Value-based care is driving a number of positive trends within the retail pharmacy sector.
To start with, providers, payers and patients alike are looking to pharmacists to become more collaborative partners in care. In addition, the increased demand for low-cost clinical services is opening the door to new revenue opportunities.
Retail pharmacies are in an ideal position to deliver better access to clinical services such as vaccinations, disease management and medication therapy management (MTM) at a lower cost. They are also primed to provide needed consultations to improve medication and care plan adherence.
The challenge is getting the right information streamlined into a pharmacist’s workflow to pave the way for proactive patient engagement. Although many any retail outlets have taken a step in the right direction and turned to solutions and services that assist with effective MTM efforts and patient education, there is more to be done.
Smart messaging, the process of leveraging current technology platforms to provide the patient with clear messaging at different points in the care process, can take outreach to the next level by giving pharmacists practical intelligence to prompt action. These solutions help pharmacists deliberately identify gaps in care and missed opportunities for wellness. Armed with actionable, point-of-care information, these professionals can then reach out and facilitate more tactical care conversations with patients.
Improving Outreach to High-Risk Patients
Smart messaging provides a framework especially well-suited for enhancing outcomes in high-risk patients. Building on pharmacy messaging solutions that speak to general patient safety concerns, smart messaging adds a new layer of sophistication by pulling data from multiple sources to increase clinical intelligence.
For example, consider one retail pharmacy pilot that is underway:
Data gained through a smart messaging platform automatically identifies patients with diabetes through past treatment history, no matter what medications they are picking up at the time. Once identified, the tool immediately triggers a medication check and confirmation that the patient is adhering to therapies. For example, the system could determine whether the patient is taking a statin—a critical component of diabetic care plans.
In such scenarios, the pharmacist can start a conversation with the patient to discuss any non-adherence issues and provide necessary education. A consultation with the patient’s doctor can also ensure that appropriate statin is ordered. Ultimately, smart messaging opens up a new way to engage patients along the care continuum.
Advancing Revenue Opportunities
Proactive outreach naturally lends itself to superior performance on the quality and cost fronts. In regard to Medicare Star Ratings, pharmacies that leverage smart messaging can assist payer networks in their efforts to identify and close gaps in care. In turn, the healthier patient population should lower medication spend, and allow payers to maximize reimbursement.
Pharmacies can also use smart messaging to identify revenue opportunities within their own clinical offerings. For instance, most people are eligible for a flu vaccination, but patients who might benefit from a shingles vaccination typically meet more specific criteria. Smart messaging can help pinpoint at-risk candidates, so pharmacists can be ready to suggest the offering during a patient interaction.
Smart messaging continues to evolve as an advantageous tool for elevating the clinical role of retail pharmacies. By getting the right information to pharmacists at the right time, it offers a powerful way to enable best practices for patient engagement.
Matt Landin is Senior Director of Product Management, Networks at Change Healthcare.