Monthly Archives: December 2015

Medicare is gradually moving providers to a new, quality driven model.The current fee for service model used for so many years rewards providers for doing more: more procedures, more prescriptions, more admissions. The new quality model is designed to reward success. For example, fewer hospitalizations, fewer complications, or fewer adverse drug events. One tool being used are the Star......
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The other day I wrote about PBMs and their role as Middleman (See The King is Naked). But every story has two sides. Today’s installment is a little more depressing: it relates to the economics of the current health care system. From a Wall Street perspective, retail pharmacy is at the bottom of the pharmacy......
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In the children’s tale “The Emperor’s New Clothes” by Hans Christian Andersen, the King is duped by a tailor promising him a suit of material so fine that it is only visible to those worthy. As the King parades around the kingdom completely naked, most everyone is afraid to tell him about his mistake. This tale, since translated into over......
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The other day, during a conversation I was involved in, an employee questioned the number of persons employees by small businesses in the United States. I recalled having heard that the number was significant and might even have been more than 50%. When I was younger, I would have had to go to an encyclopedia to......
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The Thriving Pharmacist has spent some time in the past discussing MAC prices as they are applied to PBM-pharmacy contracts. The concept of MAC price, however, is also a tool used by the PBMs in their dealings with the payor. Despite being several years old, the article referenced below address how the PBM industry manipulates MAC prices on......
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Tele-pharmacy For they un-initiated, tele pharmacy is a relatively new concept. With pharmacies being unable to sustain a practice in areas without sufficient population density, many rural communities are left without access to a pharmacy. Tele-pharmacy is a potential way to bring a pharmacy back to an under-served population by decreasing the cost of running......
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Pharmacists are acutely aware of the power the PBMs wield over their practice. With the recent House Judiciary Hearings on PBMs and other reports of PBM abuse starting to grab the public’s attention, now is a great time to teach the world about the a relatively new PBM power tool: Flexing. Flexing, as defined by one of......
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