With October just around the corner, that means Medicare Part D open enrollment is close (October 15th, to be exact). Pharmacists and Medicare beneficiaries have both found the enrollment process to be cumbersome in the past. Matt Johnson, a software engineer and PharmD, shared the common frustrations of pharmacy with Flaviu Simihaian, and together, they created a solution for independent pharmacists who wanted to participate in helping their patients find a suitable Part D plan. In 2012, the developer duo launched iMedicare (now a part of Amplicare), and it has since helped over 5,000 pharmacies simplify the enrollment process.
Flaviu, co-founder of Amplicare, recounts how he and Matt were inspired to pursue pharmacy technology when they began working together in software development. “I started learning more about some of the problems within the pharmacy industry from Matt, and then we set out to make it a little less problematic,” he says. Flaviu has heard all the reasons pharmacists choose to not conduct enrollment consultations in their pharmacies, so he and the Amplicare team designed iMedicare to tackle the common issues pharmacists encounter in Part D enrollment.
1. “It’s too time-consuming.”
If there’s one thing pharmacists don’t have enough of, it’s time. Nothing takes more time than manually entering all of the patient’s information into the Medicare website, then navigating all the possible formularies to figure out the right plan for your patient. “A big part of iMedicare is that it integrates with PioneerRx to pull all the patient information and your pharmacy’s information from the pharmacy management system, and we couple that with the formularies from CMS,” Flaviu explains. “It automates that whole data entry process so with one click, you and the patient see everything you need.” The generated list of plans can be printed or viewed on a tablet, which makes for a faster consultation. How much faster? “Probably around 10 minutes, versus 45 minutes without iMedicare,” Flaviu estimates. “So if you want to take the time to talk to the patient about their other health needs, or just chat about the weather, that’s fine because the technology won’t slow you down.”
2. “My patients don’t even ask for help with selecting a plan.”
With the amount of ads and insurance brokers targetting seniors during Open Enrollment, if seniors don’t ask you, it is likely because an insurance broker down the street at Wal-Mart has already helped them. So it is critical that you are proactive in reaching out to these patients before someone else does. Thanks to the MTM actions in PioneerRx, users can receive Part D enrollment MTM notifications within their workflow. These MTM actions will appear if, for example, a patient’s medication is no longer covered by their Part D plan, or if their premium has increased. These MTM actions prompt pharmacists to be more active in their Medicare beneficiaries’ Part D plans and become an essential part of senior healthcare management. “So even if your patients aren’t asking you about their Part D plans, it’s all about proactively targeting the patients who are your highest priority to help them and retain them at your store,” Flaviu says.
3. “My patients can go to the website and figure it out themselves.”
(For the sake of this article, the writer ventured over to Medicare’s enrollment site and couldn’t even complete the enrollment process. Full disclosure: the writer is a tech-savvy 24-year-old. “I was overwhelmed with all the variables, choices, and boxes I had to click,” she recounts. “So, how are my parents, who just figured out how to use their iPads without having to call me all the time, going to do this when they turn 65?”)
Large retailers and insurance brokers are quick to target seniors because they know they will struggle with choosing a plan if left to their own devices. During these consultations, a patient may unknowingly choose the wrong plan, though it may be the attractive option due to a lower premium. Pharmacists, however, have the knowledge of medication that allows them to see the intricacies and alternatives that could potentially save a patient money. With iMedicare, it’s easy for the pharmacist to make these cost-saving changes, and this could ultimately lead to a retained patient.
4. “Most of my senior patients already have a plan and don’t need to enroll.”
The Journal of the American Pharmacists Association recently published a study on the impact of plan comparisons on patient costs. The study found that each patient who consulted with an independent pharmacy on their Part D plan saved an average of $1166.46 per year. “In other words, the average Medicare patient is overpaying by about $1200 right now,” Flaviu says of the study’s findings. Even if your patient has already enrolled in a Part D plan, it’s always a good idea to run their information through iMedicare and see if the formularies have changed since their initial enrollment. “What we hear all the time is when pharmacists help these patients who are overpaying, they say their patients are overjoyed and always ask for their opinion,” says Flaviu. “When you save these patients money, you are creating loyalty.”
5. “My pharmacy won’t profit from the time spent going over plan options with patients.”
A simple, ten-minute conversation about your patient’s Medicare plan can open the door to many opportunities for your pharmacy, according to Flaviu. “Our 5,000 pharmacies who conduct plan comparisons versus those who don’t usually increase their patient retention from 80% to 91%. That 11% alone is a huge monetary value for the pharmacy,” Flaviu explains. Another opportunity arises when you go over your patient’s medications. If they are receiving medications from a mail-order or a chain pharmacy, this is your opportunity to consolidate all their medications to one location – yours. You can also discuss your pharmacy’s services, such as med sync, CMR, or nutrient depletion supplements. Lastly, taking the time to go over your elderly patients’ medications and health needs gets seniors talking. “We’ve noticed a huge increase in word of mouth that brings more business to that pharmacy because they’re known in their community as the expert on saving patients money. That brings new patients in the door,” says Flaviu.
6. “I’m a pharmacist, not an insurance broker. I don’t specialize in plan comparison.”
There are plenty of organizations like chain pharmacies and SHIIP (Seniors’ Health Insurance Information Program) that advise Medicare beneficiaries on their Part D plans. So, why aren’t you one of them? Some pharmacists believe they need insurance experience to help their patients navigate open enrollment. However, having a knowledge of medication is most beneficial in helping patients make the most informed plan choice.
Seniors visit their local pharmacy at least once a month, which positions community pharmacists as the ideal source of information for Medicare and Part D open enrollment. If you’re looking to broaden your pharmacy’s services, Part D enrollment is a valuable avenue that builds patient loyalty, increases retention, and sets you, the pharmacist, as the go-to guide for navigating Medicare.