DIR Fees, GER Fees, Declining Reimbursements – What’s Next? How do we Survive?
As we have spoken about in the past, when an industry changes, the businesses within that industry must change as well. Prosperity within the world of independent pharmacy has become tougher and tougher over the last decade. It’s important to note that we still have a tremendous number of clients that are doing extremely well in the very same industry that we see others struggling to stay afloat. Pharmacies that are being proactive and changing the way they operate their business are the ones that will survive – and the rest, unfortunately, will cease to exist.
We have spoken about many ways to build profitability back into an independent pharmacy, even more so in the last year. We have shared ideas that we have seen work, from reinvesting and revamping the store, to changing front end offerings to cater to your local demographic (beyond the standard OTC items you find everywhere). We continue to share success stories in the Datascan blog on our website. But, we also continue to share frustration in the fact that so many are reluctant to adopt or try out new features and the technology packed into the very pharmacy software system they pay monthly for.
Recently we have seen some clients so upset with lower reimbursements that they begin to search for ways to save money or look for technology they believe may help their business. Don’t buy into the smoke and mirrors the competition is selling – reimbursements don’t change from one software vendor to the next! Eventually a conversation with us leads to optimization training, where clients typically find themselves in awe of the capabilities of our Winpharm pharmacy management software. The very same pharmacy management software they have been using for years could do things they had no idea it could. The same pharmacy system they have been paying for all this time could help streamline their business, better organize day to day operations, and automate so many daily tasks.
Is it easier to give up and sell your pharmacy? Do you feel ready to retire? We have seen many retired clients of ours end up working in other stores to either make money or pass the time! Are you thinking about starting a new business, and if so, have you weighed the risks of a new business versus trying to revamp the one you already have?
Start off by harnessing the technology. We now have a DIR Fee estimator. You can use this tool to not only get an idea of your reimbursements after bogus DIR fees, but, you can run reports for time periods to estimate a more accurate profit picture. Most importantly, you can use our reimbursement warning system to stop on claims and show you the expected profit AFTER your DIR fees are taken out. We are building in similar technology for tracking GER fees as well. As we expand on these features, our goal is to give you a profit picture of each patient that you expect to have losses on while filling that medication. You will be able to see what that patient and their family spend in your store over different periods of time, both on the RX and OTC side. This will help you make more informed decisions while servicing your patients.
We also have our AWP rebill utility that can show you potential increased profit opportunities when AWP may go up after you have already filled a prescription. This gives you the ability to reverse and rebill these claims with potential for higher reimbursement.
The automation we have built and improved upon, as well as our adherence dashboard will help you refill more prescriptions, keep patients adherent while building star ratings, and better serve these patients.
As our technology improves, you will also be able to identify those plans and groups where you’re losing the most. A deeper look into what’s really going on with your patients and their plans is needed to help mitigate losses.
We want our independent pharmacy clients to use the technology we created. Implement it into your daily workflow, and hopefully you will recognize at some point the value in increasing refills, and the value in automation. With efficiency, if you can operate with less staff, you can save on one of your biggest expenses.
Datascan has the pharmacy management software and technology you need for the future. We understand your frustration, and believe us when we say, without you, there is no Datascan!