Q&A with Health Mart’s Chief Pharmacist


McKesson’s Tony Willoughby discusses the shifts in retail pharmacy and the opportunities for pharmacies to get credit for improving patient outcomes.

By Mark Krasnow, Staff Writer

During McKesson ideaShare 2014, this July in Orlando, Fla., Smart Retailing Rx caught up with Tony Willoughby, vice president and chief pharmacist for Health Mart®, a retail pharmacy franchise with more than 3,400 participating independent pharmacies across the country. McKesson ideaShare is an annual educational and networking event sponsored by McKesson for community pharmacists and pharmacy owners.

Much of the discussion at this year’s event centered around trends in healthcare that are having a practical and dramatic impact on pharmacies, which are on the front lines of patient care. We asked Willoughby to explain how pharmacies can convert those trends into better health for patients and customers and better business health for their own operations.

SRRx: As Health Mart’s new chief pharmacist, what are your main priorities?

WILLOUGHBY: While each of our Health Mart members is dedicated to providing the highest quality of care to their patients, it is my job to ensure they have the tools, data, education and resources they need to drive improved outcomes. I am personally committed to helping our member pharmacies get recognition from payers and other stakeholders for the positive impact they have on the health of their patients, not just the dispensing of pills.

SRRx: What is the biggest trend you feel is impacting retail pharmacy today?

WILLOUGHBY: Pharmacy performance. For years, PBMs and payers have been narrowing their pharmacy networks based on coverage and cost, but now they are starting to base their preferred network decisions on pharmacy performance as well. Through behavioral coaching to improve adherence and interventions, community pharmacies can make a significant impact on patient outcomes, and payers want high-performing pharmacies in their networks to help lower overall healthcare costs.

SRRx: What is driving the shift from fee-for-service to pay-for-performance?

WILLOUGHBY: I believe two things are driving this shift. First, due to the substantial amount of data and numerous studies that now exist on how retail pharmacies can improve patient health and lower total healthcare costs, it has become a readily accepted fact that pharmacists do indeed impact outcomes. Second, with Medicare Part D Star Ratings, we now have standard quality measures that allow us to make comparisons.

SRRx: What should pharmacies be doing right now to improve patient outcomes and increase their pharmacy performance?

WILLOUGHBY: Once again, it comes down to two things for me: Med Sync and MTM. Every independent pharmacy should be offering medication synchronization for key patient populations and completing the targeted medication therapy management interventions that are available to them through platforms like Mirixa, Outcomes, Socrates, and so on.

SRRx: What exactly is medication synchronization?

WILLOUGHBY: Med sync is where the pharmacy organizes a patient’s multiple prescriptions to be refilled at the same time each month. It’s a concept that’s been around for several years but now is really taking hold because of the positive effect it has on medication adherence. For example, we’re seeing chronic medications go from being filled 6 to 7 times out of 12 times per year to 8 to 10 times out of 12 times per year. The majority of our Health Marts who are in the top 20% from a quality performance standpoint are using medication synchronization for specific patient populations to help achieve these results.

SRRx: That’s great for patients’ health status. What about for the business health of pharmacies?

WILLOUGHBY: It has a huge impact on the number of prescriptions filled. Based on the results of a study by Virginia Commonwealth University School of Pharmacy,1 we can estimate that medication synchronization can generate an additional 1,200 to 1,300 filled prescriptions per year per 100 patients. That’s an extra week of prescription revenue for many community pharmacies. There aren’t many business moves that you can make that have that kind of impact and, at the same time, improve the adherence scores for those patients to drive better outcomes.

SRRx: Sounds like a solid opportunity. What advice do you give to Health Marts and other pharmacies with whom you talk?

WILLOUGHBY: It really depends on where a pharmacy falls along the continuum of their investment in driving performance. At one end of the spectrum, you have stores who are passionate about the clinical outcomes they deliver with the implementation of med sync and MTM programs. With these pharmacies, I share best practices from their peers and we discuss how to get other independent pharmacies in the top 20%.

At the other end of the spectrum, I speak with pharmacies who may be overwhelmed with getting started and those who are waiting because they don’t think PBMs will use pharmacy performance to define preferred networks any time soon (or at all). To the first group, I reinforce the value of using EQuIPP™ to benchmark their pharmacy’s current performance. I also encourage them to either start small by focusing on improving one measure, such as patients taking statins, or to engage someone who can coach them through a more comprehensive program like the SyncRx/SyncRx+ program offered through a partnership between Health Mart and Pharmacy Development Services.

And, with the other group, our discussions revolve around the tangible impact med sync can have on their pharmacy’s profitability, such as more scripts, higher patient satisfaction and customer referrals. I also point out payers’ rapid adoption of performance metrics in hospital and provider network development and reimbursement. Pharmacy is the logical next step, and we already know payers and PBMs are looking at last year’s data (when stores didn’t realize their performance mattered) to figure out the best way to apply this criteria. As the chief pharmacist for Health Mart, my goal is to make sure independent pharmacy comes out as delivering the best outcomes, and that means getting ahead of the market.

Check out other popular articles on pharmacy performance:

1 APPOINTMENT-BASED MODEL (ABM) DATA ANALYSIS REPORT, PREPARED FOR THRIFTY WHITE PHARMACY; David Holdford RPh, MS, PhD and Timothy Inocencio, PharmD, PhD www.ncpanet.org/pdf/adherence/thriftywhitemedadherencestudy.pdf