Medication adherence has become a large focus within pharmacies over the last decade. Now, your reimbursements from CMS are tied directly to your star ratings, which in turn are tied to your performance in keeping your patients adherent to their medications. Lets face it, tying directly into medication adherence is the fact that your filling more prescriptions, which is better for the pharmacies bottom line. Pharmacists are already busy with so many tasks in any given day, so how can you effectively run your business while making sure your patients are getting their maintenance medications on time? If you harness the technology in your pharmacy software, its not that difficult to do!
Todays pharmacy management system has so many tools built into it that automate these processes, as well as make it easier for the patient to communicate and queue up their prescriptions for refill as well. The best pharmacy software systems on the market have countless features to make sure your patients are not running out of their medications, in turn making them non-adherent, and affecting your bottom line with regards to reimbursements. Datascan’s pharmacy computer system, as an example, has an adherence dashboard built in to identify patients that need attention. It also offers auto refill so that when the next fill comes due, it can auto fill it and place it in a queue to be dispensed from. For those patients not on auto refill, the pharmacy system can auto communicate with them to let them know a prescription is ready for refill via text, the MobileScripts app, through email, and even via outbound calling through an integrated IVR system. Once refilled, the same communications tools can be used to remind patients to pickup their medications, and send multiple reminders spaced out to make sure the patient is receiving them. For those pharmacies that offer delivery, our pharmacy software system also ties directly into our Mobile Delivery Application that makes setting up, tracking and delivery these prescriptions a breeze.
Many patients, especially those tied to star ratings on Medicare plans, find themselves on multiple maintenance medications that need to be refilled monthly. Our pharmacy software offers a few features to help combat this. Medication Synchronization has proven to raise adherence rates, simply for the fact that it means less trips to the pharmacy (or less deliveries to worry about if that is offered). Winpharm has a built in medication synchronization system that makes suggestions and helps you calculate the best way to get multiple medications to be ready for refill within a date range where they will get paid and not be too early to fill. That means filling them at the same time, and allowing pickup of all necessary meds in one trip.
When filling a maintenance medication in your pharmacy system, it needs to alert you if you are using the last refill for that drug, as well as give you an option to reach out to the Dr for a new medication with the click of a button! Datascans pharmacy system also has a maintenance medication utility built right in. This system can scan through patient profiles, find medications that have been filled within a certain timeframe, but have no refills left, and automatically send requests out to doctors. Once this happens, it parks all of these requests into a workable queue. When a doctor responds, it moves that RX to the central queue to be filled, or notifies you it has been rejected.
Formularies from PBM’s can make it difficult when a Doctor prescribes a medication needed by a patient to stay healthy. If the drug doesn’t fall on that formulary for that patients insurance, it now requires a prior authorization (a bogus pain in the rear end process used to make it unattractive to Drs and pharmacists, in the hope that you will simply choose one they prefer). Cover my Meds came to market to fix this, and any retail pharmacy software product on the market will have a direct integration with this. Our software also allows for an automatic PA process, so when a drug is rejected required PA, the system can start the process by synchronizing with CMM, auto filling out the proper form, and getting it over to the Dr for review quickly.
Many pharmacy software systems are also integrated with SureScripts for their Real Time Prescription Benefits Program (RTPB). When integrated, the pharmacy system synchronizes with the SS platform to help display drugs that are on the patients insurance formulary and/or alternate therapeutic options to help avoid what can sometimes be a lengthy prior authorization process. This helps get the patient out the door immediately with a drug to help start their treatment faster, and eliminates the need for them to come back.
In conclusion, if you are operating an independent pharmacy today, your pharmacy management software can directly affect your reimbursement levels with CMS. Used properly, the best pharmacy software on the market can automate processes to ensure your patients are getting their refills on time and staying adherent to the therapies prescribed to them by physicians. Overall, pharmacy systems can really aid in the overall health and outcomes for patients by ensuring they get their maintenance medications on time, and consistently. Lets face it, making profits in community pharmacy is not getting any easier. So why not employ the technology that your already paying for in your pharmacy computer system, and let it work for you!
