For the second
consecutive year, a pharmacist at the local CVS store administered my flu
vaccine. The young man was pleasant, personable and courteous. The
facility was clean and the whole process from registration to receiving the
shot took less than ten minutes. The pharmacist mentioned that he has
been administering more than 100 vaccines per shift. This comes as no
surprise really, as my medical insurance company awarded me a $25 gift card for
getting my flu shot from a pharmacist, and not
my physician. This is the same store I buy gum,
batteries and greeting cards.......just adjacent to the gas station where I
fill up my car.
Beside CVS,
other retail pharmacy companies are realizing the value of the local
pharmacist. In a recent New York Times article, Walgreen Company is mentioned
as “pushing its army of pharmacists into the role of medical care providers.”1
The Executive Director of Pharmacy and (get this) Healthcare Experience said,
“It’s not about the product, but the care we give.” This belief in the
value of the patient experience for Walgreen is more than just words. Walgreen
is currently demanding a fee for the customer experience above the cost of the
prescriptions it receives from Express Scripts, a pharmacy benefit manager. If Express Scripts does not pay the patient
experience fee, Walgreen will let its contract with Express Scripts expire at
the end of the year. This represents a
potential revenue loss for Walgreens of an estimated three billion dollars.2 In other words, Walgreen is drawing a line in
the sand by stating that patient centered care is worth extra money. Talk about putting your money where you mouth
is!
The
transformation from a fee-for-service compensation model to one based on
value-based-purchasing is the motivation for this trend. When a patient trusts
his or her healthcare provider, the more likely the patient will be to follow
the treatment recommendations, which results in a more successful medical
outcome for the patient and lower healthcare costs.3 Not
surprisingly then, the new Affordable Care Acts (ACA) attempts to control the
costs of healthcare by rewarding medical centers, physicians and other
providers for patient centered care. For example, ACA authorizes the Centers
for Medicare and Medicaid Services to financially reward providers if the
patient reports a favorable encounter with physicians and nurses on the HCAHPS.
(See my blog of March 30).
To my
physician colleagues, and everyone else who delivers patient care, be
forewarned, the pharmacists are coming out from behind the counter!
________________________________________________________________________
1.
Japsen
B, Out From Behind The Counter, The New York Times, Oct 21, 2011
2.
Martin
TW, Walgreen Prescribes Rate Change, The Wall Street Journal, Oct 25, 2011
3.
Cassatly
M, Coaching the Patient-Physician Relationship: A Successful Approach to Lower
Healthcare Costs with Improved Medical Outcomes, J Med Prac Manage, 2010; 229-234
