Since passage of the Affordable Care Act in 2011, Medicare has covered one visit each year that addresses patient wellness by providing preventive care and screenings. A recent report in Health Affairs, though, found that only half of medical practices offer annual wellness visits to their older patients and fewer than 20% of seniors have ever had one. That gap creates space for community pharmacists to offer a valuable service that can significantly improve patient health and enhance revenues.
Medicare includes pharmacists among the nonphysician practitioners authorized to perform annual wellness visits, but they must be approved by the patient’s regular physician and offered under their supervision. While it might seem challenging to make arrangements with local practices to offer these visits, the rewards are significant.
A study in the Journal of Managed Care & Specialty Pharmacy found that pharmacists actually received slightly better reimbursement for the visits than physicians, $105 compared to $99 per visit. The pharmacists generally made more interventions, recommended more vaccines, and conducted more screenings, the authors noted. Researchers at the University of North Carolina Eshelman School of Pharmacy determined that a pharmacist who spent 40% of her time providing these visits could produce $120,000 in revenue.
Of course, screenings and preventive care do not just benefit seniors. Outside of the Medicare annual wellness visits, preventive services can be offered in a private space within the pharmacy, just like vaccines. Cardiovascular risk assessments, blood glucose testing for diabetes, blood pressure and cholesterol screening, bone-density measurement, depression screening, and tobacco use risk assessment and cessation programs are often offered by pharmacies to adults in their communities, according to the National Community Pharmacists Association.
Not only do the screenings detect serious conditions, they can encourage “patients to follow up with a physician to receive pharmacologic treatment. In addition, some pharmacies offer education and counseling” to help patients better manage their diabetes, weight, and cardiovascular conditions and even quit smoking.
Screenings provide an opportunity to better understand your patients’ needs and perhaps identify why medications or other interventions are not working as anticipated. Discussions may reveal drug interactions, confusion about how frequently a medication should be taken, or unaddressed side effects.
Promotion is critical to success of an in-pharmacy screening program. Banners and brochures will attract attention to the program within the pharmacy, and staff can recommend the program or hand out flyers about it to patients when they pick up prescriptions. Some pharmacies partner with local employers, who may reduce their insurance costs if their employees meet preventive health goals. Others advertise at community health fairs, on Facebook, in local papers, or on the radio. Offering special, time-limited programs, such as discounts for cholesterol screenings in February, National Heart Month, can also bring in patients who might otherwise keep putting off testing.
Bremo Pharmacy advertises itself as “Your Home for Health Screening.” It advertises screening services on its website, along with a full description of tests available and their costs. In addition to the standard screenings for high blood pressure, osteoporosis, cholesterol, and diabetes, the Richmond, Virginia–based pharmacy offers an unusual service—pharmacogenetic testing. The test “looks at how your genes and genetics affect how your body responds to medication” by analyzing 18 genes that help predict an individual’s response to more than 200 medications.
The NCPA notes that pharmacies need a certificate of waiver to perform certain tests in a Clinical Laboratory Improvement Amendments–waived setting. The certificates can be obtained through state health departments.
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