Our latest thoughts and inspirations on buying a pharmacy, starting a pharmacy, and ongoing pharmacy operations

Key notes about Insurance Contracts and Licensing when Buying or Starting a Pharmacy


If you are buying or starting a pharmacy one of the first things to understand is what you will have to do to receive your licenses and PBM contracts.   Not doing this could cause you to lose business or delay your opening/purchase. Below are key items to do to ensure you know what is required for licensing and insurance contracts.

1.       Call your State Board – understand what the process is for license approval. Are they going to do an inspection, when will the inspection occur, what is required to pass? What is the timeline? Some states require a board meeting you must attend. These are just examples and will differ from state to state, so call them understand it.

2.       Does your state require a state control license? Some states require a separate number via a separate application and if they do it can delay your process.

3.       Call Medicaid – every states process for receiving a Medicaid number will differ. Call Medicaid understand what is required to obtain. If buying, will you keep the number, will the number change, and do they require approval in advance of sale? If starting how long will it take?

4.       Do managed Medicaid plans require Medicaid approval? - In some states if you contract with the managed care company you automatically can bill Medicaid, in other states you have to have the Medicaid number to activate the managed care.

5.       Are you in a Hot Zone? CMS has Hot Zones and if you are in a hot zone you will be forced to wait on contracts with certain Medicare plans, sometimes up to 1 year.

6.       If buying are you doing an asset or stock sale? – this will impact all your licensing, if asset sale you will most likely get all new licenses and PBM contracts if you are doing a stock sale you will probably try to keep all the licenses and contracts. The stock sale will cause you to follow a different process and you may or may not be able to keep the licenses so make sure you understand this early in the purchase process.

7.       Are you going to bill Med B for diabetic supplies, immunizations or anything else? – Med B is not included with your PSAO like Medicare Part D and will require a separate application. Med B for immunizations can be obtained with a simple application however diabetic supplies is considered DME and all DME requires an accreditation which can take some time.

8.       Some PBMs will require an inspection – the PBMs will at times require an inspection and you will have to be open prior to them doing so. Call the key providers in your area and understand if they will or not.
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The Importance of Med Sync for Independent Pharmacies

This article maybe a little late to the game but as consultants and accountants to the independent pharmacy industry we view the operations of many more pharmacies than the average person and have noticed the focus of medication synchronization has dropped off. It was the “popular” subject at every tradeshow and at nearly every pharmacy for several years but now we do not hear it as much.   We are also not seeing the % of patients on med sync rising year on year as much as we once did.

Medication Synchronization should be a continued focus in almost every independent pharmacy. The reason why, it is the only process that impacts the 3 most important levers in a pharmacy, revenue, inventory/cost of goods sold and payroll. Med Sync increases revenue because the patients on Med Sync are more likely to get all their refills on time, it allows you to practice a true just in time inventory, whereby you order inventory when the patient needs improving your cash position and it reduces payroll in several ways (reduces number of inbound calls, reduces number of check outs/deliveries and reduces amount of separate fills you have to data entry, count, bag, etc.).

With lowering reimbursement pharmacies have to be more efficient and the process that makes the largest impact on efficiency is med sync. So, if you have 30% of your patient base on med sync we encourage you to strive for 60% and if you are starting or buying a pharmacy make med sync one of the priorities when you take over!
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What is the Purpose of Due Diligence when Buying a Pharmacy?

Due diligence from a buyers perspective three main objectives. Below outlines each:

1.       Determine if the business you are exploring the purchase of is what you expected. In other words is there a reason not to buy the pharmacy? Objectives include, finding out is the pharmacy revenue accurate, are script counts correct, are control substance %’s acceptable, etc. You should strive to verify all operational and financial information.

2.       Pharmacy Transition – Once you know the business is what you expected, then you want to gather information that will assist you in transitioning the business after acquisition. Some objectives of this diligence include, what is current wholesale agreement, what health benefits are provided, what staff is staying or not staying, what marketing is done.

3.       Legal – you should have your attorney gather and review information to ensure legally you can buy the pharmacy and that also the pharmacy does not have a legal concern that would cause you to not purchase. Examples include, assisted living contracts, PBM contracts, lease, UCC checks, etc.
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Thoughts on Notifying the Staff when Buying a Pharmacy

You have done all your due diligence, you have built your business plan, you have signed the purchase agreement, and you are ready to assume ownership of the pharmacy. Now comes a very important step in the process. How do you inform the staff of the sale?

The best way to inform the staff is to have a meeting the evening before or the morning of the transition date. If the owner has not already informed the staff he should be the one to do so at the meeting. He should let them know that he has appreciated their help throughout the years and wanted to be sure to sell the store to someone who could carry on what he has built. By passing up chain store offers the store can continue to operate. He can tell them that that he understands things won’t be exactly the same but he has taken great care to be sure the store is in good hands. Then he should introduce you.

The first thing you should do is thank the owner for the opportunity and let him know you will do everything you can to take care of his “baby”. Let the staff know that pharmacy is a relationship business and there is no way the owner could have been successful without a great staff. And there is no way you will be successful without the great relationships that the staff has with the patients. That is why it is important that everyone will be given an opportunity to continue in their roles. Emphasize, you need great relationships to be successful not only with the patients but also with you.

However it is also important that you do not box yourself in with false promises. Everyone wants you to say “Don’t worry nothing will change” for no one likes change except a wet baby. You want to be reassuring but you must be honest. It is better to say “I won’t stand here today and say that nothing will change because I want our relationship to be built on honesty and I simply cannot make that promise”. Let them know change may or may not come after you spend the next few weeks learning the business and what and who makes it successful. Tell them you want to meet with each of them individually over the next few days and you will ask them what they like about their jobs and what things would they change if they were the owner. Say “I may or may not agree with you but I promise you I will always listen”.

Finally, reassure them that they are an important part of the business and you need their trust and their help. Try to answer broad questions but stay away from individual issues such as what will me schedule be, are you offering the same benefits, etc. Let them know you will address those issues when you meet with them individually.
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Think Bigger when Starting a Pharmacy

I am asked a lot, what is the difference between very successful pharmacy businesses and those that are just okay. My answer is always the owner thinks bigger. Your typical pharmacy is primarily retail and will do traditional marketing, provide the typical services, rely on great service and market to 2 or 3 mile radius. All these are important but the great pharmacies will go big and do things that are uncomfortable. Examples include:

·         Looking at the target market not just as a 2 mile radius but as a 10 or 20 or even 50 mile radius.

·         Seeing the customer as not only the patient walking in the door but also as the prescriber, hospital, facility, pharmaceutical reps, other businesses in the community, etc.

·         Not being afraid to seek out multiple lines of business, compounding, long term care, retail and specialty.

·         Owning multiple pharmacy locations not just in the local area but maybe hours away or even a full state or two away.

·         Creating programs specifically designed for a doctor’s office, hospital or other partner.

·         Focusing on one or two disease states to drive business from a large community of patients.

·         Having a call center to attract and solicit new patients.
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