Industry Overview

Pharmacy is one of the fastest growing sectors in healthcare, and the aging baby boomer generation will only increase this growth.

There are currently more than 60,000 retail and specialty pharmacies in the United States, with nearly four billion prescriptions filled in 2010—for a retail drug spend of $259 billion. This accounts for approximately 10% of total healthcare spending in the United States. By year 2020, the retail drug spend is expected to be $450 billion.

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During this period, physicians have seen a 15% decline in their personal income over the past 20 years, due to steadily declining reimbursement rates and ever increasing costs. Federally and state funded programs, such as Medicare and Medicaid, have been the worst offenders; it is estimated that in 2014, the Centers for Medicare and Medicaid Services (CMS) will recommend cuts to physician reimbursement by at least 27%. As a result, many groups are looking at bringing ancillary services back into their hospital or physician practice.

Quality-based reimbursement
As part of the Patient Protection and Affordable Care Act of 2010, the Centers for Medicare and Medicaid Services (CMS) has begun to tie quality of care metrics (such as the 5-Star Rating system and the Readmissions Reduction Program) to reimbursements. In the Readmissions Reduction Program, CMS estimates that more than 2,000 hospitals will forfeit more than $280 million in reimbursements over the next few years due to excessive readmissions.

It is estimated that 65% of hospital readmissions are medication related. Therefore, health-systems and hospitals that can institute effective programs to reduce medication interaction and increase medication therapy adherence can greatly add to their profitability, while simultaneously lowering costs in our healthcare system.

 

Our Services

Here's how PharmaPoint can serve you.

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Pharmacy Management

PharmaPoint is an industry leader in pharmacy management services, specializing in managing retail pharmacies for hospitals, physician groups, municipalities and self-insured corporations. We have the expertise, experience and resources needed to make your pharmacy successful and profitable. We offer turn-key services, assisting you in all areas of pharmacy, including:

  • Design and layout of the pharmacy
  • Licensing (State BOP, DEA, etc.)
  • Managed care contracting
  • Wholesaler agreements and drug procurement
  • Equipment and software
  • Staffing
  • Claims reconciliation
  • Reporting

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Medication Adherence

Many patients do not adhere to the medication therapy regimen their physician prescribes—in fact, some studies show that complete adherence occurs in less than 2% of patients. This is a troubling statistic, particularly with complex, chronic patients who suffer from diseases such as high blood pressure, high cholesterol, coronary artery disease and congestive heart failure. Our Medication Adherence programs are designed to work with the patient and their physician to greatly increase complete adherence to their prescribed therapy, and include such programs as:

  • Medication synchronization
  • Generic substitution
  • Patient follow-up
  • Auto-refills
  • Deliver or mail-order

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Patient Readmission

Part of the 2010 Affordable Care Act established the Hospital Readmissions Reduction Program, which requires the Centers for Medicare and Medicaid Services (CMS) to reduce payments to hospitals who have excessive patient readmissions. It is estimated that nearly 65% of patient readmissions are medication related—either from non-compliance to the medication therapy prescribed, or from drug interactions. Our comprehensive Patient Readmission Reduction program combines our Medication Adherence program with Medication Therapy Management (MTM) and Comprehensive Medical Review (CMR) to significantly lower readmission rates for hospitals and health systems.

 

Testimonials

Nice words from some of our clients.

"PharmaPoint has handled every step in the setup and opening of our pharmacy with expertise and professionalism. Patient response to the opening of our pharmacy has been very positive. The convenience of the pharmacy cannot be beat—a great advantage for the elderly, those with mobility issues, or simply those with a busy lifestyle. For many patients, the pharmacy can have, or nearly have, the patient’s prescription ready by the time the patient arrives at the pharmacy." — Emmett Forrester, Practice Administrator of Northeast Georgia Diagnostic Clinic

“Our pharmacist is part of the care team. He regularly communicates with our doctors (and vice versa) when drug dosage, interaction, or affordability questions present themselves. Ultimately, this increased interaction positively impacts medication adherence and patient outcomes.” — Mark Morgan, CEO of Huntington Internal Medicine