Creating a Scalable LTC Pharmacy Expansion

With growth comes opportunity!  The United States currently has over 50 million people over the age of 65 representing over 15% of the total population, or one in every seven Americans.   Of that, a vast number of them are choosing to live in residential communities that offer multiple levels of support and care — a full 12 million people in 2020.

Through a wide variety of housing options (active adult, assisted living, skilled nursing), each with a different level of clinical support, many of these people have numerous chronic diseases/issues that require an average of 12 prescriptions per month.  With the required management and delivery of prescriptions, as well as an estimated three to five over-the-counter products per person, a recent McKesson report estimates that LTC pharmacies have gross margins currently between 30 and 40 percent and are poised to grow exponentially as the population ages.

In addition, as the long-term solutions for COVID-19 are sorted out, it’s clear that this population will be a major component of the vaccine program as well as requiring prescriptions related to the ongoing treatment for the disease.  Unfairly targeted by the coronavirus, nursing homes and veterans homes saw huge numbers of cases and were the unofficial epicenters in most major cities.

Managing the Inevitable Expansions

With this level of opportunity and an ever-aging population, LTC pharmacies are poised to grow exponentially creating the welcome headache of how to absorb this windfall of business.  Unique to LTC pharmacies, expansion comes in large chunks or blocks; taking on one facility may mean 100-200 individual patients, each with a customized treatment plan.

Surmounting this challenge means finding or creating a scalable and manageable way to absorb the increased block of business at a rapid-fire pace while maintaining the high-quality interactions with current customers — then be able to recreate it with each new facility acquisition.

Consider a Scalable Third-Party Expansion Team

Deft, knowledgeable expertise is what’s required when absorbing each new facility.  When the process is facilitated by a third-party partner with LTC pharmacy experience and a team of programmers able to customize the transfer of data, onboarding happens in the most efficient way possible.

Whether you are using FrameworkLTC, QS1, HBS, Helix, or some other pharmacy management software, you need a highly experienced and trained order and billing team of specialists that can seamlessly dovetail with your existing operations and ensure fast, precise entry.  Supported by an auditing team to double-check for accuracy, your organization would be assured exceptional reliability.

An electronic data conversion team can extract data from an old pharmacy system and migrate it to the new system accurately and in real-time, aided by an experienced team of programmers with UX and UI design capabilities.  New facility onboarding should be ready for the go-live date with 100% internal QA ensuring the highest quality patient set-up and order entry for both medication and ancillary orders.

Exploring Scalable Third-Party Support for Ongoing Processing Needs

So, your expansion went off without a hitch.  Everything was ready for the go-live deadline.  Maybe utilizing a third-party team to achieve similar results in your day-to-day operations may be just the solution needed to resolve operational issues, as well as improve the bottom line?

Organizations often find it more desirable to join an established group with scalability that meets expansion needs as well as ongoing daily business needs rather than taking on the sometimes overwhelming tasks of hiring, training, and retaining staff sufficient to keep things running in tip top shape.  Consider the following areas that would benefit from this continuity:

  • Admissions
  • Daily Census
  • End-of-Month Processing
  • Prescription Processing, including Refills and OTC Products
  • Medical Records
  • Refill Authorization Management
  • Emergency Dispensing Charges
  • Prior Authorizations
  • Triage
  • Mail Order Services
  • Billing and A/R Optimization

Finding long-term solutions or managing expansion workflows may benefit from scalable third-party support, including advanced automation for prior authorizations for pharmacy.  There is peace of mind in knowing that providing scalability for work crunches can be handled effortlessly and that fully audited and 100% accurate expansions are achievable.

Contact us to learn more about using third-party support during expansion activities to improve efficiencies and capture potentially at-risk revenue.

About the Author

Infinx
Infinx Healthcare provides innovative and scalable payment lifecycle solutions for healthcare practices. Combining an intelligent, cloud-based platform driven by AI with our trained and certified coding and billing specialists, we help clients realize revenue, enabling them to shift focus from administrative details to billable patient care.

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