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Preparing For Outcomes-Based Reimbursement 5 things you can do right now

+ Diabetes Education Classes Tips to start an education program that will grow your business and help your community

A Better Cost of Goods— Guaranteed Get the best deal every time with ProfitGuard




The Magazine of PBA Health


departments 5 News:

Important updates and information for your community pharmacy.

19 More for your money:

A Bright Idea Tips to improve your store’s lighting.


Text Alert Helping your patients stay on top of their prescriptions is just a text message away.

21 What’s Working For You?

One pharmacist reflects on a year of buying with ProfitGuard.

24 community: 8 Bricks & Mortar: What Does a Successful Delivery Service Look Like? Meet Debbie Richmond, R.Ph. Her family’s pharmacy has been delivering for more than 50 years. 16 ACTIVE INGREDIENTS:

What’s Your Flavor? A flavoring service can make your business the go-to pharmacy for parents.


Community Classes Host diabetes education classes to help patients and increase business. 28 outlook:

Preparing for Outcomes-Based Reimbursement Five things you can do right now to get ready. 30 notes:

New Year’s Business Resolutions Ideas to grow your pharmacy in 2014.



A Better Cost of Goods—Guaranteed How to get the best deal every time with ProfitGuard.

Explore exclusive online content to improve your business at www.pbahealth.com.

Are You Making These 5 Email Mistakes?

Email allows you to efficiently connect with your vendors, wholesalers, service providers and other business partners. Just make sure you avoid these five common email blunders. Find the article on the Marketing section of www.pbahealth.com.

ELEMENTS is published quarterly by PBA Health. Copyright© 2013 PBA Health. All rights reserved. Neither this publication nor any part of it may be reproduced without written permission by PBA Health.



“Like” TriNet Third Party Network on Facebook to keep up with the latest health care reform changes, Medicare Part D updates and more! TriNet is on Facebook! Are you a member of TriNet Third Party Network? Now you can connect with TriNet on Facebook! “Like” the page to keep up with the latest on health care reform, Medicare Part D changes in 2014, industry updates and more. Find TriNet on Facebook at www.facebook.com/ trinetthirdpartynetwork Never Miss a Good Deal With RxCircuit Text Alerts Your pharmacy’s cost of goods is the best spot for your business to save money. You probably already work to trim down expenses by shopping for the best prices on fast-moving products. Looking for low prices is a start, but what if you could receive additional manufacturer rebates on top of already cut-rate prices? PBA Health’s supplementary rebate program, RxCircuit, enables you to earn additional rebates— between 10 and 20 percent—on specific generic items. And, that’s on top of the already reduced prices you can earn through PBA Health’s other ordering programs, such as

ProfitGuard and Negotiator. All customers who already order through the PBA Health warehouse have access to RxCircuit. Now we’ve made it even easier for you to get the best deals out there. You’ll never miss an opportunity to save money when you sign up to receive text message alerts every time a new special is added on RxCircuit. For more information, or to have our customer service department set this up for you, contact Brenda Wood or Jamie Dudley at 800-333-8097. ProfitGuard Website Gets New Look ProfitGuard customers may have noticed a new look when they log in to their personalized ProfitGuard website. The website has a fresh design that’s easier to use than ever before. It features streamlined metrics, enhanced money-saving recommendations and simplified reporting tools. Now, with one glance, you can check to see that you’re meeting the terms of your supplier contract, and you can make sure that your supplier is doing the same. The

improved recommendations feature provides the same money-saving recommendations you’ve seen before, but now we only show you the biggest and best ways to save. We’ve also added a new filter option. You can filter your recommendations by rebated, non-rebated, PBA Health and endorsed wholesaler. Log in to your website today and see how the changes we’ve made can help you save money on your cost of goods. For those unfamiliar with ProfitGuard, this service is a complete buying solution unlike anything else on the market. Through expert contract negotiation and stateof-the-art purchase management technology, ProfitGuard delivers pharmacies the best cost of goods available. For more information, flip to page 10 or visit us at www.pbahealth.com. Get daily news updates on issues that matter to your community pharmacy by following us on Facebook at www.facebook.com/pbahealth and on Twitter at www.twitter.com/pba_health.

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Text Alert:

Your patients (even the older ones!) are embracing the text message as a convenient way to keep up with their prescriptions

Helping your patients stay on top of their prescriptions is just a text message away. It’s easy to let patients know when their prescription is ready and when it’s time to refill through automatic texts. Just ask your pharmacy management system provider if text alerts are included with your system. If that’s the case, all you have to do is opt in! Here are just a few reasons why it’s a good idea for your pharmacy to go mobile with texts.

adherence rates of 91 percent, while the control group saw 82 percent adherence.

What patients want You likely have patients of all different ages and preferences. Let your patients choose how you contact them by giving them the option to receive notifications by phone, email or, of course, text message.

Helpful for disabilities Typed out messages provide clear communication for your patients with hearing disabilities or for older patients who are hard of hearing.

Fast communication Text message alerts let patients know about the status of their prescription right away. They no longer have to wait to receive a phone call or check their email. Depending on your pharmacy system, you might also be able to use texts to notify patients about special offers or emergency information, such as recalls. Better adherence Reminding patients to pick up their prescriptions through text might actually benefit their health. A 2012 study published in Clinical Therapeutics was the first large scale U.S. study to link text message reminders and adherence rates. The study involved participants who were taking chronic anti-diabetes medications. The group that received text message reminders saw


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Easy opt out Most pharmacy management services that offer text messaging include an option where patients can opt out at any time. So, they’ll always be in control of how they’re contacted. Patients simply reply to the text message they received with a provided code or with “stop” to opt out.

Cost-effective Many pharmacy management systems include text message refill and pick up reminders as part of their service. Meaning, it doesn’t cost you any extra to implement text message alerts at your pharmacy. Check with your specific provider for details. More staff time Offering text message reminders can free up the time your staff usually spends calling patients to remind them to pick up their prescriptions. Stay competitive Chain pharmacies have been offering text message reminders for years. It’s becoming an established service that patients are starting to expect from their pharmacy. Don’t let your patients miss out.


Profile of Bruce Smith Drugs’ Delivery Service Number of deliveries per day Varies, between 30 and 60 during the week, 15 to 25 on the weekends.

Busiest times Monday and Tuesday. Winter is the busiest season.

Payment Cash, check or in-store charge account. Credit cards also accepted and processed before the delivery goes out.

Tracking ScriptPro’s SP Mobile Checkpoint. This wireless device can remotely capture and track signatures, HIPAA forms and patient comments. All the information gets transferred back to the pharmacy’s computer system when the device is in range.

Number of drivers and delivery cars Three drivers (each works a different shift) and one car.

Managing orders Drivers check in every hour or hour and a half. This allows the pharmacy to address urgent requests in a timely manner and plan the route accordingly. Patients outside of the delivery area know to give a few days of notice for delivery, allowing those deliveries to be streamlined.

Patient demographics Many older patients or individuals who can’t drive. Parents home with sick children. Assisted living facilities.

Service area Within a 20-minute drive of the pharmacy. Exceptions are made for long-standing patients or high-volume locations like nursing homes and assisted living facilities.

Delivery charge $5, or free if patient orders at least $15 of over-thecounter products. Free for assisted living facilities and other high-volume locations.


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What Does a Successful Delivery Service Look Like?

Meet Debbie Richmond, R.Ph. Her family’s pharmacy has been delivering for more than 50 years. By Kimberly Van Becelaere

In the Prairie Village, Kan., community, Bruce Smith Drugs’ delivery service is the subject of an urban legend. Rumor has it, the pharmacy would deliver a pack of gum free of charge if someone called and requested it. Debbie Richmond, R.Ph., a third generation pharmacist and the second generation of her family to run Bruce Smith Drugs, chuckles when she hears that story. “We used to,” she said. “And you know what, if they want to pay a $5 delivery charge, I guess we’d do it today.” While free delivery for packs of gum may be a thing of the past, Richmond has kept true to the underlying principle of outstanding customer service that has guided the pharmacy—and its delivery service—for decades. An idea ahead of its time “Bruce Smith (Bruce Smith Drugs’ founder) had a couple of ingenious ideas,” Richmond said. “One was in-house charge accounts, because they tied the patient to one pharmacy, and the other was a delivery service.” Bruce Smith Drugs has delivered medications to patients’ doorsteps since the pharmacy opened in 1955. “We have always been a service-oriented pharmacy,” she said. “So delivery was just an added service; it went right along with the whole philosophy of the store.” Adapting for today While free delivery may have been financially possible for a pharmacy in 1955, today’s lower reimbursement rates on prescription drugs changed the math. In order to continue to offer the delivery service that it had become known for, Bruce Smith Drugs had to adapt. To keep the service profitable, the pharmacy adjusted

BRICKS & MORTAR pay for the convenience. And the new policy even cut down on unnecessary trips. “Before, we’d have people that would call us two or three times a day,” Richmond said. “Once we started charging, they got more organized in their ordering and would order three or four prescriptions at once.” Landing on a formula that works While aspects of the delivery service have been refined over the years, the focus on customer service hasn’t changed. “For the vast majority of prescriptions, they’re out the same day,” Richmond said. “And if people call and say, ‘I really don’t feel well, can you get it here as soon as possible?’ those take priority. If people are in a time crunch or need something right away, we try to do that.” Of course, there are times when the weather, timing or other causes get in the way. When this happens, Richmond says that timely communication is vital. “Most people are very understanding,” she said. “They know that there are times we might not be able to get it out there really quickly. Communication to me is a huge thing with our patients.” Going the extra mile (literally) for patients has built a strong loyalty to the pharmacy. “That’s why I’m filling prescriptions for fifth-generation people, because we’ve got that reputation and have been able to maintain that high level of service,” Richmond said. “Delivery is part of what we’ve become known for. And we love continuing on with it.”

Lessons from a Pro

Top: Debbie Richmond, R.Ph., runs Bruce Smith Drugs in Prairie Village, Kan. Bottom: Joe Castro has been a delivery driver with Bruce Smith Drugs for more than seven years. the area that it delivered to (while still making exceptions for long-time customers of a store branch that closed) and changed its free delivery policy. “For years we never charged for delivery, and then with the advent of insurance and low payments, we had to start charging something,” Richmond said. “But what we do is if they purchase $15 of over-thecounter products, the $5 delivery fee is waived. A lot of people like that. Since we are a full-line store, it’s very easy for them to get other things they need. We also do not charge the assisted living facilities anything because we’re able to do four or five deliveries at one time.” For most customers, the delivery fee is a small price to

Debbie Richmond, R.Ph., offers a few tips for running a successful delivery service. You have to have the volume to make it worth it. “Paying for a car, the insurance and an employee to do the delivering is difficult in today’s world,” Richmond said. “If you are only going to do a few deliveries, it may not be worth the cost.” Think big picture. “You have to think of it as maintaining your patient base. Customers who use delivery tend to stay with our pharmacy.” Make delivery something your pharmacy is known for. “In our advertising we say, ‘Open and delivering 365 days a year.’ So, we’ve always tied our delivery service into that big motto of ours. Also, our cars are labeled, which is free advertising.”

Elements Elements| pbahealth.com | pbahealth.com 9


A Better Cost of Goods— Guaranteed

How to get the best deal every time with ProfitGuard

With decreasing third party reimbursements and an increasingly competitive market, making the right buying decisions matters now more than ever. But making the right decisions—the ones that increase your profits and keep your business thriving–can be incredibly challenging. That’s why PBA Health developed ProfitGuard. ProfitGuard was designed specifically for community pharmacies, to secure them the best supplier pricing available, and to provide them the tools they need to make informed, moneysaving buying decisions every day. How it works ProfitGuard forms groups of community pharmacies and uses the group’s combined purchasing volume to negotiate better pricing and terms for everyone. ProfitGuard’s contract experts know just what to look for, and what to ask for, to get you the best deal out there. But better supplier pricing is only the beginning. ProfitGuard also takes the time and headache out of improving your purchasing on a day-to-day basis. Personalized online tools track your contract performance, verify pricing and give you money-saving recommendations on products you are already purchasing. With just a few clicks, you’ll have all of the information you need to make buying decisions that benefit your bottom line.


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Expert contract negotiations To get the most competitive contract terms and pricing, ProfitGuard takes a different approach than most. ProfitGuard submits RFPs across multiple wholesalers to obtain the best cost of goods available, and then constantly monitors individual product pricing and offers up recommendations that keep pharmacists saving. For pharmacists like Randy Newberry, R.Ph., owner of The Prescription Shop in Jerseyville, Ill., getting the very best pricing is important. “Even though we don’t see it every day, that underlying contract negotiation has a profound effect on our business,” Newberry said. “Your wholesaler contract can make or break you.” Newberry decided to give ProfitGuard a try in 2008, after his wholesaler began to misrepresent purchases and withhold a large amount of money in rebates. “We worked and worked to get that straightened out and we couldn’t. So we decided we really needed to do something different,” Newberry said. “We were really happy when ProfitGuard came along.” Newberry no longer has to worry about getting the right rebates or pricing because all of that is tracked for him through ProfitGuard. He just checks his personalized website regularly to quickly see if he’s meeting his contract and to make sure his wholesaler is giving him the correct pricing. If the numbers don’t line up, PBA Health takes the discrepancy to the wholesaler and ensures that a full reimbursement is issued. “ProfitGuard made running our business easier and way more sophisticated,” Newberry said. “Before, we did not have the data to help us understand what a certain

contract might look like, or to identify what is good or bad in a contract. And then, of course, we had no way to follow up after the fact to determine whether we were getting the deal we negotiated.”

“Even though we don’t see it every day, that underlying contract negotiation has a profound effect on our business. Your wholesaler contract can make or break you.” Today, Newberry lets other community pharmacies know how ProfitGuard can save them money and back them up if their wholesalers aren’t meeting their end of the deal. Newberry said that a lot of pharmacies are surprised when they hear how much they could be saving

ProfitGuard makes saving money easy by negotiating the best cost of goods available and by providing tools and recommendations to purchase better every day.

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on their cost of goods. “It’s amazing. As the numbers are crunched, as (other pharmacies) share some initial data with their PBA Health rep, most all of them show significant savings,” Newberry said. “It’s almost like, ‘You’ve got to be kidding me. I had no idea that I could be leaving that much money on the table or just giving that much money to my wholesaler’s profits instead of to mine.’” Business tools that simplify What makes ProfitGuard different from anything else on the market is that it offers a complete solution to improve buying. It not only saves you money on your cost of goods, but it also tracks your purchasing data for you on a personalized, easy-to-use website. The website gives owners, pharmacists and techs the information and tools they need to make the most profitable buying decisions—all in one place. You can easily see if you’re getting the pricing you contracted for, where you’re sourcing your products from and if you’re meeting the generic percentage of your contract so you don’t miss a single rebate. For pharmacists like Randy Meents, Pharm.D., owner of Greenfield Pharmacy in Greenfield, Mo., being able to access that information all in one place takes away the burden of doing it manually, and the worry of not getting a fair deal. “Not only do ProfitGuard tools make it easier, they make it possible,” Meents said. “As a small independent businessperson, I don’t have the time, the ability, or the

analytical algorithms to do that kind of thing. We’d have to hash it out product by product individually and we’re unable to see a bigger picture like we can see through ProfitGuard.” Using ProfitGuard’s tools, Meents said he is able to focus more on his patients and on the bigger picture of his business, instead of tracking down numbers and invoices. “What I like is that PBA Health is your partner and they have the tools to make sure that the wholesaler is keeping the terms of the contract without shifting numbers or shifting the way they calculate things one way or another,” he said. Recommendations that keep you saving While getting the best supplier pricing is important and can have a huge effect on a pharmacy’s bottom line in the long term, most buying decisions happen in the day-to-day. Prices fluctuate often, product availability changes daily, and pharmacists are left to act as part-time detectives, seeking out better pricing when they can with their already busy schedules. ProfitGuard changes that. By logging on to your store’s personalized website and clicking on the recommendations tab, you will see products you could be saving money on, and the very best options to do so. Whether it is switching manufacturers, moving a product from your primary to your secondary wholesaler (or vise versa), or choosing a different

A personalized website takes the hassle out of getting the best pricing. ProfitGuard’s tools track your purchasing data to ensure you are getting the pricing you contracted for. A recommendations tab gives you the best options to save on the products you need.

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NDC, you will be able to easily compare, select and print the recommendations you want to use. And recommendations are updated weekly, so the price comparisons are always timely. “If I was buying something and the price changed, or if I was buying something and there was an alternative that was cheaper, if it was even marginally expensive or if I used it repeatedly, it adds up,” Newberry said. “It’s just amazing how much those things add up.” Newberry estimates that just by using the recommendations, he saves between $20,000 to $30,000 per year, and that’s on top of his better negotiated cost of goods. Buying better, made easy Making profitable buying decisions for your business does count now more than ever. But that doesn’t mean it has to be difficult, or that you have to go it alone.

ProfitGuard was created specifically for community pharmacists like you, to make buying for your pharmacy easier, more intuitive and much less time-consuming than ever before. Newberry has seen ProfitGuard work for his business, which is why he recommends it to other pharmacy owners. “Pharmacies and pharmacy staff are very pressed for time. We don’t spend a lot of time sitting around drinking Cokes,” Newberry said. “But it’s worth it. Just a little bit of time can make a huge impact on your bottom line.” Learn more about how ProfitGuard can help lower your cost of goods at www.pbahealth.com/profitguard Make sure to download our free white paper on increasing pharmacy profits.

There simply is no other product on the market that can help you improve your buying like ProfitGuard can. Here’s what you need to know. Expert negotiators Getting pricing from a pre-determined grid is like paying sticker price for a new car. Even if it seems like a good deal, money is being left on the table. ProfitGuard’s expert negotiators know what to look for, and what to ask for, to negotiate the best possible deal for your pharmacy. Combined volume Wholesalers deliver better pricing on larger volume. That’s why ProfitGuard groups community pharmacies together and uses the combined volume to get the best pricing for everyone. Multiple wholesalers bid for the group’s business, which earns you an even better deal. Tracking tools Finding out if you’re meeting your generic percentage for the month shouldn’t involve investigation skills. With ProfitGuard, all of the information you need is in one spot. By going to a site personalized for your store, you can easily see if you are getting the pricing you contracted for, where you are sourcing your products from and if you are meeting your generic percentage so you don’t miss a single rebate.


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Cost-saving recommendations Wouldn’t it be nice to know exactly where you could save on the products you already purchase? Not “deals” that try to get you to buy 10,000 units when you need 200. But actual apples-to-apples comparisons that show you when there is a lower price on a comparable product. ProfitGuard lets you see that all in one place. By going onto your store’s personalized site and clicking on the recommendations tab, you’ll see which products you could be saving on, and the very best options to do so. A trusted partner Just because you’re an independent pharmacy shouldn’t mean you have to go it alone. With ProfitGuard from PBA Health, you’ll have a business partner that has your back. We not only negotiate the best deal for community pharmacies, we also make sure the selected wholesaler lives up to that deal. And if you have a question or need help, there is always a friendly associate just a phone call away.


What’s Your Flavor? Make your business the go-to pharmacy for parents in your community Flavoring liquid medications is a simple solution to a common problem for your patients: getting kids to take their medicine. When your pharmacy offers a tastier alternative to yucky medicine, it leads to happier kids and more importantly, to happier parents. “If a mom comes into the pharmacy to pick up medicine for her child and the pharmacy offers this cool service that will save her a lot of hassle, then chances are she’s going to be a customer of that pharmacy for a long time,” said Chad Baker, vice president of marketing at FLAVORx, a company that makes medication flavoring for pharmacies. A 2012 study by Temple University’s School of Pharmacy and WilsonRx, a healthcare consumer research company, found that parents preferred filling their children's medications at pharmacies where custom-flavoring services were available. The study also found that parents were more likely to recommend a pharmacy that actively informed them about the services over one that did not. A well-run flavoring program clearly offers some enticing benefits for your business. It can create additional revenue, drive more traffic to your store and enhance your customer service efforts—to name a few perks. Stir together more business Flavoring provides a good profit margin if you charge a fee for the service. “Most pharmacies charge about three dollars,” Baker said. “It’s a pretty high margin for the pharmacy, about 70 points in margin, if not more, depending on the specific drugs they’re flavoring.” Besides offering flavoring to your current youngster patients, you can also use your flavoring program to


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gain new patients by promoting the service to local physicians, daycare centers and other kids organizations. “Kids ages two to nine are the sweet spot demographic for providing flavored medications,” Baker said. Watermelon or bubble gum? Cherry or grape? Kids love being able to choose their favorite flavor for their medicine. And, parents love not having to fight to get kids to take the medicine they need.

Getting started Don’t let the financials of starting a flavoring service put a bad taste in your mouth. With minimal effort and fewer expenses than you might think, you can start a profit-generating flavoring service at your pharmacy. It’s easy to do,” said Chad Baker, vice president of marketing at FLAVORx, a company that makes medication flavoring for pharmacies. “People tend to think that a flavoring program is more involved and expensive than it really is. It’s not hard to get started and we provide everything needed to promote the program and make a success out of it. PBA Health customers receive a discount through FLAVORx! Check out the FLAVORx listing in our online product directory for more details. Visit www.pbahealth.com/pba-directory.aspx to learn more.


Mix up your offerings Flavoring kids’ prescriptions isn’t the only aspect of a flavoring service. Don’t forget that over-the-counter liquid medicines like those for allergies, cold and flu can also be flavored. So can pet medicines. “If you can promote your pharmacy as a place to get yummy beef-flavored medicine for pets, that’s definitely a huge untapped market for pharmacy,” Baker said. Get the word out to your patients and to your local vets that you can customize medications to taste like tuna, beef, chicken, bacon or peanut butter for pets.

“Signage is great, but at the end of the day, it needs to be something that’s brought up with mom when she comes to either drop off or pick up the prescription,” Baker said. “The pharmacies that execute flavoring programs the best either consistently recommend the service for all liquid medications or they at least make sure to suggestively sell.” Some great lines to use to suggest flavoring to patients include, “This is a really bad tasting drug, we highly recommend a flavoring,” and “How would you like this medication to taste? We can customize it for only $2.99.” Besides making life a little easier for everyone in the family, a flavoring service can also improve patients’ adherence. “Consumers don’t really get into the words adherence and compliance, but that’s the main benefit for kids,” Baker said. “They’re going to be way more adherent to their medication regimen; it really does have an impact on quality of life.”

Flavoring kids’ prescriptions isn’t the only aspect of a flavoring service. “If you can promote your pharmacy as a place to get yummy beefflavored medicine for pets, that’s definitely a huge untapped market for pharmacy.”

Ingredients for success Using marketing materials, especially social media, to promote your flavoring service to local prescribers, patients and vets is a good way to let people know about this service, Baker said. But the best way, he said, is to let your patients know directly.

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Remember learning about contract negotiation in pharmacy school? Maybe it’s because you were busy learning to be a pharmacist. But what you didn’t learn then, doesn’t have to hold your pharmacy back now. Because now there’s ProfitGuard. ProfitGuard utilizes a team of expert negotiators to secure

better pricing, rebates and terms on your supplier contract. Guaranteed. Securing chainlike pricing is possible, if you’re backed by the expert negotiators at ProfitGuard. www.pbahealth.com/profitguard

6300 Enterprise Road Kansas City, MO 64120 800-333-8097




Q: What one change can make your front end instantly appealing, create a more welcoming environment for patients, improve staff satisfaction and save you money? A: Improving your store’s lighting. Lighting influences what your patients buy, how long they stay in your store, and according to recent studies, it can even have an effect on prescription errors. Not to mention that less efficient lighting can be a silent drain on profits through wasted energy consumption. If you are ready to reap the benefits of better lighting in your pharmacy, here are three quick tips to get started: 1. Go green. Remember when energy-saving bulbs meant harsh, unappealing light quality? Not so anymore. A new generation of “green” commercial lighting boasts light quality that rivals conventional options, with jaw-dropping life spans and a small fraction of the energy usage. LightEmitting Diodes (LEDs) are leading the way in efficiency, but there are many other energy-saving options to chose from like CFLs and high-energy fluorescents.

Lighting efficiency, in numbers

2. Talk to a pro. Getting your lighting right is a job best left to the experts. A lighting specialist can perform an energy audit and suggest the best options for your business’s needs. Check with your local utility company or a professional lighting company in your area.

- The amount of energy that a traditional incandescent bulb releases (meaning wastes) as heat.

3. Seek out savings. There are lots of ways to save money on lighting retrofits and upgrades and see a return on investment in no time. Depending on the project, there are federal, state and local funding options available, as well as tax credits, financing and rebates. Check with your tax professional, local utility company, local chamber of commerce, or the Department of Energy’s website (www.energy.gov) for more information.

35% – The amount of electricity use that

lighting accounts for in a typical commercial building.


$250 billion – The amount that

could be saved if the U.S. switched entirely to Light-Emitting Diode (LED) lights—the most energy-efficient option on the market—over the next two decades.

Sources: Department of Energy (energy.gov), Energy Trust of Oregon (energytrust.org)

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What’s Working For You? One pharmacist reflects on a year of buying with ProfitGuard

Huy Duong, R.Ph., owner of Dale’s Pharmacy in Fort Lupton, Colo., has seen his business’s profits take off since he started using ProfitGuard a year ago. We talked with Duong about how he made that happen and why ProfitGuard is the right solution for him. Tell us about your pharmacy. I have a full line independent pharmacy. We offer medical equipment, and services like immunizations, diabetes education and MTM. We also carry more than 1600 NDCs. Purchasing drugs is a very important part of our business. Purchasing correctly pretty much dictates whether or not you survive in this business right now because margins are so low.

“Purchasing correctly pretty much dictates whether or not you survive in this business right now because margins are so low.” How did you handle purchasing before ProfitGuard? I would audit drugs as I was purchasing them. I’d punch in an NDC to make sure that when I was purchasing it from my wholesaler that I was purchasing the cheapest one, whether it was a rebatable product or not. I find that a lot of wholesalers trick you with that. I also spent a lot of time trying to keep an eye on

What is ProfitGuard? PBA Health developed ProfitGuard specifically for community pharmacies, to get them the best supplier pricing available, and the tools they need to make informed, money-saving buying decisions every day. It’s a complete buying solution, and it’s unlike anything else on the market. For details, check out the full article on page 10.

changing drug prices, especially the ones where I was negatively reimbursed. I was glancing behind my back whenever I could, rather than having a product like ProfitGuard looking out for me all the time. How did you hear about ProfitGuard? I went to the PBA Health Conference. I remember hearing a speech about it, and I thought, “That’s the kind of stuff that we as pharmacy owners have been dreaming about.” Have you seen an increase in your profits since you started using ProfitGuard? Actually, I’m seeing a substantial improvement in my cash flow and profits. At the same time I’ve talked to some other pharmacy owners and it seems like they are struggling or seeing a decrease in profits. I’ve essentially gotten a pay raise with very minimal effort.

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What elements of ProfitGuard are most helpful for your business? All of it is helpful. I find it to be a truly honest system where it works both ways. For instance, it doesn’t push me to purchase from either my primary or my secondary wholesaler. It just identifies the cheapest possible way to purchase the product and presents it clearly. I think with this industry, trust is such an important factor, especially when it comes to finding a buying

“The thing I like about ProfitGuard is that it doesn’t force you to do anything. All it does is tell you how you can purchase better. At the end of the day, the independent pharmacy owner still has all of the control.” group. That’s the main factor I used when I went with PBA Health; how much I could trust them versus the buying group I was with. Honesty is very important. What are the advantages of having contract experts negotiate for you? Pharmacy owners, as much as we think that we are great negotiators and buyers, we’re not really trained in that part. We don’t do it on a constant basis, over and over and over. Owners or operators who want to


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negotiate their own purchases are doing themselves a big disservice. After they negotiate that contract, there is no way for them to make sure that the wholesaler is making good on the deal they agreed on. It truly is an art and it takes someone who has a skill set to do that job. To be able to negotiate the best price, get it down on paper and make sure the wholesalers follow through. Wholesalers can offer you a certain deal, but unless you know how to dissect that deal, you don’t know if it’s good or bad. Do you see any advantages to being in a group of pharmacies? Yes, I see a lot of advantages. If we’re not in a group, our purchases aren’t substantial enough for the wholesaler to feel a lot of pain if it loses us. Even pharmacy owners that own multiple stores, they’re not going to be better off standing alone with 15 or 20 stores than they are with 30 or 40 stores. I think essentially what wholesalers want is for you to purchase from their warehouse and not look behind your back any more. But independent pharmacy owners and operators should be able to choose where they purchase products from, especially if there is a financial incentive. What tips do you have for pharmacists to optimize their purchasing using the Profitguard tools? The first two months are the most important. The first few times they get the ProfitGuard data, they will make most of their product switches right there. After that, the changes are going to be minimal and easy. The thing I like about ProfitGuard is that it doesn’t force you to do anything. All it does is tell you how you can purchase better. At the end of the day, the independent pharmacy owner still has all of the control. Is there anything you would like to add? ProfitGuard is an excellent product. It’s intuitive. It’s easy to use. Anybody that can use pharmacy software to sell a script to a patient shouldn’t have any difficulties at all using ProfitGuard. It’s a product that clearly gives me a distinct competitive advantage. To get all of the details on ProfitGuard, check out page 10.


Community Classes Host diabetes education classes at your pharmacy to help patients and increase business By Kirsten Hudson

More than 25 million Americans live with diabetes. Many of those patients struggle with adherence, lifestyle changes and self-care, which prevent them from getting their disease under control. As a community pharmacist, you have an opportunity to go beyond just helping diabetic patients when they visit your pharmacy. You can educate more people living with diabetes—and attract new patients—by hosting diabetes education classes in your community. Tim Mitchell, R.Ph., owner of three community pharmacies and a medical equipment store in Neosho, Mo., first started hosting a diabetes support group in 1997. He saw a need for more diabetes education in his community and decided to do something about it. “I knew there were support groups in hospitals and things like that, but at least in my area there weren’t any pharmacies heading up something like this,” Mitchell said. The group, which came to be called the Neosho Area Diabetes Support Group, started with just five people who needed questions answered about their diabetes and who wanted to tell their stories. The group would meet monthly at a church to talk with each other and to listen to Mitchell and other guest health practitioners speak. “The people in the group were excited about sharing their ideas and the trials and tribulations of being a diabetic to others in the community,” Mitchell said. “Suddenly the group grew to 20, 25, 30 people. It blew me away.” Making it a success Mitchell isn’t afraid to try new things when it comes to educating people about diabetes. As participation in the support group fluctuated over the years, Mitchell began to organize different types of events to get people interested, including culinary classes, peer-to-peer sessions, and blood glucose testing at the local senior citizens center.


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Event Ideas

Tim Mitchell, R.Ph., suggests using the following programs and events to get your diabetic patients excited to learn more about living healthy with diabetes. Mitchell has hosted diabetes education events at his pharmacies in Neosho, Mo., for more than 15 years. A1C Champions® Diabetes Education Program Help your patients manage their diabetes like pros when you host an A1C Champions Diabetes Education Program sponsored by Sanofi-Aventis. “Sanofi trains diabetic patients who are managing their diabetes well to come in and do speaking engagements for patients who may be struggling, Mitchell said “It’s peer support.” He has hosted four of these events, each one featuring a different speaker. Learn more about the program at a1cchampions.com. Diabetes Academy For this free program, Novo Nordisk provides a certified diabetes educator to teach a class at your pharmacy about managing diabetes. “They pay for the program. We do the invitations and we’re sponsoring it, but we get the benefit of having the education done in our facility,” Mitchell said. “It’s a nice thing for us to offer, and I can tell you, people in our community really appreciate it.” Diabetes Food Tour Partner with a diabetes educator and a local grocery store to host a diabetes food tour. It works like this. A small group of patients meet at a local grocery store where a diabetes educator explains how to read food labels and offers healthy eating tips. “They’ll all grab a cart and go walking down the aisles,” Mitchell said. “They’ll pull things off the shelf and say, ‘This is what I normally buy, is this a good item?’ Or, ‘Would it be better to buy this item?’ A lot of people really enjoy that direct contact with a diabetes educator. It’s a different setting than just sitting in an office talking about what they should be eating.” If you partner with an independent grocery store, the store manager will likely be happy to help you out. “Typically the store manager will provide healthy

snacks, like fruit or sugar-free items,” Mitchell said. “They’ll give away coupons to increase sales and get people in the store. It works out well for everyone.” Healthy Eating Classes Partner with a diabetes educator or a dietician to host healthy eating classes for diabetic patients. Once a month Mary McCreery, a registered dietician and certified diabetes educator, cooks a healthy meal in the kitchen of Mitchell’s medical equipment store. Patients pay $40 and she provides food samples and helpful tips on eating well. In a recent class, McCreery made a few different dishes with apples. “There was an apple soup, an apple quesadilla. Just some different ideas that use healthy alternatives instead of things that are going to clog your arteries,” Mitchell said. The Sweet Spot The Sweet Spot program provides pharmacies with the curriculum to teach a diabetes education class every month. Patient handouts, physician letters, flyers and other marketing materials are included with the program. “What’s really great about it is that it focuses specifically on how pharmacists can help diabetic patients,” Mitchell said. “The presentations show diabetic patients what pharmacists can do to help move them in the right direction and make their condition better.” Learn more about the program at creativepharmacist.com. Senior Center Days Make it easy for older patients to join in by holding a simple diabetes education class at your town’s senior center. “We head over there during their lunch and do some blood glucose testing and we’ll talk a little bit about diabetes,” Mitchell said. “We always have handouts and we always have goodies to give to people to keep their interest.”

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The best way to make a diabetes education program a success, he said, is to form partnerships with others. “It helps keep the costs down. Plus, if you can get others to market for you, then they’re helping spread the word about the good work you’re doing in your pharmacy and you’re going to get referrals,” he said. “I would highly recommend that any pharmacist who wants to do a program in their store hook up with a diabetes educator or a nurse who has worked in the area, or even a physician,” he said. “Physicians might be interested in coming to speak periodically about new things they’re seeing with diabetes patients.” Mitchell also recommended working with the drug reps in your area. “Sanofi’s brought more credibility to our stores by offering some good literature,” Mitchell said. “These companies can promote their products, but they also have free diabetes educational material that you can use.” Building business “Many pharmacists will think that they don’t have time to do it,” Mitchell said. “But that’s like saying you don’t have time to market to patients and bring more diabetes patients into your store. Because that’s what you’re doing; you’re marketing.” It’s an investment that has paid off well for Mitchell. Offering diabetes educational opportunities has brought in 10 to 15 percent more patients to his pharmacies. “The average diabetes patient brings a lot of dollars to the table in a pharmacy,” he said. “So all of that marketing that you do in a diabetes education class will come back tenfold whenever they come back to do their other business with you. And they’ll bring their family business as well.” You can make sure these patients keep returning to your pharmacy by stocking the diabetic supplies they need. “If you don’t carry the products for

the patients, they’re not going to come back to you,” Mitchell said. “I give away free meters at the classes and then make sure people understand how to use them, and they’ll usually come back to me,” he said. “I think most of the patients would say, ‘I’m going to pay somebody for these products. I’d rather it be somebody who cares about me versus a chain or mail order that doesn’t have a clue who I am.’” Obstacles to expect After more than 15 of years of providing diabetes education, Mitchell knows that it’s not always easy for busy pharmacists. “Time is a big thing,” he said. “It’s difficult to do if you’re a one-pharmacist operation and can’t get away from the bench to do a class.” Mitchell’s advice is to use what you have. If your pharmacy is a rotation site for students, let your students teach a class. And, get your pharmacists involved if you can. “All of my pharmacists help out,” Mitchell said. “I involve them in these teaching opportunities because nobody in the pharmacy realm wants to sit and count pills and handle insurance problems all day long. My pharmacists really enjoy getting out into the community and spending a little time doing some positive things.”

Drive more business to your pharmacy—and improve your community—by hosting a monthly diabetes education class or support group.


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Preparing for OutcomesBased Reimbursement: Things You Can Do Right Now


You’ve witnessed the major changes in the delivery and reimbursement of health care in this country since the passage of the Patient Protection and Affordable Care Act. So far, many of those changes have only affected hospitals and physicians. That will soon change, however, as pharmacists work to become increasingly recognized as essential members of patients’ healthcare teams. As the entire health care industry moves to a performance-based model for reimbursement, pharmacists must engage the system and develop processes that accurately account for their influence on patients’ overall health. Pharmacists can establish their place in Accountable Care Organizations (ACOs), performance-driven plan networks and transitional care teams, and receive recognition for their role in the cost-savings that result from better outcomes. But to get there, pharmacists must start monitoring their activities and documenting patient care successes. Here are a few of the ways pharmacists can prepare for outcomes-based programs.


Increase the clinical services you provide

As a community pharmacist, you have an opportunity to transition patients through the gaps in care that cause them to fall short of being healthy. Use this opportunity to establish your place in ACOs, performance-driven plan networks and transitional care teams by offering more clinical services. Look into providing screenings for high blood pressure, cholesterol and diabetes, or offer disease state-specific programs. Consider becoming accredited to bill for DME. You could also teach COPD patients proper techniques or screen patient profiles to determine risk factors for heart disease and asthma. As you document the outcomes of providing these services, you’ll have a useful record to show how your pharmacy has helped improve patients’ health.


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Learn the primary areas payers look at

Accountable care focuses on prevention. The idea is to prevent patients from using acute care services or receiving unnecessary treatments or tests. Payers then reward health professionals who contribute to keeping patients, especially high-risk or chronic disease patients, healthier and out of the ER. Hospital readmissions are at the top of the Centers for Medicare & Medicaid Services’ (CMS) list regarding payment reductions to health service organizations. While there are no standardized quality measures for pharmacists yet, you can start tracking the major areas payers are already evaluating, such as high-risk medications, patients who take ACE inhibitors/ARBs, and adherence with diabetes, high blood pressure and COPD patients. It’s also important to maintain treatment guidelines in your practice. If it has been a while, JNC7, ATP III, and ADA are worth the time to review.


Align your pharmacy, staff and partnerships with the new healthcare landscape The way health professionals receive reimbursement for their services has changed dramatically. Adjusting your pharmacy’s offerings and processes now will ensure that you are able to stay profitable in this new environment. There are multiple ways to make this transition as smooth as possible. Start by making adjustments to your physical pharmacy. For example, you may need to designate a separate, comfortable area in your pharmacy to counsel patients, provide vaccinations or teach a health class. It’s also important that everyone on your pharmacy team understands the new team approach to patient care, and the process changes they’ll need to make. Consistency is important in showing results, so if one team member isn’t on board, take the time to instruct and correct that person. You can also form partnerships with other healthcare providers to get your business in line with the new model of accountable care. Reach out to the providers in your area to discuss how you can work together to improve patient outcomes.


Complete your MTMs

CMS already requires health plans to complete MTMs with Medicare Part D patients. If your pharmacy does not complete the MTM, the case will be transferred to another pharmacy. By not doing the MTM, your pharmacy risks losing those patients and all of their dependents. In addition, keeping up with and documenting your MTMs will give you a proven record of improving patients’ outcomes—one you might need to reference in the future. To start, complete your MTMs on time and know the requirements. It’s important to understand the difference between CMRs and TMRs. You’re required to complete an annual comprehensive medication review, or CMR, with Medicare patients. You also have to submit a summary in CMS’ standardized format after each CMR. Targeted medication reviews, or TMRs, are required quarterly for each patient, with follow-up interventions when necessary. Understanding these requirements will put you ahead when CMS does develop outcomes-based reimbursement programs in the future.


Start an adherence program

Creating and implementing an adherence program at your pharmacy isn’t just a smart method of treating patients, it’s the future of your business. An adherence program helps your patients stick to their medication regimens and it also allows you to keep track of your pharmacy’s efforts to improve patient outcomes. The good news is that pharmacists don’t have to recreate the wheel. First fill counseling; call, text or email reminders; and medication synchronization are all processes your pharmacy may already have in place. By expanding and tracking the services you already offer—and starting them if you don’t—you’ll be able to show results to justify reimbursement down the line.

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New Year’s Resolutions for Your Business The New Year is a perfect time to take on projects and make the changes that will help your business thrive. Here are a few resolutions to make 2014 your most profitable year yet. See your front end with fresh eyes Take an objective look at your pharmacy’s front-end merchandise. Knowing what sells and what collects dust will allow you to make the most informed and profitable decisions going forward. If one product or brand has been effective, consider other products in that line. Also think about presentation. Are the displays in your pharmacy contributing to the appeal of your products, or making them look less attractive? If the displays aren’t helping you sell, it’s time to change them out. Help advance the profession On January 1, 2014, California pharmacists will receive official health care provider status thanks to a new law. The passing of this law recognizes the valuable services pharmacists provide. Keep the momentum going and contact your state legislators to propose


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a similar bill. Make it your goal in 2014 to continue to advance your profession in your home state. Make your pharmacy a destination, not just a store There are lots of simple ways to make your pharmacy a place people enjoy visiting. People feel comfortable in stores that are clean, well organized and inviting. Take a cue from retail experts and focus on pleasant lighting, dust- and dirt-free floors and surfaces, and appealing, up-to-date displays and products. Some nice seasonal touches include offering hot cocoa or tea to waiting customers, playing soothing music or offering a small treat to children. Grow your business with new products and services Become the “go-to” pharmacy for something (or multiple things), and let people know about it. If you already offer flu shots, try incorporating other vaccines, like those for Hepatitis and shingles. If you’re already counseling diabetes patients, consider providing educational classes or related products, like diabetic footwear. Already have lots of older or disabled patents? Maybe a delivery

service could boost loyalty and bring in new business. By making your pharmacy known for a specific service, patients will start to seek you out for what you do best. Start an adherence program With the reimbursement structure gearing up to shift from a fee-forservice model to an outcomesbased model in the future, the time is now to start an adherence program. A program that notifies patients when their refills are due and ready at the pharmacy, coupled with synchronized refills, can significantly improve patient adherence. It also makes ordering inventory more efficient and predictable, provides more time to resolve insurance issues and reduces patient confusion. (Plus, it can boost your revenue.) If all those changes make you feel overwhelmed, look to other resources to help you, including your team at PBA Health! We can help you with everything from getting a better deal on your cost of goods, to marketing services that will get your pharmacy noticed. Call us today for more information at 816-245-5700.

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Elements Magazine - Vol.2 Iss.4 Dec 2013  

Elements Magazine - Vol.2 Iss.4 Dec 2013  

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