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Making MTM Central to Clinical Strategy | Outcomes: Insights Beyond the Counter · Pharmacy Podcast Network

• 0:07
  Speaker 1: Thanks for listening to the Pharmacy Podcast Network.
• 0:29
  Speaker 2: Hello and welcome to another episode of Outcomes from the
• 0:32
  Speaker 2: Counter podcast. I'm your host, John Grayce, and I am
• 0:36
  Speaker 2: excited you're here. Thanks for joining me today. I want
• 0:39
  Speaker 2: to talk about MTM. Now that sounds pretty obvious coming
• 0:43
  Speaker 2: from somebody at Outcomes, but it's been a trend I've
• 0:47
  Speaker 2: been starting to notice, and I thought, let's talk about it,
• 0:50
  Speaker 2: and if there's a chance to get ahead of it,
• 0:52
  Speaker 2: it might be in everybody's best interest that we have
• 0:54
  Speaker 2: the conversation. So I had the privilege of giving a
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  Speaker 2: talk on Saturday for a CE session about Clinical Services
• 1:03
  Speaker 2: about MTM, about how to make a pharmacy successful doing MTM,
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  Speaker 2: or what that stage looks like. Before me was a
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  Speaker 2: presenter from EQUIP and she talked about their platform, how
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  Speaker 2: it works, how it connects pharmacists. Another platform I've known
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  Speaker 2: and watched is CPESN and the programs that they do,
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  Speaker 2: the contracts that they are helping pharmacies get connected to.
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  Speaker 2: All three of our companies, Outcomes, EQUIP, CPSN, Each of
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  Speaker 2: these folks are trying to connect pharmacies to the customer
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  Speaker 2: that we don't always think about in pharmacy. So often
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  Speaker 2: we are of course looking at the patient, right They're
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  Speaker 2: the customer right in front of us in the store.
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  Speaker 2: They are the obvious one that everything revolves around, you know,
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  Speaker 2: the care, the medicine, the billing and all that. Except
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  Speaker 2: it's not everything when I said billing. The big part
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  Speaker 2: of that is the insurance company. And so what are
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  Speaker 2: the insurance company's needs as we all are working on
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  Speaker 2: helping the patient. That's a real thing. It's a big thing.
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  Speaker 2: There's a lot to it. And when you get to
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  Speaker 2: know and talk with insurance companies and find out how
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  Speaker 2: invested they are in the health of the patient, you
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  Speaker 2: realize they're another stakeholder. And for any new pharmacists coming
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  Speaker 2: out who haven't had that realization, please do you know,
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  Speaker 2: get to know the insurances, what their structures are all like,
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  Speaker 2: how they set the business up so that ideally it
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  Speaker 2: is getting the best outcomes, the best health for everyone
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  Speaker 2: as economically as possible. Anyhow, MTM is designed with that goal, right.
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  Speaker 2: We want to make the best use of the medications
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  Speaker 2: that we dispense, that our patients use, and that the
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  Speaker 2: insurances are paying for, and so partnering with them to
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  Speaker 2: find out who are those patients that you want us
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  Speaker 2: to give the most attention to is kind of the
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  Speaker 2: whole business plan behind Outcomes, or at least how it
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  Speaker 2: originally started. MTM helps reduce costs and improve care. So
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  Speaker 2: let's set up a business that contracts that formally and
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  Speaker 2: makes it an official process that insurances can now pay for.
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  Speaker 2: Prior to outcomes existing, this was all just done over
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  Speaker 2: the counter as pharmacists were able to make time to
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  Speaker 2: talk with their patients. And twenty five years ago that
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  Speaker 2: was feasible and it was great, but we were all doing
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  Speaker 2: it and living by the margin created by the dispensing
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  Speaker 2: and that's not there anymore. It doesn't cover enough time
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  Speaker 2: for the pharmacists to talk with the patients as much.
• 3:51
  Speaker 2: So anyways, that's why outcomes is here. That's what we
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  Speaker 2: are trying to accomplish, and I think reconnecting ourselves as
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  Speaker 2: pharmacists with that idea, And again, if it's not a reconnecting,
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  Speaker 2: it's a new connection being made. Understanding what our insurance
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  Speaker 2: companies are needing from us as pharmacists, I think is
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  Speaker 2: a really key point, a crucial issue at this stage
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  Speaker 2: that we're at. Dispensing has been fully commoditized clinical services
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  Speaker 2: are still recognized as very important. I watched a webinar
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  Speaker 2: last week where it wasn't even mentioned. So a pharmacist
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  Speaker 2: pharmacy owner was given a talk on how to implement
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  Speaker 2: clinical services in your pharmacy, went through a number of
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  Speaker 2: great areas, different service lines, different products to recommend, sell
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  Speaker 2: all those good things, and didn't disagree with anything that
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  Speaker 2: this person said except for the fact they omitted MTM completely.
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  Speaker 2: There was no mention of cmrs or tips or enhanced
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  Speaker 2: services like CPSN contracts, So the whole outcomes or other
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  Speaker 2: clinical services contracting entity was completely left out of a
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  Speaker 2: talk that was supposed to be coaching an independent pharmacy
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  Speaker 2: listener on how to implement clinical services. And I thought, man,
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  Speaker 2: that's a big miss. You know I sense in the industry,
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  Speaker 2: and this was another conversation I had. I had reached
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  Speaker 2: out to a good friend, trusted mentor somebody I highly
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  Speaker 2: respect in the pharmacy industry, and so a voice that
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  Speaker 2: I wanted to hear from on this topic. And I
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  Speaker 2: think as he and I talked through, you know where
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  Speaker 2: pharmacists are at right now. One of the things that
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  Speaker 2: is facing us that we have to recognize as a
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  Speaker 2: mental battle might be the wounds that we have from
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  Speaker 2: being mistreated in a lot of contract negotiations over the
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  Speaker 2: last twenty years. A lot of pharmacists feel like they
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  Speaker 2: have had their business taken from them or their negotiating
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  Speaker 2: power eroded underneath them and been represented fairly either to
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  Speaker 2: the insurance companies or just buy the insurances themselves. And
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  Speaker 2: so we've got kind of a divide right now. Maybe
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  Speaker 2: it's not in every clinical space, every pharmacy operating space.
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  Speaker 2: Maybe it's isolated to retail, maybe even isolated to independence,
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  Speaker 2: but there is a us against them feeling out there.
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  Speaker 2: And I think it's going to be tricky to overcome.
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  Speaker 2: But I even if we can't overcome it, I think
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  Speaker 2: it's something at least worth addressing as a point to
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  Speaker 2: be aware of. Be aware of your own cognitive bias
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  Speaker 2: when it comes to do I want to help the
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  Speaker 2: insurance company take care of this patient, because if the
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  Speaker 2: answer is no, then you're you might be directly harming
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  Speaker 2: your patient just because you don't think you can trust
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  Speaker 2: their insurance company. And I'll be honest, guys, I'm an
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  Speaker 2: independent pharmacist who was displaced from ownership because the margin
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  Speaker 2: in my business sank. So this hurts for me to
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  Speaker 2: talk about because it's real. But I also have to
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  Speaker 2: look at the reality of the landscape and go, Okay,
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  Speaker 2: what does the patient still need from me from us
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  Speaker 2: as pharmacists, And how can I make sure that my
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  Speaker 2: pharmacy is open another year to provide the same thing
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  Speaker 2: or better next year for them. Well, I've got to
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  Speaker 2: watch the business end of things, no doubt. Also, clinical
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  Speaker 2: care is a big piece of how that happens, and
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  Speaker 2: getting paid for it is the only way that I
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  Speaker 2: know I can prioritize it and give it the time
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  Speaker 2: that the patient needs me to give it so that
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  Speaker 2: they can get the benefit. So even if I'm I
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  Speaker 2: am accepting money to do clinical services from an insurance
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  Speaker 2: company that I already maybe don't like because I feel
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  Speaker 2: like they have been underpaying me on the dispensing side
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  Speaker 2: for too long, I've got to find a way in
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  Speaker 2: my own brain to separate the emotions from the logic
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  Speaker 2: and say, Okay, but what's most important, I still need
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  Speaker 2: to make sure this patient gets the clinical care, even
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  Speaker 2: if I can't quite see the path to where well
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  Speaker 2: they eroded the margin on the dispensing, but they're paying
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  Speaker 2: margin for a clinical service. How is that not the
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  Speaker 2: same equation it always was before the margin of the
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  Speaker 2: dispensing erote it. Maybe we will look back on this
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  Speaker 2: last ten years and actually be able to see a
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  Speaker 2: pretty intelligent design where the margin slowly eroded while the
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  Speaker 2: clinical services were being expanded. And I think that's what
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  Speaker 2: we're going to see. That is what history will end
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  Speaker 2: up saying about these last ten years that we've been through.
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  Speaker 2: But I recognize there are folks who can't see that yet,
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  Speaker 2: and we are. We're still mad, mad about how badly
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  Speaker 2: margins in farm see have become. But and I say,
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  Speaker 2: but one more time to draw us back to what
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  Speaker 2: I think is the reality where the margin of dispensing's gone,
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  Speaker 2: but it's in the clinical services and we just have
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  Speaker 2: to recognize it and do them. And I think as pharmacists,
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  Speaker 2: we've got to be able to recognize the way that
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  Speaker 2: our own wounds of the past trauma responses, however you
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  Speaker 2: like to talk about it, our biases are keeping us
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  Speaker 2: from seeing reality through a clear lens. Our own anger
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  Speaker 2: at what we didn't like as the changes were happening
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  Speaker 2: is keeping us from embracing the good sides of what
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  Speaker 2: is available to us now. So I'm going to invite
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  Speaker 2: Lauren Dare to join me. She's from here itt Outcomes.
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  Speaker 2: She puts out our State of the Network every year,
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  Speaker 2: just an expert from my perspective when it comes to
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  Speaker 2: what's going on in MTM, who's doing it, who's doing
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  Speaker 2: best at it? Why are they good at it? And
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  Speaker 2: we're going to have a talk next week about that
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  Speaker 2: to try to get an understanding of how does it
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  Speaker 2: work well if there are chains, independents, everybody from all
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  Speaker 2: different walks able to do this, and when they do
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  Speaker 2: it well, they say we want to do even more
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  Speaker 2: next year. Okay, there's something there. Teach us what's inside
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  Speaker 2: that model? Why does that work well for them? So
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  Speaker 2: we're going to have Lauren join us next week talk
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  Speaker 2: more about the state of the network. You know her
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  Speaker 2: recent report that just came out. But I'm going to
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  Speaker 2: try to address this piece that I see as a
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  Speaker 2: gap in our current understanding of the landscape, so that
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  Speaker 2: all of us, whether chain or independent alike, we can
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  Speaker 2: all see it MTM for what it is and hopefully
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  Speaker 2: grab hold of it with a fresh perspective and say
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  Speaker 2: this is something that matters, and I'm going to find
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  Speaker 2: way to get it done and maybe hopefully my business
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  Speaker 2: will flourish as a result of it. Obviously, my patients
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  Speaker 2: are going to benefit because I know what happens when
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  Speaker 2: I spend time with them. So I got for you
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  Speaker 2: this week, guys, chew on it, ponder it for me.
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  Speaker 2: I'd love to hear your feedback. I want to hear
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  Speaker 2: your thoughts. Let me know what you're thinking. Reach out,
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  Speaker 2: let's have a conversation, and maybe even before next week,
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  Speaker 2: give me some questions. You want me and Lauren to
• 11:30
  Speaker 2: talk through. What is it? What are we not maybe
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  Speaker 2: seeing that we can help answer or dig into. So
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  Speaker 2: join me next time and thanks for tuning in. This
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  Speaker 2: is outcomes from the Counter