Health Mart encourages members to become ‘better than better’
SAN DIEGO – Health Mart owners and pharmacists are putting up big numbers on the EQuIPP™ scorecard, both Steve Courtman, Health Mart president and Tony Willoughby, Health Mart’s Chief pharmacist, told Drug Store News in an exclusive interview following the Health Mart Annual Meeting at McKesson’s ideaShare 2015.
Cost, coverage and quality are the key stakes in the game that retail pharmacies play to gain and maintain access to patients – chains and independents alike. Health Mart is doing well. More than 25% of the Health Mart stores are in the top 20% of at least one of the CMS Medicare Part D Star Ratings measures. But, quality scores are still too close as the competition is only going to get better and the pharmacy performance bar continues to rise. So Health Mart pharmacies are striving to be Top 20% as a network. And they can do that by playing to their strengths – patient engagement and working collaboratively with providers.
EQuIPP is a good start that provides proof of concept to potential partners, said Willoughby. It used to be that when Willoughby or Steve Courtman would speak with payers, ACOs, or physician practices — telling them anecdotally about the great relationships Health Mart pharmacists have with their patients, and the improved outcomes borne from that relationship — those groups weren’t taking that on faith. They wanted proof. “That’s the major thing that the EQuIPP results have given us. It has given us facts to prove it: we can look at those relationships that alter behaviors and improve adherence. That’s meaningful,” Willoughby said.
To help its members execute against the game plan and showcase those proof points, Health Mart hosts town hall-style CE sessions delivered by pharmacists from Health Marts across the country to help indepedents understand the importance of quality metrics and the tools available to help them improve outcomes and demonstrate the quality care they deliver to patients. At about 100 meetings each year, any independent pharmacy and its staff have the opportunity to ask probing questions and get specifics on how their peers have used EQuIPP to improve quality improvement and execute MTM programs successfully.
“It’s not unidirectional,” Willoughby said. “It’s that dialogue that helps feed the content. We have a vision of what we want to accomplish in the Town Halls, but just like our pharmacists have a unique ability to cater to a local patient, we try to do the same for our customers, as well as allow them to see how it works.”
“It’s that kind of no-holds barred feedback that will enable Health Mart to become better than better,” Courtman added. “We talk about Health Mart making Health Mart stronger, that’s where that comes out,” he said. The feedback is additive.
“We’re not the innovators, our pharmacies are,” Willoughby said. “It’s taking their concepts, their ideas and trying to commercialize them or share them with the broader membership so that they can learn from each other.”
Working together toward replicative success is important, Courtman said, especially as the pharmacy business model continues to evolve. “There’s a certain transition in the industry from this prescription basis to a patient focus,” Courtman said. “It’s not just about our pharmacists being the ones who put the pill in the bottle, it’s actually about looking after the patient. Our pharmacists do that exceptionally well. So when we look at this shift in the marketplace and the increased focus on quality, Star Ratings, value-based reimbursement and where the industry is going, everything tees up particularly well for our pharmacies. That’s what they do. They look after patients.”
Pharmacies being recognized for the quality care they deliver gets Courtman excited. Talk about the competition getting better? Bring it on. “People talk about the competitive landscape increasing because of this focus on patient care, but it will be interesting to see how it really plays out,” he said. “Because a lot of our competitors say that they can do this, but whether they can actually execute is another matter.” Larger organizations may trump independents on some aspects of efficiency and productivity, but they can’t touch the service available at Health Mart pharmacies, he said. And it’s that service, their relationships with patients and customer focus that will drive the kind of tangible results for which healthcare partners are looking.
“Changing the patient trajectory is all about helping them make better choices and changing behaviors,” Willoughby said. “To enable you to be able to change a patient’s behavior, you’ve got to know them. You have to have a relationship with them. There’s a stability in an independent pharmacy where it’s the same pharmacist, not just for this week or this Tuesday, but for the last 15 or 20 years.” Health Mart pharmacists are icons within their respective communities, Willoughby said. Everyone can learn a person’s name, but these independent pharmacists are there when a new parent calls in about the first spiked temperature and many continue to serve that family’s needs throughout that child’s life.
If Health Mart can leverage those kinds of long-term patient relationships, they’ll be more impactful when it comes to outcomes-based health plans.
“Health care is local, and it’s personal,” Courtman added. “When I was with Marble City, this year’s Pharmacy of the Year, you see the way they practice health care in their community. It’s just fantastic to see that level of care. That’s the stuff that has come out of our Town Halls — that engagement and interaction between us and all of our customers, and among all of our customers. It’s that ability to execute at the local level that has just been so critical for our success.”
Looking ahead, the Town Hall meetings themselves will evolve with the retail pharmacy industry, while continuing to focus on sharing how to best implement the latest tools, available through Health Mart, that will enable Independents to create profitable patient-centered business models, compete, and grow their pharmacies. “You heard Steve talk more about med sync, so the Town Halls will focus more specifically around teaching Health Mart pharmacists exactly how to use a given tool to impact their workflow and allocate time so that they can have those intentful conversations,” Willoughby said. There is no question that med sync has operational and adherence support benefits, but the end goal isn’t specifically med sync; it’s a vehicle to give them time to have proactive discussions about their medication regimen and offer all the patient-centered services available through the pharmacy.”
Courtman and Willoughby also will be addressing many of the takeaways from this year’s McKesson ideaShare. Courtman explained that Health Mart members need “to understand the importance of shifting their profit model from prescription-based activities in the back of the store to align with way they are treating their patients today— a holistic perspective centered around improving and maintaining their health.”
Health Mart members can get a head start in implementing changes by focusing on rating in the top 20% on the EQuIPP scoreboard, taking advantage of the Medicare Part D marketing plan and enrolling more than 100 patients into a medication synchronization program.
Willoughby identified another key takeaway from this year’s show: Health Mart members need to be who they are. “From a feel standpoint, an emotional standpoint, we want them to leave McKesson ideaShare knowing they have our support and they had great peer examples on how to make it happen,” he said. “It’s not our Health Mart. It’s not Steve’s, it’s not mine, it’s not McKesson’s. It’s theirs. And there is nothing more motivating than when you are in a tough situation to see people who are being successful and are willing to take you with them.”
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Specialty Rx partnership with Diplomat helps McKesson’s independents level the playing field
SAN DIEGO — Phil Hagerman, CEO and Chairman of Diplomat Pharmacy, Inc., joined attendees as a special guest speaker for a “Specialty Lunch and Learn,” at McKesson’s ideaShare 2015. “Specialty is the new pharmacy,” Hagerman said.
Currently, the specialty pharmacy market stands at $100 billion and is growing at a 20% trajectory. More than half of all new drugs approved in 2014 were specialty medicines, and eight of the top 10 best-selling drugs are expected to be in the specialty channel by 2016. By 2017, spending on specialty medicines is anticipated to represent 50% of the overall drug spend.
McKesson understands that specialty patients have unique needs and it can be very expensive and time consuming for a pharmacy to build capabilities to manage these patients. McKesson’s partnership with Diplomat brings the supportive specialty pharmacy services to local independent pharmacies without the upfront investment. The independent pharmacy continues to adjudicate the specialty claim and get reimbursed; Diplomat provides the wrap around access, reimbursement and clinical services, to enable a consistent and efficient level of care to all key stakeholders including the pharmacy, prescriber and patient.
As a pharmacist, Hagerman knows that managing all of these services in house can be challenging. “Historically, the prior authorization and funding support process is the hardest thing for a retailer,” Hagerman said. As many as 4-out-of-5 specialty drugs require a prior authorization. “Our overall 2014 success rate on prior authorization on first pass is 86%,” Hagerman said. “And our overall 2014 prior authorization on appeals is 83%. We want to help our retail partners with this process.”
In addition to providing the specialty services, retail pharmacies have also been faced with an increase in the number of limited distribution drugs. “Limited distribution is a challenge, but I would say it’s one of the biggest opportunities for independent pharmacies, because if you have a specialty physician in your community, the most important thing you can do is get him to trust that whatever patient prescriptions he sends to you, you will take care of,” Hagerman said. “That doesn’t mean you will always be able to fill the prescription, but it does mean that you’ll take care of the patient.” Failing to meet a specialty patient’s needs is the kiss of death for a pharmacy. Delivering on those needs; however, brings a high-cost patient through your door — a patient who also is quite likely to also be on a high number of maintenance prescriptions.
The McKesson Diplomat relationship enables a participating store to send any limited distribution drugs to Diplomat in a non-predatory relationship. The patient is staying with their local store, just the one specialty script that can’t be filled locally will be sent from Diplomat to the patient. “We want to keep the retail store whole and keep their patients happy,” Hagerman said.
Once the store chooses to participate in the program, it is important to make it known to both area doctors and pharmaceutical reps that specialty prescriptions can be filled at your store. This is a critical patient acquisition tool, Hagerman added. “Even if the pharmaceutical rep is not your friend today and he’s sending everything to another pharmacy, when the doctor calls him with a problem, that rep has to have a solution,” Hagerman said. “You are that solution. Do not discount how important that is.”