Elements Magazine Vol. 14 Iss. 4 December 2025

PBA HEALTH + SPEED SCRIPT = PARTNERSHIP Bringing best-in-class group purchasing and technology under one roof

THE RISE OF MENOPAUSE CLINICS Helping women thrive through hormonal transitions

BEYOND THE COUNTER How medical billing technology is empowering independent pharmacies VOL. 14 ISS. 4 | DECEMBER 2025

CONTENTS ON THE COVER

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FEATURE | Beyond the Counter How medical billing technology is empowering independent pharmacies

DEPARTMENTS

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NEWS | PBA Health + Speed Script = Partnership

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TRENDS | From Scripts to Support

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Bringing best-in-class group purchasing and technology under one roof

Build a stronger pharmacy by taking care of employees

RETAIL | From Retail to Clinical Flooring strategies that support your pharmacy’s new role in primary care

SOLUTIONS | A Safe Space How your pharmacy can support youth in crisis

SPOTLIGHT | The Rise of Menopause Clinics How you can help women thrive through hormonal transitions

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MONEY | Where Your Cash Goes

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OUTLOOK | Your Pharmacy Goals for 2026

Diagnosing your pharmacy’s financial weak spots

What to include in your business planning

ELEMENTS | The business magazine for independent pharmacy | DECEMBER 2025

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ELEMENTS

ON THE WEB

The business magazine for independent pharmacy

VOLUME 14, ISSUE 4 DECEMBER 2025 PUBLISHER & EDITORIAL DIRECTOR Matthew Shamet EDITOR Gina Klein GRAPHIC DESIGNER Logan Whetzal CONTRIBUTING WRITER Cecilia Vigliaturo

Continuous Glucose Monitoring (CGM) In the past decade, continuous glucose monitoring (CGM) has become an important tool to gain insight into the glycemic patterns and trends of patients. The benefits of CGM have been rooted in many studies of patients with either type 1 or type 2 diabetes. They include improvement in A1c, reduction of hypoglycemic events, reduction of glycemic variability, and improvement in diabetes-related distress.

Data Privacy INTERESTED IN ADVERTISING? elements@pbahealth.com

Protecting patient information isn’t just a legal requirement; it’s a cornerstone of trust between your pharmacy and the community you serve. In today’s world, data breaches are in the headlines nearly daily, and patients expect their sensitive health records and payment details to remain confidential.

Medication Abandonment When patients fail to pick up their prescriptions from your pharmacy, it can have a huge impact on your store.

Prescriptions that are abandoned are a loss of revenue, resulting in wasted resources, not to mention the labor that’s involved in filling a prescription that will only be returned to stock.

Elements magazine is published quarterly by PBA Health. ©2025 PBA Health. All rights reserved.

Neither this publication nor any part of it may be reproduced without written permission by PBA Health.

Follow Elements magazine for pharmacy business tips and advice, news announcements, industry information, and exclusive offers.

NEWS

PBA HEALTH + SPEED SCRIPT = PARTNERSHIP Bringing best-in-class group purchasing and technology under one roof

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BA Health recently announced its acquisition of Speed Script, a respected provider of pharmacy management systems and technology solutions for independent and regional pharmacies. Speed Script will operate as a wholly owned subsidiary of PBA Health. Therefore, it will continue to function under its current leadership, brand, and operational structure.

Chief Operating Officer of PBA Health, Clark Balcom, says this partnership will bring together the two companies with complementary strengths and a shared vision for supporting the success of independent pharmacies. “By combining group purchasing and supply chain experience with pharmacy technology, we’re creating a more complete, connected experience for our customers.”

PBA Health isn’t new to the pharmacy software industry.

It had a strategic alliance with an Oklahoma City-based software vendor that resulted in a successful 15 years of extensive collaboration, innovation, and high-quality support for PBA Health’s member pharmacies.

While gaining access to expanded resources, strategic support, and shared innovation opportunities through PBA Health, Speed Script will keep its independence. There are no planned changes to staffing, customer contracts, or support systems. Customers and partners can expect a seamless transition and continued focus on service excellence.

“As the pharmacy software industry has seen countless sales and consolidations over the past few years, we are determined to secure and protect access to the innovation, value, and support that our independent pharmacy members desperately need and deserve,” Balcom said. “Speed Script is one of the nation’s most efficient and scalable prescription

dispensing platforms, but also one of the best priced and optimally supported pharmacy software packages on the market today. It’s a proven, stable, and high-quality platform that provides the core essentials pharmacies need.”

“Through our combined supply chain relationships and competencies, we are committed to creating pathways to new revenue channels and patient growth opportunities vital to independent pharmacy,” said Alan Arthur, Speed Script Chief Operating Officer.

With a shared history of serving many of the same pharmacy clients, we can now offer more integrated solutions, streamline pharmacy operations, and support pharmacy growth.

“Speed Script is excited to have joined the PBA Health family. Our companies have a rich history of delivering market-leading services that enhance patient care, profitability, cash flow, and performance,” said Alan Arthur, Speed Script Chief Operating Officer. “By teaming up with PBA Health, we will accelerate our ability to do even more of this, while also positioning our member pharmacies for safe and secure participation in clinically advanced and financially sustainable pharmacy networks. Through our combined supply chain relationships and competencies, we are committed to creating pathways to new revenue channels and patient growth opportunities vital to independent pharmacy.”

ELEMENTS | The business magazine for independent pharmacy | DECEMBER 2025

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TRENDS

FROM SCRIPTS TO SUPPORT Build a stronger pharmacy by taking care of employees

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our independent pharmacy thrives on personal relationships with both your patients and your team.

Unlike the large chains, your staff is small. Therefore, every pharmacist, technician, and clerk has a critical role.

When your pharmacy employees feel supported there’s less turnover, morale improves, and the quality of patient care rises.

On the other hand, dissatisfaction or burnout in your pharmacy can ripple quickly into gaps in service and financial strain.

Schedule regular check-ins with your technicians to see how things are going. It doesn’t have to be formal or long. A quick conversation can shine a light on the wins and address challenges they’ve had.

GIVE FAIR COMPENSATION AND BENEFITS • Stay on top of wages regularly to stay competitive with local chains.

• Provide health insurance, retirement contributions, or wellness stipends if feasible.

• Don’t forget small perks like free flu shots, staff discounts, or snacks. These show your employees that you are appreciative.

OFFER PROFESSIONAL GROWTH OPPORTUNITIES • Support their continuing education credits and certifications.

Here are some practical ways you can support your employees:

• Check in regularly to provide feedback and listen to employee concerns.

PRIORITIZE WORK-LIFE BALANCE AND WELL-BEING • You can offer flexible scheduling when possible, especially for technicians who are balancing family or school (or both).

EMPOWER THROUGH COMMUNICATION • Arrange short weekly meetings to share updates and invite input.

• Help your staff avoid burnout by encouraging them to take breaks and use vacation time.

• Be transparent about business challenges so employees feel like partners rather than just workers.

• Consider cross-training your employees so when someone can’t come into work, coverage is easier.

• Encourage open-door policies so staff can bring up issues without fear.

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SUPPORT MENTAL AND EMOTIONAL WELL-BEING • Remember how high stress pharmacy can be, especially with staffing shortages.

• Offer training sessions, encourage certifications, or provide resources for professional development. It shows just how much you invest in their careers.

• Give access to employee assistance programs (EAPs) if possible.

KEEP A POSITIVE WORK ENVIRONMENT • Boost teamwork by setting goals and celebrating group achievements.

• Normalize conversations about stress management and resilience.

RECOGNIZE THEIR HARD WORK • Acknowledge your staff regularly for their efforts. Doing so can boost morale, increase job satisfaction, and make employees feel appreciated.

• A simple “thank you” for handling a difficult situation or a quick note highlighting a job well done can go a long way.

• Celebrate bigger milestones, such as work anniversaries or reaching a significant goal. Give them a small gift or a heartfelt card.

FOSTER THEIR POTENTIAL • When your pharmacy staff see opportunities for growth and development, they’ll feel committed to their roles.

• Set up team-building activities no matter how small they are.

• Address workplace challenges head on. Take steps to resolve issues quickly.

BE EMPATHETIC AND SUPPORTING • Check in with your team, especially when they’re really busy.

• Create a safe space for feedback.

Building strong relationships with your pharmacy staff is key to fostering a supportive and productive workplace. When you communicate openly, recognize their hard work, invest in their growth, and show empathy, you create a team that’s deeply connected.

ELEMENTS | The business magazine for independent pharmacy | DECEMBER 2025

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RETAIL

FROM RETAIL TO CLINICAL Flooring strategies that support your pharmacy’s new role in primary care

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s independent pharmacies like yours continue to reinvent themselves as neighborhood health destinations, the surface beneath your customers’ feet will be doing more than just holding up shelves. This year, flooring in pharmacies like yours evolved from a purely aesthetic or maintenance choice into a strategic element that supports infection control, patient experience, workflow efficiency, sustainability goals, and brand identity.

Why does flooring matter so much? In small retail spaces, flooring is often an afterthought. But for independent pharmacies it plays numerous measurable roles such as:

• Patient safety and infection prevention: antimicrobial surfaces, seamless transitions, and slip-resistant materials reduce risks for staff and patients.

• Operational efficiency: zoned flooring helps guide traffic, reduces noise, and withstands heavy foot traffic and equipment like carts or automated dispensing units.

• Brand and patient experience: choices on flooring influence perceptions of cleanliness, warmth, and professionalism— important when pharmacies expand into clinical services.

• Sustainability and long-term cost: durable, lowmaintenance floors reduce lifecycle costs and support eco-conscious branding.

Let’s face it: Pharmacy owners like you who treat flooring as part of clinical and business strategy will enjoy better operational performance and trust of your patients.

POLISHED CONCRETE • Why it’s good: Highly durable, low-maintenance, and increasingly used in modern retail-clinical hybrids for a clean, minimalist look.

• Practical benefits: Good for high-traffic retail aisles and entryways. It can be sealed for chemical resistance and ease of cleaning.

PORCELAIN OR GLAZED CERAMIC TILE • Why it’s good: Very hard-wearing and easy to sanitize; suitable for wet-prone areas and high-traffic entryways.

• Practical benefits: Long lifespan and strong chemical resistance; choose large-format tiles or welded joints to minimize grout exposure.

CARPET OR CARPET TILES (LIMITED USE) • Why it’s good: Use sparingly in waiting or consultation lounge areas to improve acoustics and comfort.

Here are some top options shaping pharmacy trends today: LUXURY VINYL TILE/LUXURY VINYL PLANK (LVT/LVP) • Why it’s good: Durable, easy to clean, wide aesthetic range (wood, stone looks) that create a warm, retail-friendly environment while withstanding heavy foot traffic.

• Practical benefits: Many products offer wear layers, slip resistance, and chemical resistance to common disinfectants. Cushion-backed options improve staff comfort behind counters.

• Practical benefits: Choose low-pile, modular carpet tiles for easier spot replacement and choose products with antimicrobial treatments if used near patient areas.

ANTI-FATIGUE AND ZONE-SPECIFIC MATS • Why it’s good: Not a primary floor, but critical at dispensing counters and workstations to reduce staff fatigue and slip risk.

• Practical benefits: Easy to deploy and replace. The use of rubber or gel-backed mats improve ergonomics immediately.

SEAMLESS RESINOUS FLOORING (EPOXY, POLYURETHANE, MMA) • Why it’s good: Truly seamless, impermeable surfaces ideal for clinical rooms, consultation suites, and back-of-house areas where hygiene and rapid disinfection are priorities.

• Practical benefits: No grout lines to trap dirt, excellent chemical and stain resistance, long service life when professionally installed.

RUBBER FLOORING • Why it’s good: Excellent for staff areas and dispensing counters because it’s slip-resistant, shock-absorbing, and reduces standing fatigue.

• Practical benefits: Durable, sound-dampening, and available in modular tiles for easy replacement. It’s also good for winter entry zones to reduce slips.

ELEMENTS | The business magazine for independent pharmacy | DECEMBER 2025

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SENSOR-READY OR SMART-INTEGRATED FLOORING • Why it’s good: Pressure-sensitive mats or embedded sensors can support foot-traffic analytics, fall detection, and targeted cleaning schedules—useful in busier stores or those expanding clinical services.

As you think about return on investment (ROI), be sure to factor in: • Installation costs and any downtime during upgrades • Long-term maintenance and durability

• Practical benefits: Helps optimize staffing, cleaning, and space planning; usually layered over or integrated with primary flooring choices.

SO, HOW DO YOU CHOOSE THE RIGHT FLOOR FOR YOUR PHARMACY?

• Match zones to function: seamless/resinous or sheet vinyl for clinical and cleaning-heavy spaces; LVT/LVP or porcelain for retail aisles; rubber/anti-fatigue for staff workstations.

• The potential for increased revenue from faster patient flow and expanded services Smart flooring choices today can lead to smoother operations and stronger financial performance tomorrow. In fact, flooring in successful independent pharmacies will be defined by three principles: cleanliness, comfort, and adaptability. As pharmacies continue to expand clinical services, flooring will play a practical and symbolic role—supporting safer care, improving staff wellbeing, and reinforcing the pharmacy’s identity as a trusted local health resource.

• Confirm chemical compatibility: verify disinfectant and cleaner compatibility with manufacturer specs.

• Prioritize slip resistance at entrances and near sinks or testing stations.

• Think modular for future flexibility: tiles (vinyl, rubber, carpet) simplify phased upgrades.

• Factor staff comfort and acoustics into choices for consultation and dispensing areas.

Select materials that meet your mix of clinical use, aesthetic goals, and budget. Professional installation and correct seams and sealants are critical to realize the performance benefits of any of these options.

Investing in pharmacy flooring pays off in more ways than one. You’ll save money directly through lower maintenance and fewer replacements. But the real value goes deeper— better flooring can improve how patients feel in your space, reduce staff burnout from standing all day, and support cleaner, safer environments for clinical services.

ELEMENTS | The business magazine for independent pharmacy | DECEMBER 2025

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SOLUTIONS

A SAFE SPACE How your pharmacy can support youth in crisis

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mid rising mental health concerns, chronic conditions, and the challenge for U.S. adolescents aged 12 to 17 to access healthcare, one resource remains underutilized: independent pharmacists like you. Though you may be overlooked in the larger healthcare discussions, you play a vital role in delivering personalized, accessible, and community-centered care to teens facing tough health challenges.

Depression is one of the most common mental disorders in the United States. For some, major depression can result in severe impairments that can interfere with or limit one’s ability to function day to day. As their pharmacist, you can help identify, manage, and support adolescents who are experiencing depression. For instance, you can conduct informal screenings and early detection. During routine visits, engage teens by asking open-ended questions about their sleep, mood, and appetite. Having early conversations like this can uncover warning signs and prompt timely referrals.

You can also provide targeted medication counseling for antidepressants. Sit down with the adolescent and their parent(s) and explain how selective serotonin reuptake inhibitors work. Set realistic expectations for symptom relief and clarify the FDA’s boxed warning on new-onset suicidal thoughts. This will help them weigh the risks and benefits.

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WHAT EXACTLY DRIVES YOUTH TO SELF-HARM? • Unable to manage their emotions: When they have strong and uncomfortable feelings, adolescents and younger kids would rather experience physical pain than emotional distress. Why? Because self-harm gives them an immediate and effective means of emotion regulation. This is the most common pathway to self-harm.

• Don’t know how to communicate their pain: Some people use self-harm to outwardly show their emotional pain because they don’t know how to put it into words.

• Punish themselves: Sometimes young clients punish themselves. They internalize their negative thoughts toward themselves. They often think that they’re the reason for their unhappiness. So, when they self-harm, it’s their way to reinforce their feelings.

• Seek control: Young clients turn to self-injury to feel control in their life.

• Reviewing potential side effects and drug interactions, particularly when teens take multiple prescriptions.

• Encouraging adherence through reminder tools, personalized labels, or blister packaging to simplify complex regimens.

THE WARNING SIGNS AND SYMPTOMS OF SELF-HARM

• Scars, often in patterns.

• Fresh cuts, scratches, bruises, bite marks, or other wounds. You might notice them wearing long sleeves and pants in warm weather to hide these injuries.

• Excessive rubbing of an area to create a burn.

• Talking about feeling worthless, hopeless, or helpless.

EXAMPLES OF SELF-HARM INCLUDE:

• Difficulties in relationships with others.

• Keeping sharp objects on hand.

• Cutting their skin with a sharp object

• Frequent reports of accidental injury.

• Piercing the skin with sharp objects

• Emotional and behavioral instability and unpredictability.

• Hitting or punching oneself or random things such as a wall • Burning oneself with cigarettes, matches, or candles • Breaking bones or bruising oneself • Inserting objects under the skin

EDUCATION AND OUTREACH Your independent pharmacy can host youth-focused workshops and community events to: • Teach stress-management techniques, such as mindfulness exercises or journaling.

• Offer brief, drop-in “mental health check-ins” where teens can speak privately with you.

MEDICATION MANAGEMENT AND COUNSELING Many teens have mental health disorders that rely on pharmacotherapy as part of their treatment plan. You ensure safe and effective use of psychiatric medications by: • Explaining how medications work and setting realistic expectations for the onset of benefits.

• Help parents recognize signs of self-harm or suicidal ideation by providing family education sessions.

Normalizing conversations around mental health in a nonclinical setting, pharmacists like you play a vital role in reducing stigma and empowering adolescents to seek help early.

ELEMENTS | The business magazine for independent pharmacy | DECEMBER 2025

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COLLABORATION WITH SCHOOLS AND CLINICS Consider building partnerships with local schools, pediatricians, and mental health clinics. This will amplify your impact.

• Share anonymized inventory data with school nurses to be sure there will be availability of emergency medications.

• Coordinate with counselors to host on-site screening days at schools or community centers.

• Refer at-risk teens directly to behavioral health specialists and following up to confirm they connected with care.

The more the demand for youth mental health services grows, the more you’ll stand ready to bridge critical gaps in screening, medication management, and community education. You have the skills to help adolescents navigate mental health challenges with greater confidence and support.

PRACTICAL INTERVENTIONS YOUR PHARMACY CAN OFFER: National guidance now expects all health and social care staff to help people who self-harm. That means your pharmacy team is a part of that safety net. You report regular interactions with distressed or suicidal patients, highlighting the practical need for preparedness. Practical interventions you can offer include: • Safe medication management: review prescriptions for overdose risk, simplify regimens, limit quantities when clinically appropriate, and collaborate with prescribers about safer alternatives.

• Harm-reduction supplies and wound care: discreetly provide appropriate wound-care products and advice to reduce infection and scarring.

• Brief interventions and signposting: use short, empathic conversations to assess immediate risk and refer to urgent mental health services when needed.

By embracing your role as an accessible, trusted health professional, you can become a powerful ally in the fight for better youth mental health—one conversation, one prescription, and one connection at a time.

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HOW TO PRACTICALLY MANAGE A PATIENT IN CRISIS

Use active listening.

Give the patient your full attention. Allow them to express their thoughts and feelings without interruption or judgment. Then, repeat what you’ve heard to ensure understanding.

Validate what they told you.

Acknowledge that the patient’s feelings and experiences are valid.

Empathize with them.

Show your patient that you understand and you care about what they’re going through. For instance, “I’m here to help you.”

Use a calming voice.

Avoid raising your voice. Instead, use a slow and steady pace of speaking. Make them feel comfortable.

FEATURE

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BEYOND THE COUNTER How medical billing technology is empowering independent pharmacies

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s an independent pharmacist, you are no longer confined to dispensing medications and counting pills. You’ve stepped into a new era where you’re delivering clinical services, managing chronic conditions, and improving patient outcomes. This reshapes daily workflows, patient relationships, financial viability, and how you contribute to population health.

In the past, pharmacists were reimbursed through pharmacy benefit managers (PBMs) for dispensing medications.

However, this model has long been affected by diminishing margins, opaque pricing structures, and sparse recognition of pharmacists’ clinical expertise.

Medical billing technology is reinventing your role from medication dispensers to dedicated clinicians and care coordinators. This shift gives you a viable path to financial sustainability while increasing access to high-quality, community-based care. With thought-out implementation, effective partnerships, and attention to compliance, you can become an indispensable player in a healthcare system that increasingly values accessibility, outcomes, and integrated care.

With that in mind, you need new competencies for success in medical billing, such as documentation skills, basic coding

knowledge, and familiarity with payer rules. Pharmacy schools and continuing education providers are responding with courses on CMM documentation, billing fundamentals, and collaborative practice agreement development.

Investment in your staff’s education yields both better patient care and stronger financial performance.

Medical billing systems are now powered by pharmacists like you. You can now claim your deserved spot in the care continuum, and bill medical insurers for services such as: • Chronic disease monitoring • Collaborative drug therapy management • Durable medical equipment (DME) • Immunizations • Medication therapy management (MTM) • Point-of-care testing • Preventive screenings And if you use Current Procedural Terminology (CPT) codes and submit claims through modern medical billing platforms made for today’s pharmacies, you can be compensated for the care you provide instead of just the pills you dispense.

ELEMENTS | The business magazine for independent pharmacy | DECEMBER 2025

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Traditionally, pharmacists have been reimbursed through pharmacy benefit managers (PBMs) for dispensing medications. However, this model consistently struggled with shrinking margins, unclear pricing, and a failure to recognize pharmacists’ clinical expertise.

A tailored billing platform for an independent pharmacy like yours comes equipped with a host of features designed to simplify and automate the billing workflow, such as: • Clinical documentation tools that capture patient encounters in real time • Code mapping engines that translate services into billable CPT and ICD-10 codes • Eligibility verification systems that check insurance coverage before services are rendered • Claim submission portals that route bills to Medicare, Medicaid, and commercial payers • Analytics dashboards that track reimbursement rates, denials, and patient outcomes • Vendor support for onboarding and ongoing regulatory updates • Cost structure, including per-claim fees, subscription pricing, and implementation costs To minimize risk and help staff adjust, first offer a few billing services and then add more over time. Testing with specific patient groups will provide data to show payers and investors your pharmacy’s value.

YOUR FINANCIAL SUSTAINABILITY AND NEW REVENUE STREAMS Medical billing unlocks new revenue streams for pharmacies like yours in three main ways: • Direct reimbursement for clinical services using CPT codes and medical claims.

• Enhanced capture of care management and chronic-care payments through collaborative agreements and care bundles.

• Value-based contracting opportunities that reward pharmacies for improved outcomes and reduced total cost of care.

Medical billing is a lifeline for your independent pharmacy.

Because prescription margins are under pressure, billing for clinical services offers a new revenue stream that can stabilize operations and support growth.

If you’re conducting a 20-minute Medication Therapy Management (MTM) session for a patient with diabetes, you can bill for that time and earn between $50-$100 per visit.

When you multiply that across dozens of patients per month, the financial impact becomes significant.

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Plus, if you participate in value-based care arrangements like accountable care organizations (ACOs) or patient-centered medical homes (PCMHs)—you can share savings generated by improved outcomes and reduced hospitalizations.

COMMON DENIAL TRIGGERS AND FIXES

Transitioning to medical billing offers a significant financial upgrade, moving beyond dispensing margins to a more robust revenue model. In addition to increasing your financial stability, this shift unlocks valuable grant funding and participation in payer pilot programs. For partners in a PCMH setting, this also means the opportunity to earn shared savings for delivering better health outcomes and lowering hospital costs.

• Missing patient identifiers. Always verify name, date of birth, and insurance ID at intake.

INTEGRATED CARE Through medical billing, physicians and pharmacists like you can collaborate more deeply. By accessing shared Electronic Health Records (EHRs) and documenting their clinical interventions, you are empowered to take a more active role in patient management. This includes the ability to identify and address medication adherence issues and modify dosages as allowed by collaborative practice agreements.

You’ll be able to track patient lab results and vital signs and start patient referrals for further care. This integrated approach strengthens patient care and reinforces the pharmacist's role as a vital member of the healthcare team.

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Avoid costly billing errors with these practical solutions.

• Incorrect CPT or ICD-10 codes. Use pharmacyspecific billing platforms with built-in code libraries.

• Lack of documentation for medical necessity. Use structured templates and SOAP notes (Subjective, Objective, Assessment, and Plan) to justify services.

• Billing to the wrong payer type. Confirm whether the service is covered under medical or pharmacy benefit.

• Scope-of-practice limitations. Check state laws and payer policies before submitting claims.

If you want to do well in this new methodology, you need to acquire skills that are traditionally reserved for coders and billers. Pharmacy schools and continuing education programs offer courses on such topics as medical coding and documentation, insurance billing workflows, compliance and audit readiness, and collaborative practice agreement development. It’s equally important that you stay on top of payer policies, scope-of-practice regulations, and billing limitations.

THE BEST AND WORST OF REGULATION Numerous states have expanded pharmacists’ scope of practice, but federal recognition remains uneven.

Medicare Part B doesn’t universally recognize pharmacists as providers, therefore direct billing opportunities are limited. Medicare Advantage plans, however, state Medicaid programs and commercial insurers are increasingly embracing pharmacist-led care.

Working around this mishmash requires caution. Medical billing platforms often include compliance checks and audit trails to guarantee that the documentation and coding is correct. However, as a pharmacist, you still need to be proactive and understand payer requirements and advocating for larger recognition.

In the state of Ohio, a Medicaid initiative allows pharmacists to bill for services like smoking cessation and diabetes education. The pharmacies that are participating have reported improved patient engagement and reduced emergency room visits.

QUICK WINS TO START MEDICAL BILLING SUCCESS

Begin with high-impact services: launch billable immunization clinics and point-of-care testing (flu, Covid-19, strep) to generate immediate revenue and build billing experience.

Use an easy medical-billing partner: choose a vendor that integrates with your pharmacy system, handles eligibility checks, and simplifies claim submission to reduce administrative burden.

Standardize documentation: adopt structured templates (SOAP notes) for each service to support medical necessity and speed up claims processing.

Train a small core team: designate a billing lead and train a clinician on coding basics and a technician for intake and eligibility verification.

Start with pilots and track metrics: run short pilots for one or two services, monitor claim acceptance, denials, and patient update, then scale what performs well.

ELEMENTS | The business magazine for independent pharmacy | DECEMBER 2025

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YOUR PHARMACY’S PLAN OF ACTION • Conduct a local market analysis to identify payers that offer favorable reimbursement and profitable service opportunities.

• Pilot one to two services using a medical billing platform with eligibility checks and templates.

• Train staff on documentation standards, coding basics, and patient communication.

• Monitor claims performance, denials, and clinical outcomes with dashboards.

Expand services that prove their clinical value and lead to better reimbursement. With medical billing technology redefining the role of medical professionals, it gives your independent pharmacy a viable path to financial sustainability while increasing access to high-quality, community-based care.

Independent pharmacies in Texas have shown success in managing hypertension through programs that use medical billing platforms to cover pharmacist-led checkins and medication adjustments. These actions have led to better blood pressure (BP) control and a reduction in hospitalizations for participating patients.

If you’re wondering about the billing structure, your pharmacy will use medical billing platforms to get paid for your services. This is a departure from the traditional model where pharmacies only bill for filling prescriptions. This allows them to be reimbursed for monthly check-ins and managing care, much like a doctor’s office.

These programs often involve a combination of such things as: Regular check-ins. Patients have monthly or more frequent check-ins with a pharmacist to discuss their BP readings and medications.

Medication adjustments. Under collaborative agreements, you can initiate, adjust, or discontinue medications to optimize blood pressure control.

Digital health tools. Some programs have digital technologies like remote monitoring, text message reminders, and home blood pressure devices to improve patient engagement and health outcomes.

Patient education. Pharmacists provide education on lifestyle modifications and medication adherence.

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Accurate coding and documentation are guaranteed by the compliance checks and audit trails integrated into medical billing platforms. However, you need to stay proactive in understanding payer requirements and advocating for broader recognition. By thoughtfully implementing services, forging effective partnerships, and maintaining strict compliance, you are securing your vital role in a healthcare landscape that prioritizes accessibility, outcomes, and integrated patient care.

SPOTLIGHT

THE RISE OF MENOPAUSE CLINICS How you can help women thrive through hormonal transitions

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enopause is a natural part of biological aging in women.

Approximately 1.3 million women in the United States enter menopause each year. But despite being a natural result of aging, menopause has always been hush-hush.

As women enter the transformative stages of perimenopause and menopause, many of them are quietly suffering through physical and emotional changes, such as hot flashes, mood swings, lack of sleep, depression, and more. Though these symptoms are common, support isn’t always easy to find. That’s why independent pharmacies like yours are stepping up as accessible, personalized healthcare hubs that offer more than just prescriptions. You offer understanding, education, and empowerment.

Your pharmacy is unique because you can support women who are going through this life stage. With your clinical knowledge and community presence, you can provide such things as: Personalized consultations: Discuss symptoms, recommend over-the-counter remedies, and help women understand hormone therapy options.

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Medication management: For women on hormone replacement therapy (HRT), you can ensure proper dosing, monitor side effects, and coordinate with doctors.

Lifestyle guidance: Offer advice on supplements, nutrition, and stress management techniques that can ease symptoms.

Non-pharmacologic solutions: Suggest alternatives for women looking for natural relief, such as herbal remedies and cooling products.

Unlike the large chains, you know your customers by name, and you harbor long-term relationships with them. This creates a safe space for women to ask questions and receive tailored care.

Believe it or not, women are 35 percent more likely than men to delay or skip medical care due to cost or accessibility. But thanks to pharmacies like yours, you can help bridge the gap by offering walk-in services, affordable care, and loyalty programs.

And thanks to walk-in services, patients don’t need an appointment for consultations or product recommendations.

Community outreach is also vital. Think about hosting educational events or support groups to foster awareness and connection. This is especially important for women in rural or underserved areas where specialists are scarce.

MENOPAUSE CLINICS WITHIN PHARMACIES It’s not surprising that some independent pharmacies have already launched dedicated menopause clinics. These offer comprehensive services including: • Hormone level testing

Screening and Tracking of Symptoms Offer menopause symptom checklists or digital tracking tools that can help women monitor changes over time.

You can use these tools to help with conversations and tailor recommendations for OTC products, supplements, or referrals.

Custom Compounding Services You can offer bioidentical hormone therapy or topical treatments through compounding, especially for women who need personalized dosages or delivery methods.

Remember to teach your patients about the differences between compounded and commercial HRT options.

Private Consultations Put together a space that’s dedicated to confidential discussions about sensitive symptoms like libido changes or mood swings. Be sure to offer scheduled appointments or walk-in availability to increase comfort and access.

Support Groups and Workshops Host monthly menopause education sessions or partner with local clinicians for Q&A events. Help peer support groups to reduce the feelings of shame and instead foster a community among women going through similar experiences.

Nutrition and Supplement Counseling Support bone, heart, and mood health by recommending evidence-based supplements like calcium, vitamin D, magnesium, and omega-3s. Help your patients avoid ineffective or unsafe products by reading ingredient labels and interactions.

• Symptom tracking • Collaborative care with gynecologists • Custom-compounded medications This reflects a growing recognition of menopause as a significant health milestone deserving specialized attention.

You can empower women in your pharmacy with education.

You can help them decode medical jargon and make informed decisions. You can offer such things as printed guides and brochures, one-on-one counseling sessions, and online resources and webinars. By doing this, you are helping women feel less alone and more in control.

HELPFUL SUPPLEMENTS FOR YOUR PATIENTS

• Black cohosh: May reduce hot flashes • Calcium & Vitamin D: Supports bone health • Omega-3 fatty acids: May improve mood and heart health • Magnesium: Helps with sleep and muscle cramps

If you’d like some expanded ways to help, you can offer these additional strategies and services:

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Mental Health Support When you recognize patients who are struggling with emotions and hormonal changes, offer to refer them to therapists or mental health resources. It’s also a great idea to stock mood support supplements and provide guidance on their use.

Collaborate with Local Providers Make a list of referral networks with OB/GYNs, endocrinologists, and pelvic floor therapists. Share your patient’s data and medication histories to support coordinated care.

Navigate Insurance and Cost Transparency Answer your patients’ questions and help them understand coverage for HRT, supplements, and wellness products. Offer discount programs or generic alternatives to reduce costs.

Menopause-Focused Aisles Save a section of the pharmacy for menopause-friendly products, such as sleep aids, cooling sprays, moisturizers, herbal teas, fans, and more.

Telepharmacy and Digital Access Provide virtual consultations for women who prefer privacy or live in remote areas. Share educational content via email or social media, such as tips, product spotlights, and expert interviews.

When you proactively engage in menopause care in your pharmacy, you’ll increase patient satisfaction, a greater ability to manage difficult treatment plans, and expanded service opportunities. This role allows you to provide personalized counseling on medication and lifestyle, conduct necessary screenings, and support patients through a significant life transition, while also improving health outcomes by educating women on risks and treatments.

TOP SERVICES WOMEN REQUEST AT INDEPENDENT PHARMACIES DURING MENOPAUSE

Service Type

% of Women Seeking It

OTC Symptom Relief ................................................ 65% Hormone Therapy Guidance ................................. 50% Supplement Advice ................................................. 45% Lifestyle Counseling ................................................ 35% Emotional Support .................................................. ................................................. 25% Source: Outcomes Health & Pharmacy Times Reports, 2025

COMMON SYMPTOMS OF PERIMENOPAUSE & MENOPAUSE

Perimenopause (typically begins in late 30s to early 40s) • Irregular periods • Mood swings • Breast tenderness • Sleep disturbances • Hot flashes

Menopause (diagnosed after 12 months without a period) • Dryness • Night sweats • Decreased libido • Memory lapses • Joint pain

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MONEY

WHERE YOUR CASH GOES Diagnosing your pharmacy’s financial weak spots

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our pharmacy relies heavily on the intake of cash to survive. So, when you have a week where payroll, drug costs, and reimbursements don’t quite align, it leaves you wondering why the numbers don’t add up like they should.

Cash flow can make or break your pharmacy. It doesn’t matter if you have strong prescription volume, loyal patients, and rising sales. If money isn’t moving through your business efficiently, your profitability suffers. You may not realize it, but small leaks can easily drain your cash reserves. However, once you figure out the source of the leaks, you’ll be able to restore financial stability.

Taking charge of cash flow doesn’t have to be a guessing game.

By taking control over your finances and setting your pharmacy up for success, your stress will be a thing of the past.

LATE REIMBURSEMENTS Slow and shrinking reimbursements are one of the biggest thieves when it comes to cash flow. Your cash flow can feel like it’s constantly one step behind due to lower dispensing fees and delayed payments from pharmacy benefit managers (PBMs). Your working capital suffers when claims are underpaid or take weeks to process.

Always review your reimbursement reports carefully. This is where your pharmacy management system or reconciliation service comes into play to flag underpaid claims quickly. Also, make sure your team is resolving claim rejections daily so you’re not losing time waiting on fixes.

CLUTTERED SHELVES It’s not uncommon for independent pharmacies like yours to stock more than is needed. This often happens when wholesalers push volume-based discounts. Every extra bottle that sits on your shelves is tying up dollars that could be working elsewhere in your pharmacy.

A good benchmark is 12 inventory turns per year. In other words, you sell through your stock roughly once a month.

Audit your slow movers quarterly and send back dead stock when possible. You might even consider a perpetual inventory system or perhaps working with a third-party inventory specialist. They can help find your ideal balance.

RISING DIR AND TRANSACTION FEES Direct and Indirect Remuneration (DIR) fees, along with credit card processing costs, can silently chip away at your bottom line. As margins tighten, even a few percentage points off each transaction can add up over time.

You can review your processor contracts and find out whether you can switch to a flat-rate or membership-based pricing model to lessen swipe fees. Make sure you understand when and how DIR fees are being assessed. Partner up with your buying group or PSAO. They can help you negotiate better rates or at least let you know when fees will hit.

Review your staffing patterns versus prescription volume.

Look for opportunities to cross-train employees so coverage is more flexible. If you automate routine tasks, like refill reminders and inventory counts, you can also free up hours without cutting service.

DISORGANIZED BILLING AND COLLECTIONS Do you provide clinical services, durable medical equipment (DME), or point-of-care testing? If so, incomplete or inaccurate billing can slow payments and create cash shortfalls. And as you know, the longer it takes to collect, the more pressure it puts on your working capital.

FRONT-END STRATEGY IS NEGLECTED Front-end sales might only make up a small percentage of income, but they can be an important source of immediate cash flow. Don’t neglect your front-end strategy or you may miss out on easy opportunities for profit.

IMPROVING FINANCIAL CLARITY When it comes to cash flow challenges, you can’t manage what you can’t see. If your financial data is scattered across multiple systems, or if you only review it quarterly, it’s easy to miss problems until they’re critical.

Set up a monthly financial review. Look at gross profit, inventory value, payroll, and upcoming reimbursements.

Use dashboards or accounting software to visualize trends.

This is all about spotting early warning signs and making proactive adjustments.

It’s easy for cash flow management to fall behind everything else during the daily chaos. However, with tighter reimbursement models and increased operational costs, strong cash management is essential.

When you address the most common drains, you can steady your financial foundation and free up cash for what truly matters: patient care, growth, and the future of your pharmacy.

ESCALATING LABOR COSTS While staffing is essential, it’s payroll that can easily become one of your largest expenses. Your scheduling needs to be aligned with actual workflow because if overtime becomes routine, labor costs can ruin profits.

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OUTLOOK

YOUR PHARMACY GOALS FOR 2026 What to include in your business planning

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nother year has passed, and it’s time to take stock of everything you’ve accomplished. What did you do that made you proud? What do you think needs to change? It’s time to rewrite your business plan and jot down the goals you have for 2026.

It can be difficult to compete with the large chain pharmacies.

They often have greater buying power, larger marketing budgets, inventory, and operational efficiency. This makes it hard for pharmacists like you to compete with convenience and price. What you can do is write out a business plan that targets personalized care, involvement with the community, and personalized services that bring a better outcome.

do. However, technology isn’t only right where you see it.

Such things as inventory management systems, workflow automation, and AI-driven analytics can help simplify, reduce errors, and free up staff time so they can care for patients.

EXPAND CLINICAL SERVICES The accelerated role of pharmacists as frontline healthcare providers during the pandemic continues. In fact, immunizations, point-of-care testing, chronic disease management, and prescribing authority in some states are changing what it means to be a community pharmacy.

Patients will expect their local pharmacy to be more than a dispenser. Instead, they’ll see it as a healthcare hub.

The beginning of the year is an ideal time to reevaluate your company’s growth and determine if you are meeting your goals. Use this opportunity to fine-tune your strategies, anticipate potential challenges, and set new milestones for effectively scaling your business. Here’s how:

FINANCIAL STABILITY This needs to be at the top of every pharmacy’s business plan. Providers like you are facing reduced profitability due to reimbursement cuts and unpredictable actions by PBMs. This is why you should think about joining buying groups or pharmacy services administrative organizations (PSAOs) to bump up purchasing power and negotiate better rates. One strategy to combat reimbursement challenges is to cultivate new income streams through specialized offerings like compounding specialty medications. Soon, pharmacies that rely solely on traditional dispensing revenue will see how difficult it will be to remain profitable.

EMBRACE TECHNOLOGY Your patients expect digital convenience, such as mobile apps for refills, text reminders for pickups, or secure portals for telepharmacy consultations. If you fail to offer these tools, you’ll risk losing patients to competitors who

PATIENT ENGAGEMENT AND LOYALTY Online pharmacies offer convenience but cannot replicate the trust and relationships that are built in local communities like yours. Therefore, it’s time to double down on personalized care, loyalty programs that reward patients

Once you have a business plan, remember that it isn’t something you look at only once. It should be viewed often so you know what path you’d like your pharmacy to follow.

It outlines strategies and tactics to help you grow your pharmacy. It also helps you anticipate challenging times and sets milestones for measuring your progress.

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for staying local, and proactive outreach. By telling your story effectively through social media, newsletters, and community events, while consistently delivering exceptional service, your pharmacy will be most successful.

EMPLOYEE GROWTH AND ENGAGEMENT Your pharmacy is only as strong as its team. Burnout in healthcare is a growing concern. To help attract and keep top talent, it’s important that you invest in competitive wages, flexible scheduling, and professional growth opportunities.

Cross-train your staff to handle both clinical and operational tasks. It can also improve efficiency and job satisfaction.

KEEP UP WITH MARKET INFORMATION If you have a loyal base of customers, ask them to give you feedback about your pharmacy’s performance compared to your competitors. This is an important step. Don’t just ask for information about your own products and services.

Instead, find out what their thoughts are about other pharmacies. You’ll never know if you don’t ask. You might learn that one of your competitors has introduced a new product. So, stay up to date on market trends, customer needs, and winning competitor strategies.

Don’t forget to consider regulatory and policy awareness.

Legislative changes around drug pricing, PBM reform, and scope of practice are likely to accelerate in the next couple of years. If you stay informed and engaged through state associations, advocacy groups, and professional organizations, it will be easier to adapt. Business planning needs to include strategies for compliance, as well as opportunities to leverage new laws that expand the role of pharmacists.

2026 is right around the corner. If you set clear goals now, you will thrive in the months and years ahead. Embrace technology. Expand clinical services. Build financial resilience.

Engage patients. Support staff. Stay policy aware. Deepen your community connections.

The future pharmacy is not just a dispenser of medications; it’s a healthcare destination, a trusted advisor, and a community anchor. Plan with intention and you’ll remain indispensable well into the next decade.

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2026 BUSINESS PLANNING CHECKLIST FOR YOUR PHARMACY

Adopt mobile apps, text reminders, and telepharmacy tools Expand clinical services: immunizations, chronic care, testing Diversify revenue with compounding, specialty meds, or DME Join buying groups or PSAOs for stronger purchasing power Launch patient loyalty programs and proactive outreach Invest in staff training, wages, and retention strategies Stay engaged with policy and regulatory changes Strengthen community ties through events and partnerships

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