In-Office Prescription Fulfillment Programs Gaining Ground

A Win-Win Solution for Practice and Patient

Overview

For several years, our firm has worked with medical groups to identify areas to enhance revenue and improve patient care.  As the need for reduced travel and exposure for needed medical services have increased (thanks in many ways to the opioid crisis and Covid-19) the option for setting up a process to dispense medications at a physician office has become attractive.  While this is especially true for specialty providers such as pain management, podiatrist, and orthopedic practices, primary care or family medicine can benefit as well.  To date, this has primarily been supported by vendors servicing Workers Compensation patients, however Physicians Risk Management (PRM) has established a relationship with a company who offers a full-service program for commercial payer patients.

PRM’s alliance with several dispensing organizations will allow medical groups to enable patients to leave with needed medication from their office, eliminating additional travel, time, and cost for the patient. This is a natural extension of your practice and includes a complete turn-key solution from inventory management to pharmacy benefit management coordination and payment processing.

Benefits of the Program

A Couple of facts/Observations: over 75% of your patients would rather receive their medications at the point of care! Why send patients to a pharmacy when you can send them home with their prescription? This creates a better patient experience!

Convenience

No added travel to the pharmacy or additional delays caused by prior authorizations or unapproved medications. Eliminate staff dealing with pharmacy call backs. Pre- determination of benefits software allows to see if a patient is qualified for their medication before it is dispensed.

Compliance

Approximately 30% of prescriptions go unfulfilled ultimately increasing long-term healthcare costs. Ensure that your patients are following treatment guidelines by providing them with their medication before they leave your office. This can also help control possible negative drug interactions and higher medical cost for payers and patients.

Cost

There is no additional cost to the patient. Co-Pays are collected by the practice just as they would be at a retail pharmacy

Maximize Revenue

Payment from adjudicated claims go directly to medical group from the patient’s Pharmacy Benefit Plan. Make the revenue yours and not the chain pharmacy down the street. Many groups see between 35% – 40% of adjudicated claims.

An In-Office Dispensing Program gives medical groups an innovative opportunity to directly deliver and manage an important and frequent healthcare service for your patients. When designed appropriately, the program gives providers and patients a strategic market advantage and improved quality care. Eliminating the frustration patients deal with when coordinating access to pharmacies and time lapse before needed medication can be taken.

Protecting the financial stability of medical groups is a daunting task. PRM’s partnerships with pharmacy fulfillment companies who are integrated with Pharmacy Benefit Management (PBM) organizations makes this offering to medical groups easy and streamlined. Our program helps your medical group gain back an additional revenue generating option and adds options for ensuring financial stability while enhancing quality care thresholds.

Proven track record

At PRM, we take the time to identify quality providers with a proven track record of success. This is an additional benefit to our customers. We work with some of the country’s longest standing point-of-care dispensing companies with a specific focus on commercial and workers compensation insurance. Almost 80% of the nation’s state can offer an in-house dispensing program without restrictions. These programs need to include:

• Access to a low product cost arrangement

• An integrated easy to use inventory management platform (web-based solution for easy installation)

• Expert customer service support (from set-up through operations)

• Relationships with third-party payers and PBM organizations

Also, it is important to consider the following:

• A “Go-to-market” strategy and a simple implementation plan
• Perform benefit analysis PRIOR to each patient visit
• Offer favorable payment terms (even a line of credit) for medication cost
• Outline a clinical integration program incorporating in-house medical staff leadership
• Discuss cultural acceptance
• Project management team and timeline
• Management of program launch (typically live within 30 days)

In summary, our alliance with integrated pharmacy fulfillment companies provides the following infrastructure and systems to enable us to:

1. 1.  Offer turn-key solution for prescribing and fulfilling medication at the time of each patient visit
   2.  Provide inventory for list of most frequently prescribed medications
   3.  Provide integrated benefit and web-based inventory management software platform
   4.  Provide pro-active formulary choices for physicians prior to each patient visit
   5.  Process claims and pay providers directly
   6.  Increase patient satisfaction and quality of care
   7.  Increase pharmacy medication compliance and avoid gaps in medication use
   8.  Apply the appropriate regimens of care to those patients identified in high-risk categories under your care
   9.  Significantly reduce healthcare costs by avoiding hospitalizations and complications due to increased medication compliance
   10.  Increase practice revenue by as much as $200 per patient per visit

Call to action

We want to hear from you to discuss how we can help to protect the financial stability of your health system and enhance the relationship with your patients.

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