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Pharmacy Clinical Services: Don’t Miss Out

BY Todd Evans

As patients look for ways to obtain healthcare in more convenient and lower-cost settings, new opportunities are emerging for retail pharmacies to help meet patient needs. Many pharmacies already are recognized as cost-efficient channels for expanding public access to vaccinations, disease management, medication management, and other clinical services. 

In fact, the business case for bringing clinical services in-house is an easy one for pharmacies to make because all stakeholders win: pharmacies, payers, providers and patients. In-store clinical services are becoming an increasingly viable option for pharmacies, especially as the industry continues to embrace an elevated clinical role for pharmacists.

With payers expected to drive further expansion of pharmacy-rendered clinical care—and new infrastructures to support the addition of these revenue streams—retail pharmacies simply can’t overlook the potential benefits.

Taking Hold of Clinical Services
The concept of adding clinical services to the pharmacy is not new. Medicare Part B has allowed pharmacies to provide immunizations since the early 2000’s. Recognizing the value, commercial payers have pushed for more clinical services in retail pharmacies—which in turn has made them more practical and attractive.

Yet until recently, infrastructure limitations have challenged retail pharmacies’ ability to appropriately bill for clinical services. Since pharmacy information systems typically only support billing a patient’s pharmacy benefit, pharmacies have had to resort to manual processes to bill for clinical services through patients’ medical benefits.

Fortunately, industry advances now allow retail pharmacies to maintain their existing infrastructures while integrating with solutions to bill medical benefits. Here’s what happens:

A retail pharmacy submits a claim for clinical services through a pharmacy benefit platform. The claim is edited and pre-adjudicated. Once approved, data from the claim is translated into a medical benefits claim and submitted via the third party solution. Remittance advice is then sent back to the pharmacy so the information can be absorbed into appropriate accounts receivable systems.

This kind of technology support allows retail pharmacies to build profitable immunization programs, such as offering flu, pneumonia and shingles vaccines. It can also enable chronic disease management and preventative care services.

As helpful as technology can be, however, another part of getting an initiative off the ground is understanding the regional market. Pharmacies need to take a progressive approach to explore potential relationships and contract opportunities with health plans, employers and risk-bearing entities, such as accountable care organizations.

A Positive Future Outlook
Clinical services offerings within retail pharmacies are still in their infancy. However, with the billing workflow issue solved, pharmacies face fewer obstacles to bringing this revenue-generating business line in-house.

Large national chains, as well as many regional retail pharmacies, already work diligently to engage patients on a higher clinical level. Some states are also considering the potential benefits of elevating the role of pharmacists to provider status. Pharmacies that take steps now to deploy the best workflow infrastructures and develop key relationships within their local and regional networks stand to gain the most as the future of healthcare delivery unfolds.


Todd Evans is VP of Product Management, Networks at Change Healthcare.
 

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And the newest retailer to enter the beauty biz is …

BY Mike Troy

The newest concept in beauty retail is called The Glossary and it is arriving on more college campuses courtesy of Barnes & Noble College.

The Glossary concept was piloted at the Barnes & Noble Emory University and Southern Methodist University bookstores and more recently expanded to the campuses of Tulane University and the College of William & Mary. The newest location set to open in August will be on the campus of the University of California at Riverside.

The Glossary is a store-within-a-store concept that Barnes & Noble College describes as a “dynamic shopping environment that offers students the opportunity to explore, sample and purchase a wide variety of mass and prestige beauty products.”

“We built our reputation as one of the most trusted campus retailers by continuously innovating and creating new merchandising ideas we know our students are looking for,” said Joel Friedman, chief merchandising officer with Barnes & Noble College. “We are excited to introduce The Glossary to our college partners, making the brands and products students want easily accessible to them for the first time.”

To execute the beauty concept, Barnes & Noble College is working with global retail design and build firm RPG to design, brand and manufacture The Glossary, and prestige health and beauty brands distributor EC Scott Group to stock its shelves with product.

To distinguish The Glossary from the main bookstore, RPG used warm colors and hand-drawn original art to create a unique, approachable presence. Main drive-aisle spaces and in-store locations position The Glossary for high traffic, while product displays create and encourage in-store experimentation. To appeal to a diverse spectrum of college students, The Glossary features a wide range of products, from prestige brands like Smashbox, Philosophy, Bliss and Lipstick Queen, among others, to traditional mass-market brands including Burt’s Bees, CoverGirl and Maybelline.

“Through in-depth student discussions and focus groups, we recognized a gap in access to beauty solutions on campus and worked with them to help shape The Glossary,” said Lisa Mazzio, director of merchandise, fashion trends and beauty, Barnes & Noble College. “Their feedback informed the categories and brands we sell, the look and layout of the stores themselves, and the format that inspires self-discovery rather than in-aisle beauty consultants, which students expressed were less desired.”

According to Mazzio, RPG created a concept that appeals to a wide array of campus consumers and the concept’s design attracts value seekers, product perfectionists and brand devotees. It is also scalable to add, evolve and change the product mix in the future as Barnes & Noble College looks to extend the concept to its 748 stores on campuses nationwide.
 

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