New force in pharmacy eyes expansion of clinical care

The merger of Albertsons and Supervalu brought together more than 900 supermarket pharmacies clustered within a wide variety of retail banners stretching from coast to coast. And overnight, it made Supervalu a national pharmacy force to be reckoned with.

The company’s pharmacy management team—along with the front-line pharmacists and technicians who are the face of Supervalu pharmacy to millions of patients—have been quick to capitalize on the human and financial resources unleashed by the merger. And the combination of two strong players—each with a history of support for the pharmacy side of the business—has buoyed the new pharmacy power.

“The really interesting part of this new enterprise is that pharmacy was extremely important to the Albertsons organization, based on our drug store background and so on. But pharmacy had taken a pretty strong position in the Supervalu organization as well,” noted Kevin Tripp, who came to Supervalu with the acquisition of Albertsons and who now serves as executive vice president and president of Midwestern retail operations for the 2,500-store company.

“In my first year here, as I look across the enterprise, I see operations like Cub that have a very strong foothold here in Minneapolis in pharmacy, with a very strong reputation and terrific people,” Tripp observed. “We’ve been able to attract some of the best pharmacists in Minnesota to work for us. And Jewel-Osco, of course, has a tradition of great pharmacies—as does Sav-on in Southern California. As you go across the enterprise, every banner—although they all kind of developed uniquely—has great promise for the future.”

Supervalu’s pharmacy team has big plans for that enterprise. “We believe the future of community-based pharmacy is going to be based much more around the knowledge and clinical services the pharmacist provides, and we’re looking at how we expand that,” said Chris Dimos, president of Supervalu pharmacy. “We need to look at those types of things we can do that maybe others can’t.”

With that in mind, key questions arise. One big one, Dimos said, is, “How do you take care of the entire patient and not just a particular issue or a particular disease state?”

Closely related to that concern is another question Dimos and other pharmacy managers at the company are wrestling with: “How do we tie in the rest of the store?” Dimos said.

Supervalu has some answers. One big one is its Eating Healthy with Diabetes program, under which the pharmacy, patient education and healthcare services offered by the chain’s 900-plus pharmacies are tied to a broader, holistic approach to wellness and disease prevention.

“Eating Healthy with Diabetes also talks about heart-healthy foods,” Dimos said. For instance, he explained, “We’re addressing obesity, and work is under way now to look at childhood obesity in the United States, and how we tie in the overall patient—not only their medication therapy but their overall wellness. How do we prevent illnesses from happening, and how do we use those services to get early predictors of disease?”

Dimos sees “all sorts of opportunities” for Supervalu pharmacies to offer health screenings for diabetes, heart health, thyroid conditions and other diseases. “We have a pretty good ability to go out and take care of the entire patient,” he told Drug Store News.

Those programs, in turn, can be replicated in one form or another throughout the company’s nearly dozen retail operations, whether or not they share a common brand name, Dimos said. “I’m not sure they all need to be called one thing, as long as we can really give that patient a common experience, and that the patient understands that inside the four walls of a Supervalu-owned entity, this is the experience they’ll have.”

In other words, Tripp said, “The way we go to market is, we want our customers—regardless of which of our banners they’re having their prescriptions filled in—to have a common experience. And how we engage them with some of our newer programs may shift depending on the banner.

“All these banners entered the organization at different points,” he added. “Some of them, like Cub, Jewel-Osco and Sav-on, already are well-developed along the clinical pathway. Some of the other banners weren’t quite there yet, but they’re quickly catching up.”

Long term, Tripp said, “The vision is that we’ll have a national enterprise, and based on our ability to execute [various clinical programs] within the states where we can.”

For instance, Dimos explained, such clinical service programs as Vitality Check, a health assessment program for health plan members and other patients delivered by company pharmacists, are “only available where we’re getting paid for those services, so those services are rolled out in those areas where we have an opportunity to provide them and be compensated. We’ve built a way of doing that particular service, and when it becomes reimbursable in other areas, we can pick it up and drop it down in those areas…[where] it makes sense.”

In terms of clinical care, the Chicagoland market, both from a Cub and a Jewel-Osco standpoint, probably “had the most developed clinical programs,” Dimos said, “but we have quickly…consolidated the clinical programs group, and expanded it.

“Within Supervalu pharmacies, it’s bigger than it was in either of the two heritage organizations. And we’ve been able to come back to markets that needed some strengthening around the clinical programs group to educate, to train and to have people get engaged with those types of programs and have a fulfilling career around that type of vision.”

The clinical program group now is a fully staffed directorate at Supervalu’s pharmacy operation, headed by Albertsons and American Stores veteran Tony Proven-zano, who made his mark as director of diabetic care efforts at Jewel-Osco. Provenzano oversees four general areas of clinical pharmacy care, each with its own manager and support budget.

“It’s much more robust than it’s ever been, and frankly that’s because we believe that’s where community pharmacy is going,” Dimos declared.

One of those core clinical pursuits is in medication therapy management, Dimos said. “[MTM manager] Jaime Hendrickson has really developed that program. MTM is just now trying to figure out what it wants to be when it grows up. One of our challenges is how we reimburse for the services that pharmacists can provide.”

To pursue that objective, Supervalu’s clinical team has forged working partnerships with two outside solutions providers, Mirixa [founded by the National Community Pharmacists Association and formerly known as Community MTM] and Des Moines, Iowa-based Outcomes Pharmaceutical Health Care. Indeed, the relationship with Outcomes preceded the Albertsons merger, with jointly produced MTM pilot programs in Florida and Iowa.

“We continue to have interactions with Outcomes and Mirixa and with some other entities that are paying for our performance on an individual basis,” Dimos said. “That’s the challenge right now. We believe MTM has some huge upside. I think MTM is going to be more than just the one-time review or interaction between the pharmacist and patient. I think there’s going to be much more work around persistence and compliance or adherence, and I believe there will be a much larger role for pharmacy to play.”

Pharmacy automation and electronic communications will help drive that evolution, company leaders predict. Supervalu is well into a companywide program to convert all the diverse pharmacy technology systems used by its many retail divisions to a single, common systems platform. That migration to an integrated dispensing, record-keeping and communications system that reaches across every pharmacy will yield a slew of benefits—including the nascent effort to create a workable, paying model for MTM, Dimos said.

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