SAN FRANCISCO — What the ideal health care delivery model will look like in five or 10 years remains a mystery, but a few things that most experts agree will be key to shaping the future of health care are rooted in the words “value” and “empowerment.”
Patients, payers and providers all will be more keenly focused on the value of their health care spending, and the outcomes or quality that these outlays produce. Tied in with this shift away from a transaction-based health care model to one that’s value-driven is the ongoing swing in “control” over health care decisions. Patients are becoming more empowered with managing their health and well-being, and other health care players are also seeing their influence over the delivery model undergo various shifts.
With an eye on this ongoing transformation and how it will impact the pharmacies in its network, the management team at Health Mart has set out to create a plan that better positions its 3,600 community pharmacy members for greater success in the new world of health care. In recognition of these broad efforts, Chain Drug Review has recognized Health Mart as its Pharmacy Innovator of the Year for 2014.[symple_box color=”red” fade_in=”false” float=”right” text_align=”center” width=””]
CHAIN DRUG REVIEW
2014 PHARMACY INNOVATOR
OF THE YEAR[/symple_box]
Among its recent efforts, management at Health Mart — an affiliate of McKesson Corp. — has developed resources designed to boost local marketing efforts for its stores, added new revenue-generating services such as Health Mart Specialty Solutions and created programs aimed at improving medication-related outcomes, which can help Health Mart pharmacies gain access to a broader range of preferred pharmacy networks.
“If you look at the things we are doing,” says Health Mart president Steve Courtman, “it’s very much around empowering Health Mart pharmacy owners and enabling them to be successful. We want to provide the fuel for their growth.”
Health Mart has a strong foundation to build upon, with its individual pharmacy owners already driven by a deep-seated passion for the pharmacy profession.
“If you think about the things the independent pharmacists do exceptionally well, it’s rooted in their passion, their sense of innovation and the strong patient relationships they develop,” says Courtman, who took on his Health Mart role in 2012. What’s missing is the scale and efficiency that comes with a corporate structure, and the broader management view across the store that is important to setting strategy.
Health Mart pharmacy owners need chain-level support, “and that’s where we come in,” Courtman says. “Effectively, we are enabling 3,600 independent pharmacies to be more successful, where they become the best of a chain and the best of an independent. We view Health Mart as a way to level the playing field and to enable the growth of independent pharmacy.”
One of the areas that Health Mart is focused on is the pharmacies’ performance on the Centers for Medicare and Medicaid Services’ (CMS’) Five-Star Quality Ratings. Of the five medication-related quality measures in this rating system, three are related to patients’ adherence to prescribed medication treatment and two are tied into patient safety related to overall prescription utilization.
The ability to impact these ratings measures comes down to how successful pharmacists are at changing or modifying behavior, Courtman says. “It all comes down to the fact that you have to engage with the patient to initiate that change,” he notes. “We at Health Mart are very much about enabling that patient engagement that our independent pharmacy does so well.”
To help Health Mart pharmacies to get more insights into their performance on the important quality measures, the corporate group has begun providing member stores access to EQuIPP, an online platform that makes pharmacy performance data available to health plans and community pharmacy organizations. Using this platform, the stores can review their performance data, compare their performance to industry benchmarks and identify areas in patient care and clinical outcomes that could be improved.
One program that Health Mart has running with a national payer focuses on addressing the gaps in patient care. Working with the payer organization to identify particular gaps in patient care, Health Mart is able to play a “centralized function” to pass along a plan of action for a specific pharmacy. “The store itself actually delivers on that care plan, because the pharmacist has built that unique patient relationship,” he explains.
The feedback from payers to Health Mart on the Star Ratings’ performance has been very positive, Courtman says, primarily because Health Mart is working diligently to align with health plans’ goals. This is critical to Health Mart’s inclusion in the preferred networks that are becoming more prevalent across the nation. Under the Medicare Part D program, roughly 87% of the prescription drug plans have a preferred network.
“The things we’re doing are very much resonating with payers. It’s where they want to go,” Courtman says. Programs that keep patients adherent to their treatment regimens also are high on health plans’ priority list. To that end, Health Mart is making a big push around its medication synchronization. The idea is to align all of a patient’s medication refills to a synchronized date.
Courtman says he believes medication synchronization is “a critical foundation element” for Health Mart’s efforts to deliver higher-quality care.
“What this is really about is being patient-focused and not prescription-focused,” he says. Medication synchronization is “one of the key triggers to really transform a store” from a prescription focus to a patient focus. The ancillary benefits for stores of employing medication sync programs across a majority of patients are that it can help with labor scheduling, inventory management and cash-flow planning.
Looking ahead, Courtman says he sees tremendous opportunity for expanding the Health Mart franchise. One factor in this growth is the rollout of the Affordable Care Act and its emphasis on the delivery of higher-quality patient care. He projects a Health Mart store count of 5,000 is within reach, based on the success of recent programs for members.
“Health Mart owners got into pharmacy to care for patients,” he points out. “And, in general, they have not been happy about the commoditization of pharmacy in many respects. So the shift in health care to being much more about patient care fits with the idea of why they got into pharmacy in the first place. That’s really what they want.”