CEO says behavioral health specialist addresses unmet need

TUKWILA, Wash. — Genoa, a QoL Healthcare Co., is one of the fastest-growing community pharmacy operators anywhere.

Genoa CEO John Figueroa

Specializing in pharmacy services for behavioral health patients, the organization has expanded exponentially since it was established in July 2014, when Genoa Healthcare and QoL meds were acquired and merged by private equity firm Nautic Partners. Its pharmacy count has grown by nearly a third — from 214 to 309 in 40 states and the District of Columbia — while annual sales have almost doubled to $1.1 billion.

And that’s just the beginning for the only large-scale pharmacy chain dedicated to meeting the needs of patients with such serious mental health issues as schizophrenia and bipolar ­disorder.

“We’re growing organically faster than 25% a year, and that’s unheard of in pharmacy,” Genoa chief executive officer John Figueroa said. “We’re structuring our company to put the resources in place that will enable us to ramp up quickly and address a bigger piece of a population that is severely ­underserved.”

Genoa pharmacists provide care for more than 500,000 patients a year, an impressive number, but that’s only a fraction of the estimated 20 million people in this country who suffer from behavioral health problems. It’s no wonder that demand for the company’s services (there are now 70 potential partners on the implementation list) exceeds its ability to open pharmacies, which are almost always located within or adjacent to a community mental health center or other health care facility.

“We believe that if one of our closed-door pharmacies is on site at a community mental health center, integrated with the clinical team and engaged in a high-touch level of pharmacy practice, we can positively affect the well-being of the patients in this setting who are severely challenged,” Figueroa explained. “Our experience has shown that when we work directly with the physician as part of the clinical team and interact with the patient right after therapy, we have a chance to make a major impact, which translates into greater than 90% medication adherence rates.

“That’s much different from letting the patient walk out of the clinic without pharmacy care and having a 20% to 40% adherence rate. That’s really the crux of our model,” he added.

With the implementation of the Affordable Care Act, access to mental health care has improved, triggering a rise in patients seeking help and prescription services, Figueroa noted. That development, together with the fact that Genoa now has pharmacies in just a fraction of the nation’s community mental health centers and federally qualified health centers, gives the company ample scope for expansion for years to come.

“We opened 50 pharmacies in 2015, and we’ll do between 55 and 60 this year,” Figueroa said. “The sweet spot for us right now is about 75 to 80 openings a year.”

The rollout of Genoa’s service-intensive pharmacy model within the health care environments where it operates isn’t the only avenue of expansion for the company. People with mental health problems who are making the transition from an institutional setting, such as hospitals and prisons, are good candidates for intervention by Genoa pharmacists, as are individuals battling substance abuse.

“About 40% of our current patients also are managing substance use disorders, so we’re already seeing a lot of overlap,” Figueroa explains. “We’re starting to parlay our behavioral health pharmacies into substance abuse entities as well.”