With increasing pressure from chains and declining reimbursements, independent pharmacies are seeking alternate ways to expand into new offerings to thrive in today’s industry. Clinical services and programs, such as administering routine and seasonal vaccines to patients, are a viable opportunity for independent pharmacies to grow their businesses.
The clinical and business benefits of immunization programs to a pharmacy include:
- Generating new revenue in addition to traditional dispensing services
- Remaining competitive with other pharmacies in the market with immunization programs
- Not losing prescription revenue from customers who transfer their prescriptions over to a competing pharmacy that offers core and seasonal vaccines
- Complementing and supporting other chronic disease management pharmacy services
- Improving the overall health status of the pharmacy’s customer base
- Complementing medication adherence services like medication synchronization
Given that vaccine programs create these clinical and financial opportunities, the question is how should independent pharmacies get started? There are five main steps that pharmacies should take to establish their own immunization program.
1. Understand state regulations regarding pharmacist vaccine administration
State regulations determine which vaccines can be administered to what types of patients. Not all pharmacists can give all vaccines to all patients. So the first step is to know what’s permitted in the pharmacy’s own state. One of the most common restrictions is age. Some states don’t allow pharmacists to administer vaccines to children under age 18.
Pharmacists need to be certified to administer vaccines in the pharmacy. They are required to take an ACPE-accredited immunization and delivery course that consists of online work, an exam and a live session. Pharmacists should also be CPR certified and take a bloodborne pathogen or OSHA training.
Another regulatory consideration is reporting requirements. Some states require pharmacies to report the vaccines given and who received them to a state immunization registry. Because vaccines are offered from many members of the healthcare team in different locations, these states want to track what’s being administered and aggregate that information in one place.
It is also important to consider whether a state requires pharmacists to have collaborative practice agreements with physicians in order to administer vaccines. Collaborative agreements with physicians allow eligible pharmacists to administer vaccines to patients without individual prescriptions.
2. Acquire the reimbursement competencies required to run a vaccine program
One of the biggest hurdles that make independent pharmacies hesitant to launch immunization programs are the often complex and confusing reimbursement rules that dictate how pharmacies can bill for vaccines. For example, most vaccines are covered under the prescription drug benefits in a customer’s health plan. However, specific vaccines—like those for the flu, pneumonia and hepatitis B—often are covered under the medical benefit in a customer’s health plan. Some health plans consider vaccines as preventative services that require no co-payment or deductible. Other health plans don’t, and customers may have to pay a portion of the vaccine fee up front.
If a pharmacy serves Medicare patients, it must go through the process of becoming a certified Medicare Part B provider in order to bill Medicare for vaccines as a medical benefit.
To avoid the hassles, many independent pharmacies automate billing and collections for vaccine services through technology or outsource billing and collections through a third-party vendor.
3. Gather the resources required to effectively manage vaccine inventory and supplies
Like all prescription medications, core and seasonal vaccines come with unique ordering, distribution, receiving, storage and administration requirements. Independent pharmacies should consider the requirements before ordering their first shipment of flu vaccines. For example, planning and ordering flu vaccines for the next flu season starts before the previous flu season ends. That annual buying cycle needs to be incorporated into the pharmacy’s business plan to ensure it has enough flu vaccines on hand to meet demand.
Pharmacies should know the storage requirements for the vaccines they intend to administer. The CDC has guidelines for each type. Some require refrigeration. Others require freezing. That requires a way to monitor temperatures.
In terms of physical space, pharmacies may want to create a private area in which they administer vaccines to patients. That could be something as simple as a privacy curtain. It also could be something like a private exam room.
4. Recognize the impact on workflow and make adjustments to minimize business disruptions
Pharmacies should think about and walk through their workflows prior to starting a vaccine practice. How will the pharmacy take walk-ins? Will all the pharmacists be trained? If not, how will appointments be made?
As most experienced immunizing pharmacists can attest, actually giving a dose of a vaccine takes the least amount of time during the entire process. More time is spent by patients and pharmacies completing medical history forms, filling out consent forms, checking and verifying insurance benefits, copying health insurance cards and identification cards, billing for services and arranging and making payments.
Pharmacies should assign the most appropriate person to perform each task, ideally having technicians and other staff do most of the non-clinical work and leaving the pharmacist to administer the vaccine. The goal is not to disrupt the normal workflow of taking, filling and dispensing prescriptions and refills but integrate this new service into the workflow seamlessly.
5. Launch a multichannel marketing campaign to promote the immunization program
It’s important for independent pharmacies to promote their programs via multichannel marketing campaigns. The first channel is targeted at existing pharmacy patients. Those tactics include boards outside the pharmacy, signage inside the pharmacy at all customer checkout points and prescription bag stuffers for patients who pick up regular medications.
A second channel could be a targeted call, paper mail or e-mail campaign to a specific demographic in the pharmacy’s market. If the pharmacy is licensed to provide vaccines to children, for example, it may promote the service to school children and their families in August when they’re thinking about what they need to get ready for the upcoming school year.
A third channel should include marketing the pharmacy’s immunization services to local providers that they already have a relationship with, and new providers that have assumed clinical and financial risk under a population-health based contract with a payer. Providers are looking for partners who can help them keep their at-risk patient population as healthy as possible, and one of the best ways to do that is with an effective immunization program.
Vaccine programs can serve as gateways for pharmacies to grow their clinical operations. They can learn what it takes to run a clinical program and become comfortable adding other clinical services to their business. In doing so, they can expand their businesses to succeed in today’s industry.
Related: Learn more about Studiomaca’s solutions for independent pharmacies