Reinvent pharmacy by embedding pharmacists in clinics
- Thrive Pharmacy in Plano, Texas is pursuing an innovative business model and delivery model.
- Thrive is embedding pharmacists in clinics to manage medications and provide other services.
- By having pharmacists in clinics, Thrive is partnering and collaborating with physicians.
- This partnership is improving health outcomes and generating new sources of revenue for Thrive.
Optimism amid changing conditions
Pharmacists Tony Willoughby and John Gregg saw a different way of doing business that capitalized on the major trends in healthcare and in pharmacy — and which they believe has tremendous upside potential.
So, despite seeing declining reimbursement for filling prescriptions and intense competition from chains, they were optimistic and took the plunge, acquiring a pharmacy located in a clinic building in Plano, Texas, that was filling about 300 prescriptions per week.
Their idea was to use this initial pharmacy as a starting point to transform community pharmacy with a unique focus and new business model. They reopened in January 2016 as Thrive Pharmacy Solutions.
A new type of pharmacy
Thrive’s founders saw an opportunity to create a new type of pharmacy that would fit with major trends in healthcare and in pharmacy. Key elements of this opportunity involve:
- Focus on patients with chronic diseases. Patients with diseases such as diabetes, cardiac diseases, COPD and behavioral health issues often take multiple medications and experience adherence issues.
- Deliver an integrated practice where pharmacists work closely with physicians. Thrive saw an opportunity for a different kind of pharmacy delivery model. The idea is to embed Thrive pharmacists into primary care clinics and work closely with physicians to improve adherence and decrease costs.
- Participate in new reimbursement models. New value-based reimbursement models are causing healthcare providers to think and act differently. In Plano, Texas, a physician group formed an accountable care organization (ACO) to pursue value-based contracts with payers. These contracts often mean that an ACO receives payments with bonuses that are tied to performance measures, like improving outcomes and decreasing costs.
Thrive has worked to help ACO leaders in Plano understand how medication management can positively impact their value-based contracts. For the ACO, the opportunity is to leverage Thrive’s expertise to better manage patients, improve outcomes and lower costs.
Putting the idea into practice
Thrive’s first step was to embed a pharmacist in the clinic of the primary care group in the building where Thrive was located. After just three months Thrive expanded to place a pharmacist in a second clinic, and just one year later Thrive has pharmacists at six clinic groups. The Thrive pharmacists in these clinics review medications with patients, identify gaps in care, offer to fill prescriptions, enroll patients in Thrive’s medication synchronization program and monitor patients.
Thrive pharmacists can schedule appointments with patients in advance and also have the flexibility to handle in-the-moment referrals from the clinic’s providers.
Importantly, by being physically located in clinics and by having access to the clinics’ electronic medical records, Thrive’s pharmacists are able to collaborate with the practices’ physicians to improve the care that is provided.
Results thus far
Thrive’s new delivery model and business model are showing positive results.
|In just one year Thrive enrolled nearly 1,000 patients in its med sync program.
ACO data on a subset of patients found that between 2015 and the end of 2016 adherence* rose from:
Also, for diabetic patients with high A1C levels, the average A1C level declined significantly.
|Thrive’s sales from 2017’s first quarter exceeded total sales for all of 2015 (the previous pharmacy).
One way Thrive is boosting revenue is that as part of its arrangement with the ACO, Thrive receives a small per-member, per-month (PMPM) fee for ACO patients enrolled in its med sync program.
One payer also pays a PMPM fee for Thrive’s clinical services and a per-member, per-year payment when the pharmacy meets quality measures.
*Based on patient refills for at least an 80 proportion of days covered.
In addition to these results, by working with an ACO, Thrive is developing data to demonstrate the pharmacy’s value. This data will show differences in the cost of care between patients enrolled and not enrolled in Thrive’s programs, looking at both medical and pharmacy costs.
These initial results are producing additional opportunities. Payers are beginning to identify employers and providers that could benefit from Thrive’s services, which bodes well for the pharmacy’s longer-term results.
To learn more about Thrive’s model and success, join Tony Willoughby at McKesson ideaShare and hear the more detailed Health Mart® case study about Thrive.