Expand your pharmacy services with POC
Clinical Performance
Be there for your Medicare patients this open enrollment
In brief:
- Pharmacies may test patients at the point of care (POC) for a wide range of conditions.
- Patients value the convenience of tests at a pharmacy.
- POC testing is mostly a cash business, leading to increased revenue and profit.
- A collaborative practice agreement allows a pharmacy to offer care after the testing.
Point-of-care tests come to pharmacies
Fast, effective point-of-care tests now exist for many diseases and conditions. And increasingly, many of these tests can be done by a pharmacy. Listed below are conditions that pharmacies may be able to test for.
To administer point-of-care tests:
- Obtain a CLIA (Clinical Laboratory Improvement Amendments) waiver from the state CMS office (CMS-116). Each pharmacy needs its own CLIA waiver.
- File the CLIA waiver with the appropriate agency, which differs by state.
- States also may have training requirements to administer POC tests.
- After a positive result for some tests, such as for HIV and hepatitis C, a further “confirmatory” test is required. In these instances a pharmacy would refer patients to another provider.
Elizabeth Skoy, associate professor of pharmacy practice at North Dakota State University, sees a big opportunity for independent pharmacies. As she said at ideaShare 2018, a CLIA waiver can allow pharmacies to offer a wide range of screening tests, from pink eye to hepatitis C.
The POC business model
The initial investment to perform point-of-care tests is low, as the only expenses are for the CLIA waiver and testing equipment. The total investment can just be a few hundred dollars.
In many instances point-of-care tests are paid for by patients out of pocket. For patients, getting these tests at a pharmacy is more convenient than other options and the cash payments may be lower than their insurance co-payment.
For pharmacies, this is a new clinical service and a new revenue stream. And it delivers attractive margins.
An additional opportunity (based on test results) is providing follow-up care, which might be covered by insurance.
A POC case study: Cooke’s Pharmacy
Patients of Cooke’s Pharmacy in Cleveland, Tennessee, don’t have to go to their doctor’s office or wait hours for a flu or strep test. They can get these tests at Cooke’s Pharmacy.
Director of pharmacy operations Gina Moser said the costs for Cooke’s to get started with POC testing were low. She estimates the two-year waiver and a testing device cost less than $600.
Cooke’s requires cash payment for point-of-care tests and has set their price at $25, which is lower than most insurance co-pays. “It’s a great profit margin,” said Moser, who is considering raising the price Cooke’s charges.
During the 2017–18 flu and cold season, Cooke’s tested more than 150 patients for flu right in the pharmacy. Of those, 100 tested positive.
- For those who tested positive: Because the pharmacy has a collaborative practice agreement (CPA) with a provider, Cooke’s could provide Tamiflu to patients and their family members.
- For those who tested negative: The pharmacist recommended OTC products to relieve their symptoms.
Marketing POC tests
Offering point-of-care tests is an important service and deserves serious marketing. Market this service:
- Through a press release and articles in local papers announcing this service
- In-store and at pharmacy pickup
- As part of regular med sync calls and conversations
- Through targeted bag stuffers and emails
- On your website and through social media
Also, see if your state allows the CLIA waiver to “travel” with the pharmacy. If so, your pharmacy can administer POC tests in the community, like with flu shots. Your pharmacy could test patients at an assisted living facility, a school or a community fair.
Per Elizabeth Skoy, the most effective marketing is likely word of mouth. “People are shocked and awed that pharmacies can do this.” And they will tell others.
