Payers And Providers Want Pharmacy Partners That Offer Comprehensive Services
The programs are a big selling point with partners. An insurance company learned about Sheefa’s diabetes educational programs. Now that company is directing patients to Sheefa — and United HealthCare wants in, too.
“United HealthCare was so excited about our program, they promoted our seminar to a mailing list of their patients,” Ashraf says. “We had one joint seminar for their patients, and now we’re trying to plan some more initiatives like this.”
When independent pharmacies are working with big payers, it can take some time to figure out the relationship. As pharmacists and pharmacy owners, you know some of the challenges all too well. Work to keep the conversation going — and reframe it to focus on common goals.
“What we’re trying to do is change the mindset that pharmacies are dispensers,” encourages Whit. “If we look at health care spending as a pie, pharmacy is confined to the 10 percent cut spent on prescription drugs and dispensing. But that remaining 90 percent — the health care part — is where we’re saving them money. Our pharmacy programs keep patients out of the emergency department and the hospital.”
That’s what Moose Professional Pharmacy is working towards. They’re pushing for high-performing pharmacies to be reimbursed from that 90 percent of the pie for lowering health care costs.