What’s on the horizon for the business of pharmacy in 2023? That’s a big question, with a veritable boatload of different answers.
For a clearer picture of the opportunities, changes, and challenges pharmacies can anticipate this year, we went to the one and only, Dr. Lisa Faast.
There were so many great takeaways in this 30 minute conversation, but we managed to pick out a few of our favorites for anyone that hasn’t had a chance to watch the full interview.
Opportunities Are Out There
Running a profitable pharmacy today is probably harder than it’s ever been before. But there’s also more opportunity than ever before, too. The mentality of many patients has shifted. Instead of waiting weeks and months for a doctor’s appointment, patients are looking to take control of their health. And they’ll use the resources available to them, including your services & expertise, to do so.
Medicare is Paying for Services You Can Provide
According to Lisa, the biggest opportunity for pharmacies is in the money that Medicare will pay providers for services that patients need. Remote patient monitoring, remote therapy monitoring, chronic care management, and all the things that come with services like those make up the increasing number of billing codes that Medicare accepts. The one caveat here is that you do have to partner with a provider so they can bill Medicare. This practice is becoming more common and can be incredibly lucrative.
Resources and More Resources!
For every question you have about clinical services, Medicare billing, business management, etc. there are countless resources waiting to answer those questions. Some of them are free and that’s not a bad thing. Some of them cost money, which is awesome as you get more serious about a topic and need to dive deeper. Just make sure that who you’re learning from deserves your attention. Do they have experience in the pharmacy industry? Does their advice speak to you? Is it helpful? There are so many great free resources out there, but they have to align with what you want to learn, and how you learn.
Profit is Not a Four-Letter Word
There’s no easy button to make pharmacies more profitable. And maybe that’s why many pharmacies shy away from the idea of making changes. Or, maybe it just doesn’t feel great to talk about profit or think about it. But making a profit is a good thing. In fact, it’s a necessary thing. Your community, your employees, your patients, are all depending on you to make a profit. It’s what keeps the lights on, and it also enables you to continue to invest in new services.
The “DIR Fee Apocalypse” is Coming
It’s time to prepare, but you don’t have to go it alone. In 2024, DIR fees are going to be applied at the time of sale. The highest DIR fee will be applied and you’ll know your reimbursement for a drug at the time you bill insurance. This transparency is good. It brings better data, which leads to better decisions. But, during the first several months of 2024, you’ll be retroactively paying fees from 2023 while you’re paying current 2024 fees at the time of sale. This could be a challenge for many pharmacies that struggle with reimbursements or cash flow. Luckily, you have time to prepare and there are plenty of resources that can help you. Check out the upcoming Pharmacy Profit Summit for a start and stay tuned for more resources from Lisa and her team at DiversifyRx.
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