Crystal Lennartz was recently promoted to the role of vice president and general manager at Health Mart Atlas — McKesson’s pharmacy services administrative organization.
Prior to her current position, Lennartz spent three years as vice president of pharmacy performance at Health Mart Atlas, where she led the team responsible for managing a high-performing pharmacy network across 7,000 independent, small and medium chain pharmacies nationwide. She led Health Mart Atlas to be the largest, top-performing PSAO in the market today — including most recently being named Most Innovative PSAO by OutcomesMTM.
Previously, Lennartz spent six years supporting the Health Mart franchise. She served most recently on its strategy and business development team where she acted as chief pharmacist. She also serves as an advocacy ambassador and board member for McKesson’s Political Action Committee.
Drug Store News sat down with Lennartz to discuss her new role.
DSN: What are your goals as you assume your new role?
Lennartz: Pharmacies are continuing to feel pressure from declining reimbursement, and that pressure is now amplified in a lot of cases with COVID-19 workload and staffing issues. So, one of our goals is supporting our pharmacies appropriately around COVID-19, and specific to the PSAO appropriate reimbursement for vaccine administration and testing.
Another goal is around our contracting strategy to ensure access to the right opportunities to help ensure our pharmacies access to patients and the ability to serve patients in their communities. Also, we want to make sure that we’re helping pharmacies to maximize any other reimbursement opportunities that are available to them. And finally, to streamline and improve customer experience, making it easier for pharmacies to engage with Health Mart Atlas team and resources needed to manage their reimbursement.
DSN: What additional pressing issues will you seek to address?
Lennartz: One of the issues we will be tackling is around effective rate and DIR fee management. Both of those result in a lack of transparency at the point of sale for prescriptions. We’re seeing about 75% of the claims across our network have the potential for reimbursement to not be final at the point of sale. Imagine trying to manage a business or even your own personal bank account if you weren’t sure what your true net reimbursement would be? That’s definitely a goal to try to increase transparency and also to advocate along with our pharmacy members for more transparency and reforms around DIR fees and other post point of sale true-ups like effective rates.
DSN: What is the state of the industry towards your goals being realized?
Lennartz: There’s been more industry attention as far as awareness and advocacy efforts in many of the states and also on a federal level regarding both reimbursement transparency and pharmacist as a provider. Recently, federal legislation was reintroduced that would help pharmacists in medically underserved areas to be recognized as providers and be able to bill for their services under Medicare Part B. We’ve seen this type of legislation come and go throughout the years, but especially at this time with the impact pharmacists were able to make with COVID-19 there’s more momentum behind it than in the past. I’m most excited about pharmacists’ ability to be recognized and allow them to get consistent reimbursement beyond prescriptions for the services they are providing. I’m very hopeful if pharmacists are recognized under Medicare Part B, it will cause a snowball effect with other payer willingness to cover pharmacist services.
We’re also seeing in some states like Ohio, where Health Mart Atlas is based, payers like Molina Healthcare and others have started to recognize pharmacists as billable providers and pay us under the medical benefit. I’m thankful for the work of pharmacies and state associations in their advocacy for that, and we’re starting to see some of the benefits of those efforts.
DSN: How is Health Mart Atlas using technology to help its pharmacies and pharmacists?
Lennartz: We continue to look at the technology that we can leverage across McKesson and also within Health Mart Atlas to be able to monitor and manage reimbursement, effective rates and DIRs. We want to provide more transparency and reporting to our pharmacies through our customer portals like myHealthMart and myMcKesson, where pharmacies can access information about their PBM contracts, submit underwater claims and better plan for DIR fees.
One example of this is called My Performance Dollars, [which] helps pharmacies see what they may need to accrue to meet DIR obligations, where they should focus their improvement efforts and to see where they have additional patient care opportunities like MTM.
DSN: How do you view the future?
Lennartz: As we go into the year, I’m cautiously optimistic. Reimbursement pressures continue to be challenging. However, some of the efforts the pharmacies are continuously doing around COVID-19 like vaccines, point-of-care testing and MTM can help round out access to patient services. Additionally, this could help generate reimbursement and revenue for the pharmacies. There’s no magic bullet unless DIR fees and effective rates are replaced with alternate approaches, but the more we can help pharmacies understand and manage their reimbursement, the more successful they can be going into the rest of 2021.