If you have been following the Thriving Pharmacist, you undoubtedly saw an abrupt halt in the posting of content. One could have attributed this to Covid. While the crisis did contribute to the dearth of written content, we also put our efforts into a podcast during that period to support pharmacies called Thrive Subscribe.
As that project wound down, another distraction consumed time to create content in this space: acquisitions. Since I last wrote in this space, we have purchased four pharmacies. The process of purchasing a pharmacy is involved, time consuming, and tedious. After completing the purchase of even one store, energy is required to assimilate new organizations into the culture of the parent organization.
In a sense, the Thriving Pharmacist went on sabbatical to practice what it preaches: thriving.
And to be fair, during the Covid pandemic, pharmacies that were putting effort into immunization and other projects were rewarded. In many ways, the pandemic was one of best periods in recent history for pharmacy owners. The new and unanticipated revenue stream from vaccination provided many owners a respite from the difficult challenges of ownership. Not that pharmacies and staff weren’t stressed during this time. But the stress was related to workflows and business and not trying to find ways to pay the bills.
We enjoyed the respite from worries about reimbursement woes and DIR fee worries during the pandemic. These worries weren’t gone, but instead, masked by other revenue. Covid is now endemic, and the stark reality of these challenges, for a while forgotten, are back.
Since we last chatted here, The DIR landscape has changed. Significantly. These fees, starting next January, will instead be applied at the point the pharmacy adjudicates the prescription. This is both good news and bad. We will know what we are going to receive for our efforts (service and product) before it goes out the door. That is good.
The bad news is that the middlemen (PBMs) continue to squeeze reimbursement to pharmacies. And while it is too early to tell right now, by next week we will have a much better idea what 2024 will look like. Medicare Part D Open enrollment starts October 15th, and at that point we will start to see what reimbursement will look like in this new era.
A spoiler: we anticipate reimbursement to be significantly worse come January. The respite is over. I am hearing a rapidly escalating fervor from pharmacy owners that the sky is again falling.
I won’t argue that we face some stiff headwinds. But panic is not the answer. To thrive, one needs to plan. To act! And that means disseminating ideas and information. It means that it is time to get back to work here at the Thriving Pharmacist.
Hello again. We are back.
