Majority of retail pharmacists fear losing Medicare-eligible patients

A majority of retail pharmacists fear losing their high-value, Medicare-eligible patients when those patients choose a Medicare plan that is out of the pharmacy’s network, according to a new survey conducted by EnlivenHealth, the retail pharmacy solutions division of Omnicell.

Underscoring the significance of these findings for the retail pharmacy industry, the survey found that 70% of pharmacists who responded say a third or more of their pharmacy revenue comes from Medicare-eligible patients.

EnlivenHealth's first-ever Pharmacy Medicare Patient Engagement Survey asked pharmacists what concerns their patients expressed to them regarding their Medicare Part D plans. More than 78% of responding pharmacists said their patients indicated they are worried about their preferred pharmacy not being in-network if they choose a different plan. More than half of the survey respondents said their patients also expressed concern about increased drug copays and the overall cost of those Medicare plans.

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In an effort to help pharmacies retain their high-value, Medicare-eligible patients, EnlivenHealth offers Medicare Match, a comprehensive suite of Medicare plan comparison and selection tools that are designed to enable pharmacists to assist their patients in choosing the plan that best meets a patient’s needs. With Medicare Match featuring the NavigateMyCare.com plan comparison website for patients, pharmacies should be able to help their patients choose an affordable Medicare Part D plan that covers the patient’s specific medication needs. This should result in healthier, happier patients and stronger business results for pharmacies, the company said.

"Medicare-eligible patients are often the lifeblood of the retail pharmacy, which is why we believe the majority of pharmacists responding to our national survey were so concerned about losing these valuable patients when these patients choose a new Medicare plan," said Danny Sanchez, senior vice president and general manager of EnlivenHealth. "We have been working closely with pharmacies large and small to empower them to retain their Medicare-eligible patients by helping patients successfully navigate the major life event of enrolling in a Medicare plan that's right for them. With our Medicare Match solution, we believe pharmacists can further enhance their growing role as a trusted community healthcare provider and adviser focused on their patients’ health and well-being.”

More than half of the pharmacists responding to the EnlivenHealth survey ranked "insufficient staffing" as the top barrier to implementing a Medicare plan comparison solution in their pharmacies. For those pharmacists who have the staff to provide Medicare plan advice to their patients, respondents indicated in-person communication was the preferred method. According to the survey, 75% of responding pharmacies use in-person communications to regularly engage with their patients about Medicare Part D plan enrollment.

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Medicare plan comparisons have always been important for our pharmacy to ensure our patients can afford their medications and, ideally, save money," said Nicolette Mathey of Palm Harbor Pharmacy in Palm Harbor, Fla. "In our view, Social Security and pension benefits have not increased their payments enough to counter current levels of inflation. We think inflationary pressures make plan comparisons even more important for this year's Annual Enrollment Period.”

"[Our] patients love the Medicare enrollment consultations we provide," said Steve Adkins of Health Park Pharmacy in Raleigh, N.C. "Last year, we [generally] saved all [our] patients $250,000 to $300,000 by helping them compare Medicare Part D plans with Medicare Match from EnlivenHealth."

Other findings of the survey include:

• Seventy percent of respondents indicated that at least a third of their patients are Medicare-eligible;
• Fifty-four percent of respondents indicated that they're "very active" or "extremely active" in helping patients choose a Medicare Plan;
• Seventy-three percent of respondents stated that they regularly communicate with their patients about Medicare Part D enrollment; and
• Eighty-two percent of respondents indicated that they want to improve adherence and health outcomes for their Medicare-eligible patients.

EnlivenHealth's survey, which was conducted in July 2022, surveyed 14,450 retail pharmacists and used results from 375 respondents who completed the survey.