Hot Topics: Pharmacy May 31, 2012

1. Hot Topics: PharmacyMay 31, 2012 William green, r ph, western michigan university Deborah Hubbell, R Ph, University of Connecticut Carolyn Lancon, R Ph, Louisiana State University Lon C. Muir, Pharm D, Bowling Green State University Amy Sauls, Pharm D, University of North Carolina at Chapel Hill

2. Disclosure • We have NO actual or potential conflict of interest in relation to this educational activity or presentation

3. Objectives • Discuss marketing your college health pharmacy. • Discuss the decision to become a participating provider in third party prescription insurance plans. • Discuss how a pharmacy might respond to a Pharmacy Benefits Management (PBM) audit. • Discuss the impact of EMR on college health pharmacy.

4. Why are we here? • To gain a better understanding of who we are as college health pharmacists and explore what we can offer to our health centers • Presenters will share their experiences on the topic areas • Audience is invited to share their experiences also to expand the knowledge base of everyone in attendance

5. Marketing Pharmacy Services Lon C. Muir, Pharm.D. Bowling Green State University Pharmacy Manager

6. SHS Marketing Committee • Consists of: • Pharmacist, Counseling Center staff member, Administrative Secretary, and a Marketing Student • Meet Monthly to Bi-monthly

7. Meeting Agenda Items • Discussion of upcoming campus events • National health awareness campaigns • Promotion of new services • Seasonal products/services • Review of prior minutes • Assess progress and provides a blueprint of tasks to be accomplished

8. Outreach Checklist • Simple form used to promote different events Example: • Promote in Student Union • Send campus wide email • Collaborate with another university dept Details of the event: Event planning began in August. Event was promoted in October using outreaches listed above. This event can be improved for next year by having more staff present at event.

9. Marketing Information • Basics • Location, hours, services, payment options • Additional information • Seasonal specials • New staff • New services • Special hours (i.e. breaks) • New products/pricing

10. Collaboration Opportunities Academic Affairs departments • Guest speak for health or introductory classes • Greek professional organizations • Guest speak to students who have a common interest in the public service/health care field • Student Affairs • Learning outcomes • Health and Wellness • Health Fair • Market in conjunction with Health and Wellness promotions

11. Collaboration Cont…. • Human Resources • Educate new employees to services offered by your pharmacy to staff members • Open houses, orientations

12. Marketing Basics • Don’t be wordy • Students don’t read • Always have a visual • Incorporate logo • University approved if applicable • Departmental • Watch out for bright colors • Ease of reading text

13. Marketing Basics Cont…. Follow set color schemes Show accreditations Proof-read Know your audience Try to incorporate known figures such as mascots, university officials

14. BGSU Pharmacy Website

15. Handouts/Bag Stuffers

16. BGSU University Ad Campaign 12 ads highlighting staff and services provided at SHS

17. Other Marketing Sources T-shirts Campus Events- Parade Email Sandwich boards Publications Campus locations SHS locations Bag Stuffers Website • Departmental • University Signage High traffic areas • Union • Sidewalks/chalk

18. What cool marketing ideas have you done?

19. Accepting Third Party Insurance: Considerations and Implications May 31, 2012 Amy Sauls, Pharm.D., CPP Campus Health Services Student Affairs The University of North Carolina at Chapel Hill

20. Campus Health Pharmacy • 29,000 students at UNC-Chapel Hill • Serve only students, post-docs, spouses, and staff of the health center • Average 250 prescriptions/day – school year • Technician staff: 4 FTE • Pharmacist staff: 2.8 FTE + 1 FTE Pharmacy Director

21. RX Volume

22. History of Third Parties at CHP • August 1996 – signed contract with QS1 Family Care • Why? • Competition from local pharmacies • As of 2010-11 year, insurance mandatory in the UNC system • Right thing to do – help students navigate health care system, enable students to get the medications they need, and enable them to get them from CHP

23. Contracts • QS1 Family Care – majority of contracts, enhances negotiating power • Separately negotiate with Medco, Prescription Solutions, Express Scripts • University Counsel reviews and approves all contracts • Director of Pharmacy completes annual Verification Forms • CHP serves as Pharmacy Benefit Manager for Student Insurance Plans

24. Typical Contract Terms • [(AWP - x %) + dispensing fee] or usual and customary, whichever is lowest • For example, • Brand: AWP - 17.5% + disp fee of $1.25 • Generic: AWP – 25% + disp fee of $1.50 • May have different rates for 30 versus 90 day supplies

25. Credentialing/Verification • NPI and BOP license numbers • Liability insurance certificates • Copy of DEA certificate • Federal Tax ID • Services offered, operating hours • Every 3 months, check applicable state and federal exclusion lists • FWA training

26. Insurance Requirements • Fill prescription exactly as written • No substitution of sizes of tubes, etc • Can only fill for the amount prescriber writes on Rx, even if BOP rules allow for more • Must be able to calculate days’ supply from sig • Keep a printed copy of every prescription, even electronic prescriptions, for 6 years • Call for travel overrides, early fills, prior authorizations • Signature Logs

27. Submission Policies • Current NCPDP HIPAA-compliant format • Appropriate DAW code • Accurate National Provider Identification (NPI) on all claims • Only for the eligible person for whom the prescription is written by the prescriber • Submit claims simultaneously with dispensing • Usual and Customary price

28. Avoiding Audits • PAAS – Pharmacy Audit Assistance Services • Newsletters • Assistance with audits • Resource for questions regarding insurances • Staff meetings • Best Practices Policy • Provider manuals

29. Workflow Issues • Technicians must become familiar with the most common insurance cards • Educate students about cards • Find and clarify insurance information – must call insurance companies, use websites • Who is going to help with problem insurance issues? • Expect longer wait times • Reconciliation

30. What Does CHS Pharmacy Staff Say About Insurance? • “Nothing logical about it” • “One of least understood aspects of health care” • “Patients can be health literate and insurance illiterate” • “The cards are not always helpful”

31. Insurance Cards • BIN • PCN • Group Number • Person Code • Relationship Status

33. Financial Implications • Average $9 margin per prescription at CHS Pharmacy • Third Party Loss Report – monthly • Constant vigilance for medications that are being reimbursed below acquisition • Transmission Fees • Look for other ways to be reimbursed • Vaccines • Medication Therapy Management Services

35. How to Survive Your Audit William Green, RPh Sindecuse Health Service Western Michigan University DUE TO UNFORSEEN CIRCUMSTANCES, BILL GREEN IS UNABLE TO present today. his slides are included here for informational purposes.