The other day, my business partner and I had a conference call with our wholesaler and our PSAO about the impact that DIR fees were having on our bottom line. The representative from our PSAO kept emphasizing that the reason why they signed the contracts with some preferred networks (with very low pharmacy reimbursement) is … Continue reading Access to Lives: What does that mean and to whom?!
The other day I sat contemplating the pricing of a large pizza. Yes, I am a bit of a math geek, and I was having trouble wrapping my head around why the price of a 16 inch pizza was only a couple of dollars more than a 12 inch pizza despite the exponential nature of … Continue reading Large Pizza and the 90 day Refill
DIR fees are a hot button item for many pharmacies and pharmacy owners. These fees are not well understood and their impact on the health of pharmacy as a profession is significant. Recent conversation with both our PSAO and (surprisingly) representatives from a major PBM have me questioning why pharmacies are even being involved with … Continue reading DIR Fees–Why Are Pharmacies in the Middle?
Background/Intro: Studies have continually shown that community pharmacists can impact and improve patient outcomes if they utilize clinical skills during the dispensing process. The question that arises is: How can we change current reimbursement models to reward pharmacies for the clinical and cognitive services we provide in the dispensing role? Traditionally, as highlighted in previous … Continue reading Residency Project: What Types of Interventions are Pharmacists Performing and Documenting with a New-Payer Model?
Kevin Schweers with NCPA posted a piece about the PBM industry last month on “The Dose” (NCPA’s blog). It is an interesting read and ties in with some of the themes here on the Thriving Pharmacist’s Blog. You can read his post at That Man Behind the Curtain? Pay No Attention
Yesterday, our pharmacies received an update from a major Part D plan in our area. This update stated: Effective immediately, [plan] will continue to cover brand name ABILIFY at the non-Preferred Brand Tier. The generic, aripiprazole, will NOT be covered for the [plan] members. Please continue to dispense ABILIFY rather than substituting the generic product… … Continue reading Part D Follow-up
For the first time, numbers from CMS hint at how much Pharmacy Benefit Managers may profit for their role of managing the Prescription Drug Plans.
An EXTRA dose of Thriving for your weekend reading, with a follow-up to yesterday’s “Rewards for Performance” where we address flaws in claims based PDC and explaining Double Jeopardy with respect to performance payments.
Recently, 2014 performance reports have begun to emerge and pharmacies are starting to see the fruits of their quality oriented labor. Was it worth the wait?
[dropcap color=”white” background=”black” style=”rectangle” size=”big”]M[/dropcap]ore and more, we are hearing that MTM is the future of pharmacy. And while there is some truth with this statement, the reality is a lot more complicated. MTM, as it has evolved under Medicare Part D’s parentage, is a poorly conceived service. The separation of the medication costs and … Continue reading Rx: MTM in small, frequent doses.
