At the National Association of Chain Drug Stores (NACDS) 2022 Total Store Expo, Pharmacy hours spoke with Danny Sanchez, senior vice president and general manager of EnlivenHealth, to learn about a recent survey that found pharmacists are very concerned about losing Medicare-eligible patients when switching plans Medicare. Sanchez said that while pharmacists can play a role in educating patients about Medicare plan options, staffing issues can limit their ability to do so.
Q: An EnlivenHealth survey found that the majority of retail pharmacists are concerned about losing Medicare-eligible patients when switching plans. Why does this loss occur?
Danny Sanchez: Yeah, so every year Medicare patients are eligible for open enrollment, right? So it’s a time of year where patients can go out and choose new plans, so it gives plans the ability to go and take patients from other plans. And so the danger is that if you’re a retail pharmacy and you have your patient population, and they switch to a plan that you don’t serve, you lose those patients, right? So it’s a risk. And now, we recently did a survey and the survey told us that, you know, a third of the patients, on average, in a retail pharmacy are Medicare patients. It is therefore a significant number of patients who [pharmacies] risk losing or moving to another pharmacy.
Q: What potential financial impact does this have on retail pharmacies?
Danny Sanchez: Yes it is, it is a big impact on a retail pharmacy. You know, [number] First, these patients are what we call poly-medical patients, and most of them take many drugs, right? So prescription-rich patients, even though they make up a third of the patient population entering this pharmacy, now account for a large portion of this pharmacy’s profit and loss, right? So the impact is if you lose those patients, how do you replace those patients? Right?
And, you know, there’s also a patient satisfaction perspective here. If you lose a patient, the patient goes to another pharmacy and suddenly they no longer have their trusted pharmacist. And, as you know, pharmacists are the second most trusted healthcare professionals. You know, you lose access to that professional who knows your background, who knows your health profile.
Q: In addition to this financial impact, changing plans may impact patient care with their pharmacist. Can you discuss the impact this has on patients?
Danny Sanchez: Yeah, totally. I think it’s sometimes underestimated, the role that pharmacists play, and now a broader role, isn’t it? It’s kind of like pharmacy moving into this new generation, more of a care environment. You know, pharmacists don’t just help dispense medications, they help talk to a patient about their medications, how they should take their medications, if they feel like a prescription isn’t not properly prescribed for a patient, he steps in, he reaches out to their doctor, so knowing your patient is a big deal, isn’t it? So if a patient moves to another pharmacy, all of a sudden you have to rebuild that relationship from scratch. And that’s not good for the pharmacist or the patient. The pharmacist now has to teach this patient, and the patient, again, is at a disadvantage because they’re starting from scratch, right?
Q: How can pharmacies keep their Medicare-eligible patients?
Danny Sanchez: Yeah, so, I mean, the great thing is that EnlivenHealth has a really great tool to help look at a patient’s profile. So look at their drug regimen, look at their prescribers, and then recommend a plan that works best for them. And that’s a big deal, because if you look at the market today, what happens frequently is during this open enrollment period, plans just contact seniors without any kind of data, and their just say to join our plan. I recently visited a restaurant, and when I came out of that restaurant, there was a registration table there with a young woman registering patients. And I asked them questions, and she had no data on these patients, except that she gave them a back scratcher and tried to enroll them in their plan. How good is that for an old person, right? It’s a terrible, terrible way to sign up a patient. EnlivenHealth has a solution that reviews a patient’s medications, reviews their doctors, and then recommends the best plan for that patient. We also take into account that,
“Hey, do you want to stay in this pharmacy?” and we also weigh this piece. Thus, we are able to take all of these elements and then recommend the best plan for the patient. And that’s a huge, huge differentiator in the market. We are not trying to lead a patient to a plan. We try to recommend the best plan for that patient.
Q: Helping patients select and manage their health insurance plan is important and an opportunity for pharmacists, but the survey also revealed that staff limit their ability to do so. Can you discuss this discovery?
Danny Sanchez: Yeah, I mean, staff is a problem in retail. As we see more and more departments moving into retail pharmacy, staffing becomes an issue. EnlivenHealth offers all sorts of solutions to help you with staffing, one being to simply digitize your engagement, right? Being able to message your patients, being able to engage them through automation, so they don’t have to come to the pharmacy as often, or even when they call they’re able to solve a lot of their problems within our Technology. And if I have to speak to a pharmacist, if you walk into any pharmacy at 6 p.m., you’ll see that the pharmacists are on the phone, literally with the phone glued to their ear, trying to sort through questions, trying to get through to through the volume of patients entering at that time. You know, our mission is to reduce that. We want to free pharmacists from these mundane tasks so that they can go and work on these higher value-added services that really improve health.
Q: Are there legislative efforts to address these issues?
Danny Sanchez: In 2022, over 150 bills have been introduced to drive change and expand the scope of practice for pharmacists, [and] about a third of those have passed in 2022. And the momentum continues. So I think society sees, and our legislature and our regulators see that, you know, there’s more opportunity for pharmacists, that they can do more. And frankly, it’s the footprint. This is the caliber of what a pharmacist can do. You have a very underutilized healthcare professional, and we want to maximize it, right? We want to move more services. So there’s a lot of regulation going on. I’m happy to say that some of these bills have bipartisan support, because you need bipartisan support to get these things passed, and we’re going to see expanded capabilities for pharmacists in the future.
Q: Is there anything you would like to add?
Danny Sanchez: Yeah. I mean, I think, you know, I’m really excited about where we’re going. EnlivenHealth liberates the pharmacist, right, allowing the pharmacist to step out of the everyday, as I mentioned, using our technology, and then we bring solutions that help them evolve into this next generation. Gone are the days of pharmacists simply filling prescriptions. If you’re just a pharmacy filling prescriptions, you won’t survive it, will you? It is not a good thing. You should turn the corner and come up with other solutions, other health care opportunities, and that’s what EnlivenHealth does – it allows you to really modify and change your business, and so I’m thrilled to be able to lead this effort.