healcare system with dr brown

•Understand primary components needed to open a pharmacy

-Application Process

Application Process

-Pharmacy License & Controlled Substance Applications
-Online portals for state of Michigan

The following are required for every pharmacy application:

-Criminal Background Check

-Criminal/Disciplinary History Questions

-Verification of Licensure

-Operational Documentation

-NABP e-Profile ID

-Pharmacist in Charge (PIC)

-Outside of State Applications

-Controlled Substance License

-DEA License

-Controlled Substance License

Other Requirements to Consider: when opening a pharmacy

•Sink with cold/hot water
•Scales for weighing
-Torsion balance
•References
•150 Sq footage requirements
-Additional requirements as you add pharmacy staff
•Operating Software
-Dispensing, labels, automation, etc
•Product wholesalers
-Legend drugs and OTC products

•Understand basic reimbursement models available to community practice settings

Third Party Payer

Cash-Based Model

Establishing Payment Models

Third Party Payer

Third Party Payer

–Pharmacy signs contract with pharmacy benefit manager (PBM)

i.Federal payer groups (Medicare)

ii.Commercial plans

– Most common in retail practice setting

–Application process

•Online portals

–Different requirements for retail, compound, long-term care pharmacy

Establishing Payment Models

Cash-Based Model

Cash-Based Model

–Pharmacy creates cash pricing strategy in lieu of contracting with third party payer

–More common with compounding pharmacy model

–Retail models starting to create models

•Generic markets can be more cost-effective than insurance models

•Acq Cost + x% markup= Generic Cash Price

–Example of Cash Only Pharmacy Model

–Cash models popular for other pharmacy services

•Clinical consultations

•Insurance consultations

•Point of care testing

•Understand primary metrics of pharmacy operations management

Pharmacy Data Analysis

Pharmacy Data Analysis

-Pharmacy prescription volume
-Inventory management

-Pharmacy prescription volume

•Total volume
•Brand vs Generic
Gross Profit Margins (GPM)

-Inventory management

•Inventory turns
•On-time ordering
•Drug product selection
-Wholesaler/buying group contract drugs
-Rebates based on certain drug products
•Supporting materials and services
-Vials, labels, IT support, clinical programs

•Understand considerations for human resources aspects of business operations

-Establishing Job Descriptions

-Small employer group vs. Professional employer organization (PEO)

-Establishing Wage/Benefit Packages

-Regulatory Aspects

-Training & Retaining Talent

-Creating Company Culture

Establishing Job Descriptions

-Pharmacy Managers
-Staff Pharmacists
-Pharmacy Technicians
-Clerks
-Delivery Drivers

•Small employer group vs. Professional employer organization (PEO)

-Payroll services
-Leverage pricing in the insurance market
-Regulatory services, insurances

Establishing Wage/Benefit Packages

-Market Analysis of wages in area
•Also consider previous experience/credentials
-Benefits packages
•Health insurance
-Flex spend accounts, HSA accounts
•Retirement savings portfolio options
-401k plans
-Traditional vs. Roth, company matches

-Regulatory Aspects

-Employee training
•Fraud, waste & abuse requirements
-Attestations required for third party contracting
•Bloodborne pathogen exposure, communication skills, harassment in the workplace, etc
•On-the-job technician training requirements
-Accreditation requirements
•Optional for most pharmacy operations, but promotes best practice models

-Regulatory Aspects 2

-Monitoring state/federal employment laws
•Minimum wage requirements
•Right to know laws
-Hazardous chemicals and safety data sheets
-Establish standard operating procedures (SOPs)
•State officials and third-party auditors
•Employee handbooks
•Policy & Procedure manuals

Training & Retaining Talent

-Performance incentive programs
•Medication Synchronization Goals
•Medicare Part D Star Ratings Metrics
•Enhanced service training opportunities
-Technician immunizations, CMR management
•DIR fee mitigation strategies

Creating Company Culture

-Mission Statement
-Workflow expectations
-Managing geographic expectations
-Relationship development
•Emphasis on the soft skills of leadership and personnel management