|
With
more insurance carriers moving their customers into managed health
care programs, community pharmacies are being excluded from supporting
the pharmaceutical needs of a larger portion of their current
customers. Trends in future health care management indicate significantly
more enrollment in managed care programs. Lost pharmacological
patients will have a negative impact on the revenues many community
pharmacies can realize from their prescription business. Corporate
competition for the remaining OTC's, health & beauty, greetings
and gifts your current customers purchase have many community
pharmacy owners finding their stores revenue flattening or dropping.
Today, many owners are considering retailing new product lines,
or are contemplating adding new services to develop another revenue
center for their stores. At an alarming rate, independently owned
stores, under pressure from corporate providers and shrinking
revenues, are closing their pharmacy doors or moving into non-health
care related fields. Yet many of those closed stores, and countless
other independently owned community pharmacies over look or fail
to realize the potential they have. Most pharmacies can expand
into home health care services by capitalizing on the most valuable
ingredient they have in their pharmacy, their valued patients.
For years, independent community pharmacies have played a vital
role in their community's total health care solution. Many owners
have ingratiated themselves and their profession to; physicians,
hospitals, health care agencies, and often multiple generations
of the same family. Independent pharmacists have for years been
the highest trusted professionals in numerous polls. Their total
drug management of patients pharmacological needs have saved
mountains of money and perhaps countless lives. It is this respect
as a health care professional that enables them to develop ancillary
health services. Their valuable reputation can be a decisive
element for expansion into the rapidly growing home health care
services marketplace, and move beyond the traditional role of
just dispensing pharmacological services.
Home health service is growing at a phenomenal rate. A bipartisan
analysis indicated that as many as 9 to 11 million Americans
need home care services (1). During 1994, about 37 million aged
and disabled citizens were enrolled in the federal Medicare program.
About 3.3 million received some form of home health services,
many of which could have been supported by their community pharmacy
(2).
Medicare home health expenditures have reached $3.9 billion dollars
(3). Of the almost 4 billion spent by Medicare in 1994, home
health services represent approximately $ 29.9 million. Indications
are that for 1994 growth in home health grew an incredible
67 % . Clearly, developing a home health services center
can lead to sustainable revenues with a market that is projected
to grow for decades.
Can I develop home care referrals ? How many times has a patient
or physician asked you if you could do a home health product
? Did you support the patient or did you give it away to the
Durable Medical Equipment (DME) company down the street ? Each
lost opportunity for supporting a patient in the last year could
have been potential revenues. Many patients you have for prescriptions
may be working with another provider for services you haven't
supported. If you took a pool of your candidate patients, the
results may shock you. When you expand into home health services,
your patients that are receiving home health services from another
provider will surely tell you they would have rather used you
if they knew you could have helped them. If you've been sending
your patients somewhere else you could be letting profits slip
away. Nationally, a typical wheelchair can generate about $ 300.00
(4). Based on actual performance of community pharmacies expanding
into home health services and Home Medical Equipment (HME) in
the state of Pennsylvania from 1990 to 1994, typical growth and
markets penetrated can be used to identify candidate patients
from the pharmacy in store referral base. Analysis indicates
that, on the average, 50 % or more of the community pharmacy
customers are 65 or older. Of that candidate group, approximately
16% will require some form of home health services, products
or advanced modalities (5) . This data has been extrapolated
to identify possible candidates a pharmacy might generate from
within it's current customer base. Figure 1 shows the candidates
a pharmacy could develop in house if the pharmacy expands into
providing home health services.
FIGURE 1.
candidates for home health services at a typical community pharmacy
|
|
Today,
Medicare, and for the majority of states, Medicaid is "patient
choice" driven. That means your patients can choose you
to support their home care needs. Unlike exclusionary pharmacy
plans, there is nothing prohibiting your customers from specifying
you to be their home care provider. With the need for home health
services growing yearly, a marketplace that is projected to grow
for decades, and the potential of developing home health patients
from seniors that are patronizing you monthly for their pharmacologic
needs, community pharmacies are in a position to expand into
providing home health services. You could be generating revenues
from those patients for years.
THE PROBLEM
Pharmacies, faced with declining revenue in their traditional
health care role, might consider expansion into home health services
as an alternative revenue stream. To develop a home health revenue
center in a community pharmacy, the pharmacist must recognize
elements to control. The pharmacist must have a strategy to deal
with vital components of the industry to ensure successful implementation.
Prior to your roll out and before you spend a single penny, you
must consider these factors;
· LEVEL OF PARTICIPATION
· OUT SOURCING SERVICES
· CALCULATING RISKS
· PURCHASING
· PRODUCT COVERAGE
· BILLING ISSUES
· MERCHANDISING
· MARKETING STRATEGY |
|
