For pharmacists who provide immunizations, signs of progress and plenty of opportunity
Good, but it could be better.
I’m talking about the results of a nationwide survey of Americans who were vaccinated against influenza for the 2012-2013 flu season. Based on an online poll of nearly 1,100 adults in mid-January, researchers for Ipsos Public Affairs found a solid majority of Americans still rely on their family physician for their flu shots, but that retail pharmacies and walk-in clinics are making significant progress in their campaign to shift the center of gravity for immunizations away from the doctor’s office.
Drug Store News senior editor Michael Johnsen reports that about 20% of respondents received this year’s inoculation at a retail pharmacy, while another 12.6% were vaccinated at a walk-in clinic. That means that as of Jan. 15, as many as 18.5 million Americans had received their flu shot from a community pharmacist during the current flu season, with another 11.7 million relying on a nurse practitioner or other retail or urgent-care clinician.
It’s good news for chain and independent pharmacy, and affirms the success retail pharmacists have had in expanding their patient-care efforts and convincing patients that there’s a more convenient and cheaper alternative for basic health services like immunizations. But the Ipsos survey results also mean that roughly two of every three Americans are still going to a physician’s office or other professional site for something as universally available and accessible as a flu shot.
That suggests opportunity. Tens of thousands of chain and independent pharmacists have become certified to provide immunizations, not only for influenza but for other diseases, and tens of millions of patients are still bypassing their local drug store, supermarket or discount store pharmacy so that they or their health plans can spend more to get immunized at a doctor’s office.
The survey pointed up another area of potential for retail pharmacies and clinics as well. Pollsters found that only about 40% of Americans had been vaccinated as of Jan. 15, with another 5% of respondents reported to be still considering getting a flu shot this year – despite the fact that the flu epidemic continues to rage in the western U.S.
What’s more, only one in three of those surveyed seemed concerned about catching the flu, and roughly the same number said they were afraid that getting the vaccine increased their chances of getting the flu. Roughly one in six respondents told researchers the vaccines aren’t safe.
Who better to counter those fears than the pharmacist or clinician. Your comments, as always, are welcome.
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American Greetings unveils collection for Valentine’s Day
CLEVELAND — "Romantic," "sweet" and "funny" are three of the words that might describe American Greetings’ line of Valentine’s Day cards for this year.
The company highlighted one card in its American Greetings Premier collection that says, "Will you make me the happiest person in the world … Will you marry me?" saying the entire collection was designed for people seeking a "sophisticated touch."
The company also is marketing Boofle, a stuffed dog, which will be featured on greeting cards, gift bags and other accessories. The collection "A Heart’s Journey" features watercolors by artist Kathy Davis and celebrates different kinds of relationships.
In addition, Vinyl Notes cards feature technology that plays songs with the crackle and spin of old vinyl records. Other products include Taylor Swift cards, cards with hand-drawn art by Mary Englebreit, justWink app cards and others.
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Billions at stake in CMS’ pay-for-performance rankings
Money is a powerful motivator. Look no further than the sports world for validation. The PGA’s FedEx Cup encourages golfers to earn “points” towards participation in playoffs that offer a big season-ending payoff. Tennis has a similar format with the U.S. Open Series where performance in a series of events equates to a huge prize purse. Both instances use hefty prize money to help ensure the top performers participate and at high levels. The Centers for Medicare and Medicaid Services (CMS) have applied this sports theory to its rankings system of Medicare Advantage (MA) and Prescription Drug Plans (PDP) plans. And there’s billions of dollars up for grabs for healthcare plans.
CMS Ups the Ante on Star Ratings
Since 2007 the CMS has posted rankings of MA and PDP plans to give consumers an informational tool when comparing and selecting plans. It was designed to help identify poor-performing plans and provide consumers with informed choices. The CMS rankings system—called Star Ratings—has always played an important role, not only as an informational tool but a mechanism to encourage quality and accountability with providers. With the passage of the Affordable Care Act (ACA), however, those CMS Star Ratings have a renewed importance for health plans in the form of big money and strategic business advantages.
Billions Up-for-Grabs for Health Plans
By tying bonuses to performance, the CMS upped the ante for all those playing. Insurers now have an added incentive to achieve for higher performance ratings. Not only is big money available—more than 3.1 billion in 2012, according to Kaiser Family Foundation—but plans awarded high-ranking status have extended enrollment periods and also can boast a high performing gold star “icon” associated with their plan. You can see how these two things can easily sway more enrollees their way.
How it Works
So how do these rankings work? MA plans are assigned a Star Rating for five different areas or domains: 1) Staying Healthy: Screenings, Tests and Vaccines; 2) Managing Chronic Long Term Conditions; 3) Member Experience with Health Plan; 4) Member Complaints, Problems Getting Services, and Improvements in Health; and 5) Health Plan Customer Service. PDPs are evaluated in four areas, too. The CMS then derives a summary score for each plan and assigns a rating. According to the new law, CMS will pay up to 5% of a health plan’s total yearly benchmark payments to those plans receiving four stars or higher. Pending the plan’s size, that could equate to big money. (For additional details visit www.medicare.gov.)
The changes have many organizations scrambling to make sure they are among the highest-ranking plans—which means achieving a 4 ranking but striving hard for a 5. But very few plans will receive the coveted five-star ranking; data shows only 2% earning top status.
How Plans Can Succeed
To achieve best practices, of course, every organization needs to take a holistic and strategic review of every facet of their overall business: member interactions, service and offerings; pricing and procedure; and operations and organizational structure. And it should be a company-wide priority. But there are two domains I believe should have a special focus: 1) Staying Healthy: Screenings, Tests and Vaccines; and 2) Managing Chronic Long Term Conditions.
Many complain that ratings system is heavily skewed towards preventive measures such as screenings for chronic health issues. Although that’s raised some criticism, it’s actually a great thing for plans. Why? Today two big things are changing the healthcare landscape: Technology and access.
Technology & Access: Driving Today’s Empowered Consumer
Today there is a new type of consumer. They are most likely armed with technology, on-the-go, and expect a higher level of customer access, information and service. The rise of digital, social and mobile gave rise to this trend. This goes for almost every demographic group—including seniors. The dark days of healthcare—lack of information, knowledge, access and understanding—are being replaced by open access and information. Those “walls” are being kicked down. The most successful healthcare insurers and plans will provide their members with convenient access to services and information that empowers them to take charge of their health.
At SoloHealth, our entire business model revolves around free healthcare access for today’s empowered consumer. Our nationwide network of SoloHealth Stations offer consumers free access to a comprehensive health screening, personalized health assessment, list of medical professionals for follow-up care, and unlimited abilities to educate and inform. Located conveniently in retail locations, it’s all done through a simple, easy-to-use self-service touchscreen kiosk. It takes less than seven minutes.
We are already in discussions with cutting-edge health insurers who want to bring new services and offerings conveniently to their members where they are frequenting—retail locations like pharmacies in Walmart and Sam’s Clubs stores. Imagine a member being able to quickly do routine screenings or learning valuable information at a kiosk while picking up a prescription or doing some shopping. It’ll hit on two CMS Star Rating points—routine screenings and customer satisfaction.
There are many technologies that plans can take advantage of to provide better more convenient access and services to members. There are mobile apps for checking activity levels, eating habits, and now even EKGs. There are technologies to digitally and efficiently remind people to take their necessary daily medications. There are a slew of “fitness bands” that do a remarkable number of health and wellness capabilities. And most every one of these are attached back to a data source—many cloud-based—so you can track, trend and share your results. And what about online services like website, social media and email communications? How engaged are you across all today’s digital channels?
Bottomline: Health insurers need to evaluate their current technology offerings and services and from the viewpoint of the consumer. What consumer-centric services can you be offering that would empower your members to conveniently take charge of their healthcare. Not only will you be empowering them towards better health but you’ll be striving toward your goal of that coveted 4-Star and 5-Star ranking. Much of the CMS Star Ratings is about perception: How do consumers perceive your plan and services offered? Start delivering on that service promise by leveraging the latest technologies and create positive member perceptions.
Need a little motivation? The CMS has more than three billion dollar bills to help.
Bart Foster is the CEO & Founder of SoloHealth.