Pharmacies have more data than ever, but where should they focus? How are pharmacies being evaluated and compensated based on performance? What does this mean for patient care?
The EPIC Rx Clinical Programs team has developed a roadmap to help pharmacies navigate this changing landscape and put them on a path to success.
Step 1: Know which payers/plans have the biggest financial impact on your pharmacy.
The impact of each plan varies by state and region. EPIC Rx’s RxRegulator® can help identify the plans making the biggest impact on your business.
Step 2: Know how these payers evaluate performance.
Each payer has a specific way it evaluates pharmacy and network performance. EPIC Rx can show you how your pharmacy is being evaluated.
Step 3: Know how payer’s view and track your pharmacy’s performance.
EQuIPP is a program that uses claims data from payers to generate your pharmacy’s performance scores. Your pharmacy’s scores impact direct and indirect remuneration (DIR) fees and bonus payments.
Step 4: Identify patients impacting performance and in need of additional care.
a. EQuIPP Outliers: updated weekly and highlights patients who drive down scores and are late on refills
b. PrescribeWellness: View your patients through the eyes of your dispensing system and sort by prescriber, payer, disease state, etc.
Step 5: Engage with these patients and work to improve outcomes.
Use the tools available! From PrescribeWellness, a medication therapy management (MTM) vendor (OutcomesMTM ), and dispensing software, the EPIC Rx clinical programs team can provide one-on-one training on how to efficiently use the tools available to improve your performance.
EPIC Rx members have access to exclusive resources to help their pharmacy work through and find success with these steps. Contact EPIC Rx today to learn what we can do for your pharmacy.