Best practices, tenacious independent spirit help kick off McKesson ideaShare 2016
A crowd of independent pharmacists, owners and various other McKesson customers filled the Arie Crown Theater in Chicago at McCormick Place, Monday afternoon, where McKesson executives welcomed attendees to the Opening General Session of McKesson ideaShare 2016. The event capped off a day filled with continuing education opportunities, marked the official opening of the 2016 McKesson ideaShare Exhibit Floor and saw the crowning of this year’s Health Mart Pharmacy of the Year Award winner.
Mark Walchirk, president of U.S. Pharmaceutical and lifelong Chicagoan, kicked off the program with his own Top 5 list of things to do in Chicago, before turning the stage over to McKesson SVP corporate strategy and business development Chris Dimos, who talked about the current challenges and opportunities facing independent pharmacy owners today.
Dimos presented attendees with four macro trends influencing health care today, underscored the need to change and evolve to meet the demands these forces place on independent pharmacists, and talked about how pharmacy owners can go about making changes in their businesses to follow and create best practices. (For more, see “Leveraging global strategy to help independents navigate macro trends in health care, business”.)
“These forces are happening — there's nothing we can do, we can't just close our eyes and hope it doesn't happen to us,” Dimos said. “We have to evolve our businesses. Our competitors are evolving their businesses, and everybody that we rely on in the healthcare ecosystem is evolving their businesses. … We have to make sure we make the investment in our time, our education, who we are and what we're providing to the patient in order to be differentiated.”
Dimos suggested four strategies independent pharmacy operators should deploy in order to meet the many challenges they face as all of health care moves to a value-based model. He urged independent owners to strengthen core business operations, expand clinical services, form partnerships with local payers and providers, and to develop new streams of revenue. He pointed to the regional winners of the McKesson 2016 Pharmacy of the Year awards — including Mountain View Pharmacy in Pleasant View, Utah and Iuka Discount Drug in Iuka, Miss. — as examples of companies that were putting these plans into action.
Pharmacy of the Year
Dimos turned the mic over to McKesson SVP and COO U.S. Pharmaceutical Frank Starn and Health Mart president Steve Courtman to announce the Pharmacy of the Year award winner, which this year went to the team at Rex Pharmacy in Atlantic, Iowa.
“Rex Pharmacy has strong community engagement,” Courtman said. The store, which was recently bought by Josh Borer, has been a key part of the community it has served for 75 years.
“They're certainly not running an old-fashioned operation,” Courtman explained. “They have a strong patient focus and rank in the top 20% in all Star ratings measures.” Since Borer purchased the store from a prior Health Mart owner, “the staff is very heavily tenured … and together, they figured out how to evolve the pharmacy, which I think is just tremendous.” (For more, see “McKesson Pharmacy of the Year winners put patient care, community first.”)
“What excites me most about our future is the ability to have more collaborative involvement in patient care,” Borer said in a video. “We knew we had to change our mindset from a reactive approach to really more of a proactive management approach.” As an example of the need to expand clinical services, partner with local stakeholders in the local healthcare ecosystem and find differentiated streams of revenue, one of the newer services Rex Pharmacy has added, pharmacogenetic testing, “has sparked the interest of the local provider community,” leading to a partnership with nearby Cass County Health System.
Exploiting chaos, leveraging community
That community engagement Courtman described at Rex Pharmacy was also a key theme of opening session keynote speaker Jeremy Gutsche, founder of TrendHunter.com and author of the book “Exploiting Chaos: 150 Ways to Spark Innovation During Times of Change.”
Gutsche shared stories about his father Sig Gutsche, a serial entrepreneur who started early, opening his first business as a boy, selling old fruit from the local grocer door to door. Gutsche’s father went on to own a number of businesses before passing away in 2013 — perhaps most notably as the owner of the Canadian professional football team Calgary Stampeders, who at the time the elder Gutsche had acquired the team, had suffered from dismal attendance. Gutsche’s father righted the ship by reaching out to the community, personally chatting with more than 800 fans and forming a connection with them.
The secret to remarkable success, Gutsche explained exists at the convergence of hard work and overlooked opportunity. He pointed to failed examples like Blockbuster — which gave up on an online streaming business of its own that was giving Netflix fits at the time, to focus on retail — to highlight how past success can feed a most dangerous complacency among top-performing companies that can prove fatal to the business, driving repetitiveness and a protective instinct over what has worked in the past.
According to Gutsche many of the most successful companies in the history of business, from CNN and MTV to Disney and Microsoft, were all created amid times of massive change, exploiting chaos and upheaval to drive innovation and amass massive fortunes.
What separates these types of companies from those that accept the status quo or look to the past instead of the future for innovation, Gutsche explained, is a characteristic that also made his father successful — something he describes as the “hunter instinct,” a desire to fill unmet customer needs, to adapt very quickly to feedback and make changes to the business as a result. This type of thinking has helped propel companies like Zara to grow a $70 billion fashion empire.
It’s also a trait many independent pharmacy owners share, he explained. “In the end, I believe that there's a lot of opportunity in your world,” he said. “You're people like my dad was — talking to people, able to make those human connections. In a world that has become faceless, you are the face of your communities, and that's the reason I believe in you.”
But Gutsche also cautioned attendees not to become victims of their own success and left with an important call to action: “Be insatiable, be curious, be willing to destroy and you'll keep on making the independent pharmacy better and faster.”
SLIDESHOW: Live from McKesson ideaShare 2016
McKesson ideaShare 2016 kicked off this year at the McCormick Place in Chicago, June 26 to 30, with continuing education sessions, a packed Exhibit Floor and a dymanic Opening General Session, where Rex Pharmacy was named the Pharmacy of the Year. On Tuesday, executives announced the launch of MyHealthMart at the Health Mart Annual Meeting.
Continuing education brings provider partnerships, med sync to the forefront
McKesson ideaShare 2016 may have officially kicked off Monday afternoon with the conference’s Opening General Session, but even before McKesson executives took the stage and this year’s Pharmacy of the Year award winners were announced, many attendees already had been busy in continuing education sessions, learning about new aspects of patient care as well as how to grow their independent pharmacy businesses.
Among the clinical programs, major educational themes this year ranged from trends in value-based reimbursement and the growth in specialty pharmacy to advancing pharmacy-based clinical services and building partnerships with providers in ways that turn pharmacists into key members of the healthcare team
In all, McKesson ideaShare hosted more than 30 CE sessions over the course of the conference. Drug Store News reporters sat in on a number of the sessions. Following is a brief recap from a few of them:
Keeping an eye on quality
As the Centers for Medicare and Medicaid Services have begun the transition to value-based payments, it is critical for pharmacies to understand and achieve the key performance measures by which CMS — and soon, a growing number of commercial payers, too — will evaluate and compensate them. Elliott Sogol, VP professional relations for Pharmacy Quality Solutions, talked about the current Star ratings measures in place today and also gave attendees a look at what’s coming next.
Among the new Star Ratings measures for 2016 are evaluations of medication therapy management completion rates for comprehensive medication reviews, as well as display measures for drug-drug interactions. Another, which looks at statin use among people with diabetes, will likely be among the Star Ratings measures by 2019, Sogol said.
Looking to 2017, Sogol outlined a planned suite of asthma measures and medication possession ratio for patients with asthma — as well as a focus on high-risk medications and overuse of opioids.
The opportunity for pharmacists, Sogol said, lies in positioning themselves to improve outcomes by screening high-priority patients and counseling those taking cholesterol or diabetes medications, while implementing medication synchronization. A pharmacy that can implement these solutions and deliver outcomes is also well-positioned to partner with providers as part of the overall patient care team, he said.
“As we see these metrics continue to emerge, you’re probably well aware that hospitals are being penalized if patients are readmitted within 30 days of being released,” Sogol said. “That allows me to recognize that if pharmacy can be involved, we may be able to begin to stop that trend.”
Enhancing prescriber relationships
Tackling the different ways pharmacists can leverage their clinical training with the physician community, Thrive Pharmacy Solutions president Tony Willoughby talked about how pharmacies can partner with local provider groups to help deliver improved outcomes through patient-centric care.
“An integrated pharmacy team,” Willoughby said, “begins with understanding such common ground between pharmacy and providers as declining reimbursements, increased patient volume, a rise in competition and a heightened focus on quality. These trends are forcing all healthcare stakeholders to look to form partnerships and help share financial risk.”
“You’ve got to do your homework and understand what the provider’s pain points are,” Willoughby said. “There are both long-term and short-term areas you can work on, and you want to start where you’re solving problems that providers feel the results of quickly.” Often it’s more fundamental pharmacy services like medication reconciliations, chronic care management and medication synchronization before building up to bigger qualitative issues, such as decreasing cost of care, reducing hospitalizations and ER visits, and improving adherence over the longer term, he said.
According to Willoughby, the key for pharmacies looking to partner with providers is to be proactive in seeking out these relationships, be willing to test new ideas fast — and be willing to fail — but to bounce back quickly to test another new idea.
Managing digital listings for independents
Monday morning, Ebus Innovation chief idea officer Elizabeth Estes impressed upon independent pharmacy owners one of the most important things they can do to grow their business — to make sure its digital listings are being seen by potential patients searching for pharmacies online.
According to a 2014 study by Google, 4-out-of-5 consumers used search engines to find local businesses, and 50% who used their smartphones to search visited that business the same day.
Estes helped attendees understand which digital listings and online directories are most important to an independent pharmacy business, and walked through such popular platforms as Google, Bing, Yelp and Foursquare, as well as YellowPages.com. In addition, Estes talked about the types of information and content needed to create an effective digital listing, how to encourage positive reviews online, as well as how to respond to negative reviews in a way that flips the script — and allowing them to highlight the many positives their business offers the community.
Also important, Estes explained, is the need to grow one’s online presence organically, rather than paying to improve search results. Independents can have a natural advantage over big chains because they are naturally more tied into what local customers think is important.
“Creating listings that are optimized for organic search… is so important, because we’re not going to compete with Walgreens on a local level,” she said. “We’re not going to compete with the amount of money they’re going to spend to make sure they’re No. 1 in paid listings. But you can beat them because you [created your digital listings] the right way.”
Clinical services profit igniter
One of the hot issues in the industry is the greatly anticipated passing of federal provider status legislation for pharmacists under Medicare Part B. Indeed, the potential that provider status holds both to expand access for patients in underserved areas as well as to expand the scope of practice for pharmacy and open up new revenue streams for the industry is a source of much excitement.
But according to Nicolette Mathey, creative solutions specialist at Pharmacy Development Services, there is no need for pharmacists to wait for provider status — there is a host of clinical services that they can offer patients right now that will also add new revenue streams.
In particular, Mathey highlighted several ways pharmacies can partner with local providers to provide support and introduce new services that can be billed through the physician’s office, from annual wellness visits — which can be performed by a pharmacist at the physician’s office — to chronic care management and transitions in care management.
Even if pharmacy operators feel like they aren’t yet ready to partner with physicians, Mathey emphasized that there are a number of other existing services — MTM, immunizations, diabetes education, hormone testing and pharmacogenetics — that can bolster a pharmacy’s billable services while providing areas for pharmacists to offer more services to customers, something she called “upsolutions.”
“It’s the mindset of ‘What else can I do for you?’” Mathey said. “A lot of times pharmacists don’t like [to do that sort of thing]; they don’t like how it feels to be a salesman.” But Mathey offered attendees a different way to look at it: “If you don’t use your clinical expertise to recommend something to the patient that could benefit them with one of their side effects, you’re actually doing them a disservice.”
Implementing med sync
Trey Crawford, owner of three pharmacies, including Diket’s Professional Drugs in Laurel, Miss., has some 600 patients enrolled in his medication synchronization program. His message to McKesson ideaShare 2016 attendees was that getting patients synced is not as daunting a task as it sounds, and it can provide new efficiencies and opportunities for revenue while improving adherence and assisting with other clinical offerings.
Beyond simply improving a pharmacy’s financials by helping to balance workload and better manage inventory, Crawford also talked about how med sync can help improve quality performance measures, facilitating such activities as medication therapy management, comprehensive medication reviews and checking up more regularly on patient adherence.
Crawford instructed attendees to create an action plan and emphasized the importance to start slowly and to set realistic goals in order to build to a critical mass.
“Once you get to 100 patients, you’re going to be able to tell the difference … in your workflow,” he said.
Advances in specialty pharmacy
In order to help McKesson ideaShare 2016 attendees understand the potential that specialty medication can play in their pharmacies and to underscore just how big the boom in specialty medications is, Catalyst Enterprises president and CEO Marsha Millonig took a macro look at recent progress in the rapidly emerging “life sciences” arena.
As innovation continues at an amazing rate, the industry is seeing the convergence of the pharmaceutical, device and technology manufacturers, and blurring of the lines of conventional medication therapy, she explained, as nanotechnology plays a key role in preventive medicine and scientists are able to map the human genome.
This convergence is giving rise to a new class of highly targeted therapies, with some 50 new biologics approved in 2015, she said. Given the rate of advancement in specialty and the high cost associated with the treatments, Millonig noted that it is a space that offers a lot of potential for pharmacy owners, and one that also comes with its share of challenges, including access to drugs whose manufacturers have sought to limit.
Independent pharmacies, particularly ones that deal with specialty, do have an advantage over larger, national specialty pharmacies, Millonig said. “I think often locally you have relationships with providers that put you at an advantage over another kind of specialty pharmacy that maybe is nationally known but doesn’t really have any relationships in your community,” she said.
Improving outcomes by being involved
Ten years ago Randy McDononugh, co-owner of Towncrest Pharmacy in Iowa City, Iowa and Solon Towncrest Pharmacy in Solon, Iowa, left his job in academia to focus more on pharmacy practice. And though the industry has changed much in that time, McDonough has managed to make his pharmacies high-performers when it comes to quality measures, and he shared his best practices with McKesson ideaShare 2016 attendees.
Some of the largest areas of opportunity, McDonough explained, include clinical partnerships with local providers and performing pharmacist interventions for every patient. And though the latter sounds like a difficult task, McDonough shared workflow solutions and some of his own strategies for success, including making a small note on every prescription dispensed to patients.
“If you think this is impossible, you’re wrong,” McDonough said. “I’m not saying you have to look at every single medication. It might just be the medication the patient is getting at that time, and in that particular instance you need to say ‘Is this drug therapy OK for this patient?’ You can do that and do it consistently with every patient. Every single patient gets a touch. How comprehensive that touch is will depend upon the complexity of the case.”