By Craig Burgess, PharmD, Owner of Pinon Family Pharmacy, WSPC Regional Leader
The Pharmacy to Hospice Administration program increases profits and creates better patient outcomes—a win-win for community pharmacies
As pharmacy owners, we struggle to get a fair reimbursement rate with each prescription filled. PBMs are the primary beneficiary of our day-to-day hard work.
During a recent visit with Kevin DeMass, I was explaining how hard it is to stay competitive with hospice pharmacy PBMs such as HospiScripts. (Kevin is the owner of The Apothecary Shoppe and a Western States Pharmacy Coalition board member.) Even if we form personal relationships with locally owned hospice agencies, they are still always under increased pressure to decrease their expenses, and pharmacy services are under constant review.
Then Kevin told me about a program that AmerisourceBergen PBA Services offers all Western States members, the Pharmacy to Hospice Administration program. The program has a competitive pricing schedule, easy billing, a wealth of reports for the hospice agency, and very low administrative fees.
AmerisourceBergen created the program to:
- Solidify and enhance the relationships between independent pharmacies and local hospice agencies
- Allow for increased profitability
- Create better patient outcomes
A direct partnership between your pharmacy and the hospice agency can increase your profitability and efficiency
Through the Pharmacy to Hospice Administration program, AmerisourceBergen provides administrative tools (claims processing, eligibility management, formulary management, network access, cash management, CMS reporting, and more) to local pharmacies so that they can devote more time and resources to dispensing medications and expanding their offerings to local hospice agencies.
Creating a direct partnership between the pharmacy and the hospice agency has resulted in a win-win outcome for community pharmacy. The pharmacy wins by contracting directly with the hospice agency, providing improved clinical services for better reasonable reimbursement levels. The hospice agency wins with improved patient care and increased savings. This program allows the pharmacy to dispense medications, actively participate in clinical programs and replace the third-party administrator (TPA). Without interference from the TPA, savings are shared between pharmacy and hospice agency for improved patient outcomes.
I contacted Mark Bernhardt at AmerisourceBergen immediately after learning of the Pharmacy to Hospice Administration program, and we started working on new contracts and professional marketing materials right away. Now, I am receiving a fair profit for my efforts, and I am consistent and competitive with pricing.
I believe this program will play a larger role in my pharmacy’s future. Our next step is setting up contracts with local businesses that are trying to decrease insurance costs. These businesses are going to utilize our pharmacy PBA program and drop their current pharmacy benefits. Once the businesses have dropped their pharmacy benefits, they can then offer a catastrophic insurance plan or keep medical insurance under their current plan.
This is just one way Western States Pharmacy Coalition and AmerisourceBergen have helped me improve my independent pharmacy business and stay innovative and ahead of the game.
You can contact Craig Burgess at 505-327-4826 if you’d like to learn more.
With thanks to Mark Bernhardt, Director, Product Development PBA Services, Elevate Provider Network, who provided a full description of the program for this article. Mark can be reached at 714-329-9560.
You can also find more information about the program at www.pharmacytohospiceadministration.com or contact Mark directly to learn more.