Boost revenue, drive prescription volume, and promote patient care services.
John Beckner, RPh
Offering more than just the flu shot and becoming a full-service vaccination clinic is one way pharmacies can distinguish themselves from other pharmacies, bolster revenue, and become a true healthcare destination for their patients.
John Beckner, RPh, senior director of strategic initiatives for NCPA, defines a full-service vaccination clinic as a pharmacy that is willing to offer all the vaccinations approved by the American Council on Immunization Practices (ACIP).
“Full-service can vary by states because states have different laws and regulations particularly when it comes to age,” Beckner says.
While offering a full-service vaccination clinic can help a pharmacy stay competitive and generate additional revenue, setting one up requires forethought, planning, and strategic implementation to be successful.
“The gateway and the entry is flu, and really the sky is limit from there in how you expand it and turn your pharmacy into a healthcare destination,” says Lisa Petersen, vaccine program manager for McKesson Pharmaceutical Solutions and Services.
Why Have a Clinic?
Offering a full-service vaccination clinic can have significant advantages for the public as well as the pharmacy itself.
Petersen says pharmacies can earn approximately $38,000 in additional gross profit by offering vaccines.
Expanding the offerings beyond the flu vaccine also further demonstrates the pharmacist’s ability to be a trusted and reliable member of the healthcare team, while also offering the customer a level of convenience and accessibility not available in other healthcare settings.
“It’s a tremendous upside opportunity and a modest downside opportunity,” says Bruce Kneeland, an independent community pharmacy consultant.
According to Beckner, a full-service vaccination service has the potential to also drive your prescription business. “It helps brand your pharmacy as a wellness destination, it helps drive your prescription volume and really it’s an opportunity to help you promote other patient care services that you might be offering such as health screenings or point of care testing,” he says.
Determining State Regulations
The first step in establishing a vaccination clinic is researching what pharmacies are allowed to do within each state. “As a pharmacy is setting up a full-service vaccination service or immunization service, one of the first things they need to do is be knowledgeable and aware of the different laws and regulations in their particular state,” Beckner says.
Pharmacists can discover this information through their own research, using the NCPA website, contacting their state’s pharmacy association, or calling their state board of pharmacy.
Some states will be regulated by immunization collaborative practice agreements (CPA), or legal documents that are state specific. These agreements, must be signed by a physician and outline all the vaccinations a pharmacist is allowed to give in their pharmacy.
“You want to read your CPA. What does it say? Can you vaccinate anyone that’s under 18 years of age in that state? Can you vaccinate babies?” Petersen says. “That’s when you really have to fine line read the regulations. You need to have the emergency plans, you need to look at the state regulatory reports, the consent forms, and make sure you have all of that.”
Pharmacies in states with CPA requirements will either need to identify a physician to partner with on their own or work with a company like McKesson, which offers a program that identifies the appropriate legal documents for a state and finds a physician to sign off on the agreement doing much of the “heavy lifting” for the pharmacy, Petersen says.
Assessing Your Pharmacy
Once pharmacies have taken a state-level review of the restrictions and opportunities within their own state, they need to turn their focus much closer to home: their own pharmacy.
Before implementing a full-service plan, pharmacists need to assess the skill level of their staff, the pharmacy’s ability the handle an increased workload, and the storage requirements that will be necessary for the list of vaccines they want to administer.
Pharmacies will also need to consider their store set-up. The best-case scenario would be that the pharmacy would have a private area where the shots could be given to provide patients with the privacy they need.
“Ideally, you’ve got a private wellness center type room to be able to provide this service, that would be an ideal situation, but not every pharmacy is going to have a nice office type layout,” Beckner says. “So you are going to need to be flexible in terms of where you are going to offer the flu shot.”
Aside from the physical space to administer the vaccines, pharmacies also need to make sure they have an emergency kit on hand, with epinephrine, a sharps disposal, alcohol wipes and other items that make administering the vaccine a smoother and more professional process for the both the pharmacist and patient.
The Billing Process
A key to a successful vaccination clinic is having the billing process set up before advertising it. Pharmacies can research the billing requirements and implement their own programs.
However, there are third-party vendors, including OmniSYS, TransactRX and electronic billing services, that are designed specifically to assist pharmacies in billing for vaccinations, Petersen says.
“That’s their wheelhouse. They are subject-matter experts. They partner with the pharmacist, and the pharmacist pays them directly to process their claims,” she says. “That way they make sure they are checking the right boxes, they are coding the right things, they are making sure they are putting the right pertinent information to where they get reimbursed for not only the vaccine but for the administration cost, so that all of that is accounted for.”
Chris J. Meyer, PharmD, a pharmacist at Medicap Pharmacy in Austin, MN, says pharmacies face greater inventory challenges now because many manufacturers have gone from allowing pharmacies to buy vaccines in single quantities to often requiring they be purchased in bulk packages.
This may add additional storage and investment considerations for pharmacies, but Meyer believes pharmacies who want to be able to compete need to have the vaccines in stock.
“You have got to have product here if you are going to run a business, and if you don’t, they are going to go elsewhere,” he says.
It can be particularly difficult for pharmacies in their first year of offering immunizations or adding a particular vaccine because there is no past history to predict how much to order. Beckner suggests pharmacies talk with other pharmacies in the area that have offered similar vaccines to see whether they are willing to share their experience. “Some of these vaccines are pretty expensive, so inventory is definitely a consideration,” he says. “I think you try to gauge the demand.”
Creating a full-service vaccination clinic can also be an effective strategy to retain customers and maintain other more common vaccination business, such as flu shots.
“If they come to your pharmacy and you’re not offering a particular vaccine, you don’t want to be referring to another pharmacy, so you really want to be able to offer the full-service,” Beckner says.
Petersen agreed that pharmacies really need to begin thinking of their vaccination programs as offerings that are available 365 days a year and that extend beyond the traditional flu vaccines. Targeting college students about to head off to school, for example, helps signal to customers that the pharmacy is a one-stop shop for all a customer’s vaccination needs.
Offering a full-service vaccination clinic can have its challenges, but pharmacy owners don’t have to go at it alone. There are software and programs specifically designed to help ease the process for pharmacies. For example, McKesson offers a VaccineComplete program that alerts pharmacists to patients in their store who might be missing necessary vaccinations. They also offer a Vaccine Starter Kit that includes six months of customer-service support and a program for Health Mart pharmacies to secure CPAs.