Expectations and Opportunities for Pharmacies in 2025

Marci Strauss, PharmD, Manager, Clinical Operations at Pharmacy First talks about medication adherence and clinical services in 2025 and what expectations and opportunities are available for pharmacies this year.

Podcast Host Nick Dorich, PharmD, PQS Senior Manager of Pharmacy Accounts, asks Strauss about revenue generating clinical services programs, continuous quality improvement, and how to prioritize these programs throughout 2025. Strauss recommends the pharmacist work with staff to understand contracts, review patient outreach and communications, and leverage appointment based models.

https://www.pharmacyfirst.com/

Transcript

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00:00:00:24 - 00:00:28:20

Marci Strauss

And we're seeing and even as we start off 2025, and we're already almost halfway through the first quarter, but we're seeing adherence be a cornerstone of so many different payer programs, whether it be payer performance, network programs or like enhanced services in EQUIPP, for example, if people are familiar with the LAMP program, first longitudinal medication adherence, MTM programs adherence plays into that is as well.

00:00:28:22 - 00:00:48:12

Marci Strauss

And how a pharmacy performs on those adherence metrics, whether it's adherence to statins or diabetes medications or others. This can impact the pharmacy's ability to earn those bonus payments or drive those revenue streams. And also, of course, it can tie into your patient satisfaction and patient retention rates.

00:00:50:08 - 00:00:54:06

Voice Over

Welcome to the Pharmacy Quality Solutions Quality Corner Show,

00:00:54:22 - 00:01:00:01

Voice Over

Buckle up and put your thinking cap on. The Quality Corner Show starts now.

00:01:00:14 - 00:01:22:24

Nick Dorich

Hello Quality Corner Show listeners, welcome to the PQS podcast where we focus on medication use quality improvement and how we can utilize pharmacists to improve patient health outcomes. I'm your host, Nick Dorich. Now, today's episode, we've got a very special, partner and friend of PQS and friend to community pharmacy. This is someone that I've known and worked with for a long time, and we're very excited to have her on the show today.

00:01:23:01 - 00:01:33:12

Nick Dorich

Her name is Doctor Marci Strauss. She is a pharmacist. And her current role is manager of clinical operations at Pharmacy First. Marci, welcome to the show. And how are you doing today?

00:01:34:00 - 00:01:45:00

Marci Strauss

Thanks, Nick, for having me. Appreciate it and doing really well. Just trying to keep warm in the middle of January, but really enjoy the opportunity to join you on the podcast today.

00:01:45:02 - 00:01:59:16

Nick Dorich

Absolutely excited to have you here. And like I said, know that you've been a big advocate. You're a big proponent for pharmacy, but let's hear a community pharmacy in particular. But let's hear from you. You know, what is it that you do at Pharmacy First? What's your role and what's your background in the pharmacy?

00:02:00:07 - 00:02:29:13

Marci Strauss

Yeah. So I'll first go into a little bit about my role here at Pharmacy First. So I've been with Pharmacy First so for almost a year now. But I've spent most of my career in the independent pharmacy space. So at Pharmacy First I currently serve as the manager of clinical operations. So I work to support our member pharmacies in implementing and expanding clinical programs to help them achieve optimal clinical and operational outcomes, and also drive those non dispensing revenue streams.

00:02:29:15 - 00:02:54:24

Marci Strauss

That includes things such as providing education and training to pharmacies, help them to best utilize pharmacy performance programs and related tools such as EQUIPP among others. Help them identify what are those revenue opportunities outside of dispensing? Who are those patient groups in most need of care, supporting them with implementing different programs within to their into their daily workflow?

00:02:55:04 - 00:03:18:16

Marci Strauss

So it's been a real joy to come back to the independent pharmacy space. So just prior to coming on board with Pharmacy First, I took a little break from independent pharmacy space and worked for an international health care technology startup in the med management space, where they utilize AI to help improve patient outcomes through medication management. So that was a really great opportunity.

00:03:18:16 - 00:03:55:22

Marci Strauss

And but also made me realize how much I missed working with independent pharmacies. They're such a vital part of their community. And I've been in the community space. And as you alluded to since I graduated from pharmacy school from University of Maryland. Go Terps. I started in the retail space and then pivoted over to the independent pharmacy space and worked for another CEO for quite a while, helping to drive engagement in clinical programs, helping to build up a clinical support program to help pharmacies, and especially because there's been so many changes in the industry since we graduated and even just in the past few years.

00:03:55:22 - 00:04:16:11

Marci Strauss

So helping those owners to really make sense of what's going on so they can thrive and keep their doors open and help their patients. So and even outside of that, you know, for me, giving back to the pharmacy community is so important. So in addition to my day job, also very active with national and state pharmacy associations.

00:04:16:11 - 00:04:49:22

Marci Strauss

I currently serve as the immediate past president of the Maryland Pharmacists Association and chair of the Board of Trustees, and also held leadership roles with the American Pharmacists Association. And I would say I wouldn't be where I am today if it weren't for those around me and mentors and colleagues and friends. So when I have that opportunity to give back and, and I, you know, this as well as those associations, whether it's your local pharmacy association or national association, that all kind of ties back to independent pharmacy and community pharmacy.

00:04:49:22 - 00:04:56:13

Marci Strauss

And so trying to just stay ahead of what's going on and see how can we best support those independent pharmacy communities.

00:04:56:24 - 00:05:11:24

Nick Dorich

And I think that's going to be our call to action today, Mark. And when I reached out, this was, you know, beginning of the year and was thinking about, okay, how do we start our podcast, how do we start our episodes for 2025? And as you mentioned it, we're working in a different environment. Pharmacy is working in a different environment.

00:05:12:01 - 00:05:30:20

Nick Dorich

And, you know, that really causes it's or there's a need for us for pharmacies to perhaps be aware of these changes and really kind of change how they're thinking about what they do at the pharmacy counter, how they're interacting with the patient. So that's what we want to talk about today and going through that, that perspective. So I've got some high level questions that work that I'm going to present to you.

00:05:31:00 - 00:05:44:14

Nick Dorich

And then you're going to help us explain, you know, what does this mean for our pharmacy. How do we operationalize some of these activities. And ultimately how does that benefit both the pharmacy, the staff at the pharmacy, but most importantly, the patient? So are you ready to dig in for today's episode?

00:05:44:19 - 00:05:46:21

Marci Strauss

I am ready and excited. Let's go.

00:05:46:21 - 00:06:08:04

Nick Dorich

All right, so first off, let's start with what is a very key topic. And when we're talking about clinical services for pharmacy the primary consideration around, you know clinical services or what it is that pharmacists do is optimizing medication regimens, but in particular optimizing medication adherence. And this has been a big topic because there has been changes in the industry.

00:06:08:06 - 00:06:22:21

Nick Dorich

But when it comes to clinical services and considerations, for how much time and work do you need to put into optimizing and having solutions for medication adherence, How much of that focus does that play? As we are here in the early stages of the 2025 year?

00:06:23:19 - 00:06:49:16

Marci Strauss

That's a great laid off question, Nick. And medication adherence is something that's so important and still continue to be a main focus for community pharmacies and referral pharmacies. And as one of the most accessible and trusted healthcare providers, pharmacists can have such a big impact on patients’ medication adherence. And it's really important that pharmacies continue to have solutions in place to drive adherence.

00:06:49:16 - 00:07:16:00

Marci Strauss

And we know that non-adherence can lead to a lot of negative outcomes for patients. A lot of patients across the country are still not adherent to their medications, not taking them as directed. And we know that non-adherence is responsible for a lot of adverse effects, hospital readmissions and unfortunately, deaths annually. But also when we think about why is it so important for pharmacies to continue to focus on driving it here,

00:07:16:00 - 00:07:39:16

Marci Strauss

And I think as clinicians, yes, we're always aware of the impact to our patients outcomes, and we want to help keep our patients as healthy as possible and living great lives. But also when we think about the ROI for independent pharmacies and why it's important, we're seeing and continue to see medication adherence be a big part of payer programs and value-based contracts.

00:07:39:16 - 00:08:04:19

Marci Strauss

And there's been significant changes in what that looks like in terms of a payer program. Just in the past few years, with the changes in DIR fees and emergence of new programs. So for any pharmacies, it might be a different way of thinking of how they approach their adherent solutions or how they approach different payer programs. But it's something that still requires significant attention and focus.

00:08:04:23 - 00:08:32:19

Marci Strauss

And we're seeing and even as we start off 2025, and we're already almost halfway through the first quarter, but we're seeing adherence be a cornerstone of so many different payer programs, whether it be payer performance, network programs or like enhanced services in EQUIPP, for example, if people are familiar with the LAMP program, first longitudinal medication adherence, MTM programs adherence plays into that is as well.

00:08:32:21 - 00:08:52:12

Marci Strauss

And how a pharmacy performs on those adherence metrics, whether it's adherence to statins or diabetes medications or others. This can impact the pharmacy's ability to earn those bonus payments or drive those revenue streams. And also, of course, it can tie into your patient satisfaction and patient retention rates.

00:08:52:12 - 00:08:59:01

Marci Strauss

And when we think about what are those different types of solutions, because of course, you know, there's so many different reasons a patient could be not adherent.

00:08:59:01 - 00:09:23:06

Marci Strauss

And there's different ways to approach that. But once I know many of our listeners are probably familiar with med sync, adherence packaging, medication therapy management, and I'm going to call it MTM just for a moment, because that's a significant part of my background. But what we've noticed here at Pharmacy First is pharmacies that also engage in MTM services have significant improvement in their adherence scores.

00:09:23:09 - 00:09:44:08

Marci Strauss

So by at least 3% on average. When we think about how much of a part adherence plays in these programs and opportunity bonus payments, the tie in to these solutions and being able to execute on these solutions such as sync and MTM, can it really has a domino effect to your improving outcomes and also driving those those revenue streams.

00:09:45:10 - 00:10:06:21

Nick Dorich

Great points Marci. And this is often been a topic of consideration or topic of conversation with pharmacies is, you know, tracking adherence. And hey, why why are we doing this? Or why do we have to kind of show the work? And you spoke about it to some degree. Why where there is a number of different solutions. The reality for a lot of us in the industry working with this is that there was a solution that was a, you know, 100% silver bullet.

00:10:06:23 - 00:10:32:20

Nick Dorich

We wouldn't still be here having this conversation. And I think the reality is whether it is, you know, medication synchronization, compliance, packaging, right, or other product packaging delivery, there's a number of different services or tools that pharmacists can engage with. Some of them, of course, are clinical in nature. Some of them are more administrative. But I think what we really are looking at the whole system as a whole, and then payers on us as we're having these conversations is how do we empower, inform and educate?

00:10:32:22 - 00:10:48:04

Nick Dorich

You know, pharmacies to work with patients, to use all of the tools at their disposal to maximize adherence in all of these cases. I think, you know, again, going back to it, where I've had conversations with pharmacies and I'm sure you've been in the same boat where, oh, I put all my patients on med sync. They're all adherent.

00:10:48:06 - 00:11:07:20

Nick Dorich

We know that that's not the case. You know, for pharmacies. And it ultimately becomes, well, hey, let's make sure we have the right tool for the right job. Each and every single patient is going to be unique. And let's dig in, you know, to work through for those patient opportunities. Now going into our next question, Marcy, let's talk about those revenue opportunities.

00:11:07:22 - 00:11:30:23

Nick Dorich

And you talked about this a little bit already, whether it's performance network programs or enhanced services or items. But how can pharmacies maximize revenue and financial opportunities here in 2025? This is we're still seeing a growth of value based contracts. Outcomes based measures are still important. You know, you reference DIR fees are going away. But that does not mean that the measures in consideration and optimizing performance for the measures have gone away.

00:11:30:23 - 00:11:43:20

Nick Dorich

So, you know, from your standpoint and as you take a look at the industry, what is pharmacy need to consider? What are they especially here as we're at the beginning of the year, what does a pharmacy need to consider for their operations that starts now and goes through to the end of the year?

00:11:44:24 - 00:12:09:22

Marci Strauss

Yeah, that's a great question. And for our listeners in any pharmacy, it really starts first with understanding your contracts, knowing what programs are out there and that your pharmacy is eligible to participate in. So if we don't know where the opportunities are or what programs we can even participate in, how are we supposed to go from there, and that's where your PSAO can really play an important role.

00:12:09:24 - 00:12:27:08

Marci Strauss

And a lot of what I do and what we do at Pharmacy First is helping our pharmacy members really make sense of all that is going on there. So a lot of different programs out there and different structures and different metrics. And we all know our pharmacies are strapped for time. They don't have time to sit there and go through all this information.

00:12:27:08 - 00:12:47:09

Marci Strauss

So that's where we can come in and help them with that, help them understand, okay, here are the programs. Let's say there's, you know, six programs that they're eligible for. Here are the revenue opportunities. These are the program components providing that education so they understand what's on the table, how they're being evaluated, and also then what tools come into play.

00:12:47:09 - 00:13:06:03

Marci Strauss

Okay, maybe there's a program here that's in EQUIPP. So they they need to utilize EQUIPP in this way to maximize their revenue opportunities and outcomes through that program. Okay. Maybe there's another program in Outcomes. Maybe there's another program somewhere else. Every one, every program is different. So really helping the first to make sense and identify what are those opportunities.

00:13:06:05 - 00:13:23:16

Marci Strauss

I think once you know, kind of what that playing field is and what's on the table for your pharmacy, then you can start to prioritize that and put together a plan, because it's one thing to know, okay, here's what's on the table. But then we have to actually implement it and execute it and sustain it to drive those results.

00:13:23:18 - 00:14:03:05

Marci Strauss

So really work to help our pharmacies with implementation of those opportunities. You're starting first with making sure that they have someone in the store that can be that program champion, and it does not always have to be that pharmacist, you know, leveraging their support staff who worked with hundreds of pharmacies over the years and technicians and support staff are amazing champions for for these programs, you know, making sure the pharmacy has access to all of the needed platforms to be able to execute all these different programs, making sure that they complete any kind of training that they may need, whether it's more technical training on how to use a specific tool, or maybe it's more

00:14:03:05 - 00:14:24:12

Marci Strauss

of training on a clinical area, or maybe they want to go take a, you know, a course on or an exam on point of care testing or something like that. But really helping them to ensure that they have that training completed and then making sure the pharmacies are logging in regularly to identify those opportunities in these programs, because they're familiar with us as well.

00:14:24:14 - 00:14:53:00

Marci Strauss

New opportunities appear throughout the whole year. And then working with them to again integrate that into their existing workflow, setting those goals, tracking progress. And and also, again, when we think about what are those best practices for success. Something that I also often will recommend is the appointment based model trying to leverage that as much as possible, because as I alluded to earlier, there's so many different programs out there.

00:14:53:00 - 00:15:19:18

Marci Strauss

And if we think about in the context of, oh my gosh, there's six programs of opportunities, how am I going to integrate this? I don't have time to add all this to these things, but if we try to utilize that appointment based model and say we have a patient with opportunities for MTM or they have an enhanced service, or they also have some opportunities in another program, well, why don't we try and combine all that for one patient visit to the pharmacy or when we're on the phone with them.

00:15:19:18 - 00:15:28:05

Marci Strauss

So making the most use of the pharmacy, the patient's time, the pharmacy staff time to be able to execute on those.

00:15:28:12 - 00:15:44:07

Nick Dorich

In a way, Marci, as you're explaining it, it kind of hit me where to some extent, it's like the pharmacy needs to do their own, patients will have an annual wellness visit, right? Or a comprehensive medication review where it's like, hey, this is why we're going through this to create a plan for your health for the year.

00:15:44:09 - 00:15:59:01

Nick Dorich

Pharmacies kind of need to do the same thing at the beginning of the year to say, hey, where are these programs? How are these programs designed? Where do we need to log in? How frequently do we need to log in or check for the work? And, you know, to your point, pharmacies are busy and they may look at some of the programs and they may prioritize.

00:15:59:03 - 00:16:16:00

Nick Dorich

They likely will prioritize work in certain programs and maybe not all of them. And that's okay. But the key part is that it needs to start early in the year, and then it needs to be continuous. When we talk about quality improvement in health care, people often reference it as just quality improvement. But I always reference this from CMS where it really comes from.

00:16:16:00 - 00:16:33:06

Nick Dorich

It's continuous quality improvement. So there's really no such thing as taking a month off or two months off or on medication adherence. Because when it comes to especially when we're talking about a senior population of Medicare population, a lot can happen in the span of two months where you may have a consultation with the patient to talk with them about their lisinopril.

00:16:33:08 - 00:16:49:13

Nick Dorich

A lot can happen in two months where the reason they were adherent or non-adherent, two months ago can be drastically different. We're having a conversation in here now and present, so having those gaps there certainly doesn't help the patient and certainly can create or exacerbate some issues for your pharmacy. Trying to catch up on those as well.

00:16:49:15 - 00:17:07:15

Nick Dorich

Well, Marci, I'll get to kind of our third part and we you talked a little bit about how you need to train and educate and inform pharmacy staff. And, you know, you talked and I really loved these mentions about engaging pharmacy technicians, engaging really the kind of whole pharmacy staff, we often talk about having a quality champion for the pharmacy.

00:17:07:20 - 00:17:24:24

Nick Dorich

But there's another aspect to this. And health care is about the individual, about the patient. And when it comes to these different services and follow ups, some of these may be new conversations that patients are not used to hearing from their pharmacist, or maybe they're not used to getting a blood pressure reading or a hemoglobin A1c check at their pharmacy.

00:17:24:24 - 00:17:41:12

Nick Dorich

So, you know, from your standpoint, from your consideration, what are the important things and how do pharmacy staff members appropriately communicate or prepare patients so that they can expect that, hey, yes, this is a new service at the pharmacy, but you should expect this kind of care from us going forward. What do you what's your take on that?

00:17:42:10 - 00:18:04:07

Marci Strauss

So great question. And when we think about the patient that's the center of all this. And it really comes to shifting that mindset of the patient. For so long, people think about the pharmacy and what services they can give to the pharmacy. Okay. Going to the pharmacy kind of like when you do your errands, I'll go to the pharmacy and pick up my prescription.

00:18:04:07 - 00:18:28:02

Marci Strauss

I'm going to go get my groceries or pick up a dry cleaning. Okay. Done. And and we are seeing that shift in mindset and of many, many people all across the country now turn to their pharmacy as their destination for immunizations. But it took us a long time to get there. And people are now seeing pharmacies as a destination for other services like point of care testing or counseling.

00:18:28:04 - 00:18:50:02

Marci Strauss

But there's still a large perception out there, I think, among the public of pharmacies just being a place where, you know, you put the pills in the bottle and maybe sometimes you get your flu shot. And then I think that's kind of it. And with pharmacists being the most accessible health care provider, and patients sometimes may go into their pharmacy three dozen times a year.

00:18:50:03 - 00:19:17:01

Marci Strauss

When we think about how many times they go into their provider's office, their primary care providers office, maybe four times a year, that presents a huge opportunity for pharmacies to work, to kind of shift that mindset of the patient, to provide that education and help the patient to understand the value add for the pharmacy. And hey, if you come to the pharmacy, you know, the way it's going to be a lot less, you know, you can come in and get your flu shot.

00:19:17:01 - 00:19:38:15

Marci Strauss

Hey, you know, we can test you for and understanding it varies from state to state. And that's a whole other conversation. But in general, hey, maybe we can test you for the flu and or prescribe contraceptives or something that would help patients understand in their community what they can do... anything, the kind of, you know, pushing you from, you know, marketing perspective from a patient care perspective.

00:19:38:15 - 00:20:07:05

Marci Strauss

And it's going to take some time. And sometimes pharmacies have to get a bit creative of how they approach that. But and we're still continuing to see that shift as we see expansion of pharmacists’ scope of practice at the state level. And we're still pushing for that at the national level. You know, it's never been more important to help change that mindset of the patients and be able to demonstrate the value to our communities that the pharmacists can play.

00:20:07:13 - 00:20:23:04

Nick Dorich

Yeah, becomes a key point. And I know speaking with many pharmacists in whether it's people now in the day job or Marci, you and I again you know both pharmacists are maybe our colleagues or classmates we went to the pharmacy school with, but that can be a part that's very uncomfortable for a pharmacist because it comes off as really trying to sell.

00:20:23:06 - 00:20:42:11

Nick Dorich

Hey, this is why you got to use our service or this is what we want to provide, because it's the standard of care. It can feel a little bit uncomfortable from that part at first, but we have to be our biggest advocates. And and ultimately, if we can have and create these patients as advocates for pharmacy to be able to do, to be able to provide these services, that really becomes the ultimate winning situation.

00:20:42:11 - 00:20:56:02

Nick Dorich

And it's really about what the patients want. If they're able to get those services, have them provided by a member of the pharmacy staff to get some of these services. Hey, could be the pharmacists, some of these services, it could be the pharmacy technician, right, where they're providing immunizations and able to do some other, other aspects of care.

00:20:56:02 - 00:21:18:12

Nick Dorich

So we have a really great opportunity to continue to maximize the opportunity of utilizing the pharmacies, the physical buildings, as a hub for patient care in the community, where patients want to be able to, you know, receive care. But really utilizing pharmacists and pharmacy technicians to the greatest of the clinical ability, but also just to the maximum of their of their capabilities as professionals.

00:21:18:14 - 00:21:44:04

Nick Dorich

So, you know, with that, Marci, I think we're kind of close to wrapping up here and there's a lot of opportunity for pharmacy in 2025. But it is a changing world, of course for the environments and what pharmacies are going to be doing. Before we wrap up and get into it, are there any, you know, kind of final comments, maybe thoughts that you didn't get to get to specifically address as we were going through the questions or perhaps any kind of, you know, words of wisdom or cheers that you would get for the pharmacies and for those that are listening to this podcast today.

00:21:44:23 - 00:22:06:08

Marci Strauss

Yeah, I would just say, and in these final moments of the podcast, and again, thank you to all of our listeners today. And again, when we think about just how can we start the year off strong and maximize those opportunities for our pharmacies, helping our patients, improving those outcomes. There has been so many changes as from 2024 to 2025 when we think about clinical opportunities.

00:22:06:08 - 00:22:26:04

Marci Strauss

So for our listeners out there, I highly encourage you to reach out to your PSAO. You know, reach out to your organization that you're a part of and really utilize them. And, you know, if you're a Pharmacy First member, please reach out to us, you can find me on LinkedIn or you can email programs@pharmacyfirst.com.

00:22:26:06 - 00:22:47:21

Marci Strauss

But your PSAO is such a great resource and often underutilized when it comes to those clinical support services. But we can really help you make sense of all of that happening out there, so you can know what opportunities are on the table for your pharmacy. Prioritizing those opportunities, and we'll help you make that plan and execute on that plan.

00:22:47:21 - 00:23:09:14

Marci Strauss

So you can be successful this year and really work to diversify those revenue streams. So again, encourage you to to reach out. And we're here to help as much as as possible, you know offering consulting offering that training even if you just have a quick question, even if you're listening, thinking, that sounds great, and I have no idea where to start or what opportunities my pharmacy has, that's okay.

00:23:09:16 - 00:23:12:14

Marci Strauss

Give me a call. Give us a call that is why we're here.

00:23:12:19 - 00:23:23:16

Nick Dorich

Got to ask the question. That's the starting point here. Marci, final item I think you mentioned it, but, if folks do want to reach out to you, connect with you directly about some of these items, can they find you on LinkedIn? Is there a best way to contact you?

00:23:23:24 - 00:23:32:12

Marci Strauss

Absolutely. You can find me on LinkedIn, or you can also email programs@pharmacyfirst.com if you have any questions.

00:23:32:15 - 00:23:48:17

Nick Dorich

Fantastic. Well, Marci, this is a great opportunity. Again, this was me thinking about what do we do to kind of get pharmacies excited and understanding some of the changes or just, hey, what do we need to do to make sure that 2025 is a success is tied very well in the conversations that you and I had at the Napa conference last fall.

00:23:48:23 - 00:24:06:20

Nick Dorich

So, yet another, benefit of engaging and talking with other pharmacists, really trying to make the world a better place and maximize the opportunity for pharmacy. So, Marcy, thank you. Best wishes and best of luck for you and the team here as we go into 2025. And for our listeners, that does mean we have wrapped up this show for today.

00:24:07:01 - 00:24:16:05

Nick Dorich

So we thank you for joining us. We hope you listen to the next episode of the Quality Corner Show. And before we go, we have one final message from the PQS team.

00:24:16:12 - 00:24:20:21

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00:25:00:07 - 00:25:00:15

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well.