simple mantra that every independent pharmacist should remember: “I’m an investment, not a cost center.” In other words, by helping patients get better, the independent pharmacist can offer value to a health plan or a provider. That means taking advantage of opportunities to improve patient health in areas such as chronic illness.

See also: Pharmacists share best practices

“Don’t keep your head in the sand,” said Trygstad, vice president of Pharmacy Programs with Community Care of North Carolina, who spoke at the recent annual meeting of the National Community Pharmacists Association. “Things you would have told me were crazy five years ago are happening - and quicker than I would have thought when I talked to you a year ago.”

New payment models are the big drivers of this revolution, he said, as healthcare reform forces a massive rethinking of how doctors are paid. “What happens outside pharmacy will affect pharmacy for the next five years,” he predicted.

 

It’s all about results

The key to success, said Trygstad, is understanding that the entire system is moving toward an emphasis on results. The next generation of Medicare, for example, is focused on adjusting the demand: “How do we prevent hospitalizations, increase co-payments, increase price sensitivity, and create incentives among providers to change health trajectories?”

Consequently, physicians will face newfound pressure to help patients get healthy and stay that way - or at least get healthier and stay healthier - especially if they have expensive and uncontrolled conditions. Health plans will need to see results, and so will providers. That’s where pharmacists come in, Trygstad said, by providing assistance on both fronts.

See also: Insurer placing pharmacists in PCMHs

“Providers used to care about what was going on with the patient only when they were in front of them,” he says. “Now, they care when they’re not in front of them. But who are they in front of, then? All of you.”

This is where creativity and business savvy enter the picture. As billions of dollars move toward models that emphasize results, independent pharmacies will need to show health plans and physicians that they can save them money.

Recipe for success

“Know your value,” Trygstad advised. “But I’m not sure you know what your value is outside of that PBM bubble.” If you’re in the dark, he said, you’ll be treading on dangerous ground, because there will be a divide between high-performing pharmacies and low-performing pharmacies.

 

Pharmacists can learn from the craft breweries that are popping up across the country, said Trygstad. “They’re incredibly profitable with really good margins, and they’re growing like gangbusters.”

But does every neighborhood need a bunch of craft breweries when locals used to get along fine with six-packs of Budweiser and visits to the watering hole down the street? Neighborhoods do indeed, said Trygstad, and that’s why craft brewers should be such an inspiration to pharmacists. They’ve won people over by creating a new market - top-notch beer - and convincing people not to accept anything less.

It’s an old-fashioned approach with a sudsy modern twist: Don’t just give people what they want. Set new standards for what they will want and give them that too. What worked for craft brewers, suggested Trygstad, will do just the same for independent pharmacists as they seek partnerships with  physicians and health plans. We can all drink to that.

Randy Dotinga is an independent medical writer in San Diego, Calif.