The COVID-19 pandemic in the U.S. has further uncovered the severity of our country’s healthcare inequities and their related challenges. In response, pharmacists, the country’s most accessible healthcare providers, are finding new opportunities to address specific disparities for improved care.
In particular, independent pharmacies are successfully modeling strategies that retail pharmacies—if enabled by the right tools—can adopt. The independent “high-touch” pharmacy approach is built on personalized care for each patient, one that meets them where they are instead of where their diagnosis defines them to be. Retail pharmacists can remain competitive in value-based healthcare models with a deeper understanding of their patients’ underlying needs and, more specifically, barriers to medication adherence.
While the current crisis requires creative solutions, they don't need to be “extreme” or outside the box, as independent pharmacy colleagues discovered long ago. What begins with a listening ear develops into a holistic approach of each patient, enabling proper resource allocation for individualized needs and improved outcomes.
Improved treatment outcomes originate with a deeper understanding of patient needs, both inside and outside the EMR. Clinical and non-clinical information that’s accurate, current, and well-integrated enables educated decisions by providers. In independent pharmacies—which are usually smaller in size and scale—the environment is ideal for slower, closer, open-ended conversations. Patient relationship-building develops amid brief discussions about their conditions, their lives, and their challenges. The high level of personalized service they provide also includes some niche services to further wellness, conveniences to enhance treatment, and medication therapy management, or MTM, to improve adherence.
While retail environments are inherently different, retail pharmacists certainly can reach their communities in more direct, personalized ways to guide patients toward better health and adherence. Important conversations open up options for both the provider and patient: deeper understanding brings flexibility in addressing patients’ unique needs. There are tools to help guide retail pharmacies in this quest for deeper insight.
SDOH for support
Clinical care alone has a very limited effect on overall population health, and research shows that it could be significantly enhanced by pairing it with approaches that address social determinants of health, or SDOH. Up to 80% of our health is affected by factors outside the traditional health system, for example housing, public transportation, education, food and nutrition, social support and human interaction, and public safety. These factors help represent the whole patient and what shapes their worlds, particularly for underserved populations.
Retail pharmacies implementing SDOH by way of a socioeconomic health score can leverage specific insights about those at most risk for failing to follow their medication protocols, and therefore, guide them to achieve the intended benefits. This is a key tenet of value-based care that both independent and retail pharmacies strive to achieve.
With “high,” “medium,” or “low” scores that alert providers of challenges regarding patients’ finances, education level, or transportation access, for example, pharmacists can ask appropriate questions, gain further insight, and connect patients with vital resources to overcome treatment barriers. Whether it’s mail-order refills, counseling about the regimen, transportation assistance, or cost-cutting alternatives, the pharmacist has a real opportunity to identify solutions that improve medication adherence rates. SDOH-based insights can help pharmacists allocate resources in line with specific needs and behaviors, a benefit that engages both patients and available support services for improved outcomes.
To the stars and beyond
When it comes to the collaboration with payers, pharmacists are well aware of the star ratings’ ability to improve in tandem with medication adherence and patient care. To optimize performance on quality measures, pharmacists—independent and retail alike—are utilizing all the tools in their box to reach those at risk for poor outcomes, particularly related to adherence. In reaching these patients and targeting chronic disease treatment, pharmacies are experiencing a higher refill rate, which also improves the bottom line. Deeper understanding enables vital predictions that are required for large-scale changes in the value-based care environment.
Enabling personalized care in the pharmacy via appropriate SDOH interventions benefits all patients, during the pandemic and beyond. By eliminating barriers and establishing a personalized action plan for patient management, our communities will realize enhanced treatment and healthier lives.
Craig Ford is the senior vice president of pharmacy sales at LexisNexis Risk Solutions Healthcare.