Opportunity, Advocacy Fuel Optimism for Independent Community Pharmacy

Brian Nightengale

Tom Mullin

Don’t count independent community pharmacy out. Changing demographics, evolving consumer expectations, and more effective advocacy point to a strong future for independents.

“Dramatic changes in the marketplace are driving optimism for independent community pharmacy,” says Brian Nightengale, RPh, PhD, President of Good Neighbor Pharmacy. “In demographics and in mindset, there is a major movement toward customization. People are more focused on their overall experiences and interactions. The mindset is moving toward preventing sickness and optimizing health. The independent community pharmacy is set up perfectly to meet that expectation for a relationship with a care provider who knows me personally, knows my expectations, knows my health and wellness plan, and can help me accomplish it.”

The key to providing personalized care is having the time to get out from behind the counter to work with patients directly. Good Neighbor Pharmacy tools such as medication synchronization streamline the patient workflow, giving the pharmacist more time to spend with patients.

“Another way we are investing in independent community pharmacy is in trying to change the reimbursement landscape,” Nightengale says. “If you think about that desire for more personalized care that more and more patients are seeking, you first need the time and you secondly need the financial wherewithal to provide it. That means being reimbursed for providing that clinical service that is not connected to dispensing a specific medication. We need a mechanism for reimbursement for those highly valued, highly impactful care services that the independent community pharmacist can provide.”

AmerisourceBergen is approaching reimbursement reform from two directions.

One is through demonstration projects. AmerisourceBergen is partnering with Community Pharmacy Enhanced Services Network (CPESN) Tennessee and the Tennessee Pharmacists Research and Education Foundation, a direct subsidiary of the Tennessee Pharmacists Association, to launch a readiness programs that allows for 70 CPESN Tennessee participating pharmacies to provide care and intervention for patients with congestive heart failure. The readiness program is designed to test and validate a scalable roadmap for pharmacists, payers, and other providers to expand a consistent model of congestive heart failure services provided by community pharmacists.

“The goal is to reduce hospital readmission rates,” Nightengale explains. “The pharmacist will be reimbursed separately from any drug products to ensure patients are on their care plan. When you look at the high demand for high-touch community-based care and a shrinking supply of community physicians, the community pharmacist is the most accessible healthcare professional to fill that gap. That’s the opportunity.”

Meeting that opportunity requires new reimbursement mechanisms. That means changing the reimbursement rules in Washington and in all 50 states.

“Pharmacists are willing, able, and fully capable of providing these enhanced services, but the current reimbursement model doesn’t pay for that,” Nightengale continues. “That’s where advocacy comes in.”

Federal advocacy targets Medicare and other federal programs. State advocacy targets Medicaid, scope of practice, and other state responsibilities.

Pharmacists have multiple opportunities to make their voices heard. Active involvement in state and local pharmacy organizations is the first step.

“Just as important is being the local voice with your state legislators and Congressional representatives,” Nightengale says. “Invite them into your store, show them what you do, show them the amount and the quality of the care you provide. It’s an eye-opener for them.”

AmerisourceBergen facilitates advocacy through OurIndependentVoice.com. The website makes it easy for pharmacists to keep up with the issues and to contact their elected representatives.

“One of the things that distinguishes AmerisourceBergen is our advocacy efforts,” says Tom Mullin, President, Community and Specialty Pharmacy, AmerisourceBergen. “We have an opportunity to bring thousands of independent pharmacy voices together so they can be heard in Washington and in every state legislature. Fair reimbursement, reimbursement for cognitive services, these are key topics where we can enable pharmacists’ voices for advocacy and policy.”