By: Jason Ausili, Pharm.D., Head of Pharmacy Transformation, EnlivenHealth®
For most retail pharmacies, Medicare-eligible patients represent a significant source of recurring revenue. Protecting that revenue and ensuring the continued health and happiness of patients during Medicare Open Enrollment is extremely important.
To learn more about pharmacies’ relationships with their Medicare-eligible patients, EnlivenHealth conducted a national survey of pharmacists, with 375 pharmacists responding. We wanted to know how involved most pharmacists are when their Medicare patients are looking for a Medicare Part D plan during Open Enrollment, or when patients turn 65 and enroll in Medicare for the first time. Pharmacists are a trusted source of health-related information and can help patients make sure they choose a plan that saves them money and allows them to continue to use their trusted local pharmacy.
The fear of choosing the wrong Medicare Part D plan
As we learned from the survey, both pharmacists and their patients have concerns about choosing the right Medicare Part D plan. For example, patients may select plans that are out-of-network with their trusted pharmacy, which could result in the pharmacy losing that high-value patient. This concern is well founded given the fact that 70% of pharmacists say that a third or more of their pharmacy revenue comes from Medicare-eligible patients.
“Medicare-eligible patients make up about 40% of our patient population,” said Tiffany Graham Barber of Hillsborough Pharmacy and Nutrition in Hillsborough, NC. “When we work with them to choose a Medicare Part D plan, we can make sure they select a plan that will save them money and allow them to continue working with us.”
Patients have the same fears. They want to save money on their Medicare plans, but our survey found that more than 78% of pharmacists said their patients are most worried about their preferred pharmacy being in-network. This far outweighs the overall cost of the plan, drug restrictions, and increased drug copays. The bottom line is that patients want to stay with their trusted pharmacy. As pharmacists, we can help them do that by empowering our patients to choose the best, most affordable Medicare plan.
Helping patients choose the best, most affordable Medicare Part D plan
In our survey, we discovered that most pharmacies play an active role in helping patients choose a Medicare Part D plan. As many as 54% of respondents indicated that they are “very active” or “extremely active” in helping patients choose a Medicare plan.
When we asked about their comfort level in discussing Medicare Part D plan options with their patients, 40% said they felt very comfortable having the conversation. And as many as 73% said they regularly communicate with patients about Medicare Part D enrollment.
Nicolette Mathey from Palm Harbor Pharmacy explained why: “Medicare plan comparisons have always been important for our pharmacy to ensure our patients can afford their medications and, ideally, save money.”
Adopting tools to compare Medicare Part D plans
It’s widely known that most pharmacists are overworked, and staffing is often insufficient. Helping Medicare patients with their Part D plan decisions can’t be an additional burden placed on pharmacists’ shoulders.
With that in mind, many pharmacies are discovering the benefit of an online plan comparison solution. This kind of technology-driven solution allows pharmacists to review plan options with their patients quickly and easily. Pharmacies can help ensure that their patients choose an affordable Medicare Part D plan that fully covers their specific medication needs, resulting in healthier, happier patients, reduced staff burdens, and stronger pharmacy business results.
To understand whether pharmacists are aware of these benefits, our survey asked them if they plan to implement a solution or strategy to build and retain Medicare patients. The majority of respondents (65%) said yes. We also asked what type of solution they were looking to implement. Most respondents (62%) said they were considering an in-pharmacy plan finder tool. “Patients love it,” said Steve Adkins of Health Park Pharmacy in Raleigh, NC. “Last year, we saved patients $250,000 to $300,000 by helping them compare Medicare Part D plans with Medicare Match from EnlivenHealth.”
Medicare Match from EnlivenHealth
EnlivenHealth’s Medicare Match is the industry-leading Medicare plan finder solution that empowers pharmacies to strengthen patient relationships while expanding revenue growth opportunities and reducing DIR fees. With Medicare Match, pharmacists can efficiently help patients choose the Medicare plan that’s the perfect match for their healthcare needs and budget. The result is a true win-win for your patients and your pharmacy’s bottom line.