ACOs are one of the many organizations that pharmacy owners can partner with to bring better patient care and increase revenues.
In this blog, our good friend Kris Rhea from Biolyte will help us dive into ACOs and their impact on the independent pharmacy owner.
About Kris
Kris has been working in the independent pharmacy business for about a decade now and is passionate about the community service model that independent pharmacy is all about.
He is probably the only person in the country who has been to almost every independent pharmacy! Chances are, he has been in your store at least once. Kris is a great advocate for the industry, supports many organizations, and therefore learns about various opportunities.
What is an ACO?
Accountable Care Organizations (ACOs) are crucial to community health.
ACOs are a multidisciplinary provider group where Medicare incentivizes health systems, general practice, and other disciplines to collaborate, share information, and create care plans to reduce the risk of chronic disease.
In general, healthcare has operated in silos. And that’s been a hindrance to chronic disease management. That model financially worked when Medicare paid just for volume-based care.
Now, that’s not sustainable.
Medicare cares about outcomes and fiscal responsibility when treating patients. For ACOs, Medicare gives the organization a bundle of funds for each patient. The more efficiently the ACO manages its patients, the more net income it keeps.
Why Should Pharmacy Owners Care About ACOs?
The strength of community-based pharmacies is your relationship with your patients, drug optimization and utilization, and then the education because of that trust relationship.
Pharmacy owners can be on the ground floor to help manage patients by doing basic-level testing, screening, and education. Pharmacies are already doing many of the activities that the ACOs are graded on. Services such as medication adherence and immunizations.
Since these services are critical for the survival of the ACO, it presents an excellent opportunity for pharmacies to provide these services.
ACO and Pharmacy Owners
A cool aspect of ACOs is that all their data is freely available online. You can see what their performance is and which ones need help. This data makes it easy to approach an ACO specifically about what you can help them with. All this data and information is on CMS’ website.
On the innovation center page, you can put in a state or a zip code, and it will pull up any of the groups and what model they’re using in your community. Then you can research who that medical director is and reach out to them and the playbooks already laid out for you because it shows you what that model is being graded on.
If your pharmacy is good at what they are weak at, you could provide precious services and be paid directly from the ACO.
If you want to get involved with other opportunities, CPESN is working to integrate pharmacies and use these clinical initiatives’ approaches. Kris shared that much legwork in East Tennessee and Southwest Virginia has already been done. The local CPESN network he’s affiliated with has a contract with an ACO that has seen value in independent pharmacies.
They are working with us to scale that opportunity nationally.
If you still need to be embedded with a CPESN’s local chapter, go to CPESN USA’s website, and there will be contact information for your state chapter. CPESN is working on several opportunities with organizations such as Emergent to launch options nationwide.
How Do You Get More Information?
CPESN has a jot form to fill out the information about your interest. They will have someone reach out to you and give you a little bit of deeper detail about what we can do to help and what we’re looking for in terms of partnerships with some providers in the community.
You can reach out to us at [email protected] to get in contact with Kris at [email protected].
