
There is no doubt that the practice of pharmacy has changed significantly during the last ten years. In honor of entering a new decade, we wanted to take a moment to reflect on a few major industry shifts, and to also look forward to what lies ahead for the community pharmacy. Read on to ensure your pharmacy is in the best possible position to thrive as an established and central community healthcare destination.
The Rise of DIR fees
Over the course of the past decade, direct and indirect remuneration (DIR) fees have continued to rise and remain a source of frustration for many community pharmacies. Though DIR fees have been around since 2006, many pharmacies have become more concerned about their impact in recent years, and for good reason. The Centers for Medicare and Medicaid Services (CMS) have documented a 45,000% increase in DIR fees paid by pharmacists between 2010 and 2017![1] This squeezing of margins is undoubtedly taking a toll, and while the fight to reform DIR fees is in motion, many pharmacists are beginning to take matters into their own hands to improve clinical outcomes in order to make the system work better for them, their business, and the patients they serve.
On the horizon: legislative reform for DIR fee relief is underway, presenting opportunities for standardization of pharmacy quality measures.[2] It is important to also consider how technology-enabled solutions can help optimize your business operations. The PrescribeWellness VRxAssist service extends the impact of your pharmacy and expands the revenue streams of your practice without taking on the ongoing expense of hiring extra staff members. VRxAssist provides your pharmacy with expert virtual consultants who work alongside your team and act as an extension of your practice to support key clinical, operational, and marketing initiatives.
A Shift in Identity: Pharmacists as Providers
Up until recently, pharmacies were viewed simply as a place to pick up a prescription, and in the earlier days, perhaps even a milkshake or ice cream soda. The shift from “pill dispenser”, to ally in everyday health, has officially commenced as pharmacists continue to become equipped with provider status in a variety of regions. Community pharmacists have also oriented themselves around accessible, convenient service offerings and care opportunities – more on that below.
While provider status still lacks a universal definition, pharmacists have declared a seat at the healthcare table to begin serving patients in new and exciting ways, such as consultation and prescription of hormonal contraceptives and point-of-care testing. To date, this legislation has largely been decided state-by-state, and the battle for federal recognition continues. Continue to tune-in to the PrescribeWellness Blog to stay informed on how to take advantage of these changes. We also recommend following the National Alliance for State Pharmacy Associations (NASPA) for updates and developments.
On the horizon: universal reimbursement continues to be a prevalent development as leaders at the state and federal levels weigh-in on the status of pharmacists-as-providers. With this evolution, and the general transition to value-based care, pharmacists may be able to begin billing for tasks previously perceived as “free” services, such as the recommendation of vaccinations and OTCs prior to travel, or the delivery of point-of-care (POC) testing which introduces additional patient engagement and revenue opportunities for community pharmacists – more on POC testing here!
A Shift in Focus: Pill-centric to Patient-centric
For a pharmacy to serve as a trusted hub for preventive care services and comprehensive health support, a change in operational workflow must occur – one that supports a fundamental shift from pill-centric tendencies, to patient-centric services focused on the overall health of your community. Instead of organizing your day around dispensing as many medications as possible, consider leveraging your time to fulfill a larger scope of patient needs, with medications being one, important piece of the puzzle. Enhanced clinical services, such as Medication Therapy Management (MTM) services, point-of-care testing, collaborative practice, and the ability to furnish and adjust medications, help to position your pharmacy at the center of the healthcare continuum to provide better, comprehensive care to your community.
On the horizon: many pharmacies offer vaccinations and will continue to have the opportunity to expand revenue through enhanced clinical services. Chat with us today [DK1] to learn how PrescribeWellness can help your business leverage available enhanced offerings including travel vaccines, point-of-care testing, and much more.

Technology to Support and Adapt to Industry Changes
As the healthcare industry evolves, so too do the tools pharmacists utilize to keep their businesses on track. Founded in 2010 on the principle of pharmacist-patient communication, PrescribeWellness, a Tabula Rasa HealthCare (TRHC) technology solution, is a leading patient relationship management solutions provider that facilitates collaboration between more than 15,000 pharmacies, providers, and patients for better health. Proprietary cloud-based technology and services empower healthcare professionals through improved adherence, loyalty, outcomes, and revenue. From patient insights and communications to support for enhanced services and documentation, the PrescribeWellness CompleteCare service helps pharmacy teams work in step with each other to scale patient care and grow pharmacy revenue. CompleteCare provides a holistic view of patient information and real-time pharmacy performance in a centralized dashboard. Pharmacies can identify revenue growth opportunities and build patient relationships through multi-channel communications such as phone and intelligent two-way text messaging.
On the horizon: as Americans look for more convenient ways to manage their health, the role of the pharmacy within a patient’s healthcare journey continues to expand. Through the advent of science-backed technology solutions, pharmacies are better positioned than ever to impart actionable and effective care. Technology-enabled services, like those facilitated by TRHC and PrescribeWellness, help transform the role of the pharmacy from traditional medication dispensary, to disruptive healthcare destination.

The past ten years have no doubt been challenging for community pharmacies across the nation, yet industry shifts have also proven to be transformative and have begun to offer unprecedented opportunities for pharmacists to serve as dedicated care providers in their communities. By establishing connection between patients and practice, pharmacists can begin to operate at the top of their licensure while providing optimized care for reduction of healthcare expenditures and improved outcomes.
To stay ahead of the curve of continued industry shifts, or to learn more about how PrescribeWellness can help optimize your pharmacy business, fill out the form below – we look forward to speaking with you!
[1] United States Senate Committee on Finance, “Grassley, Wyden, Bipartisan Senators Push HHS for Pharmacy DIR Reforms in Medicare Part D,” September 12, 2019, https://www.finance.senate.gov/chairmans-news/grassley-wyden-bipartisan-senators-push-hhs-for-pharmacy-dir-reforms-in-medicare-part-d.
[2] NACDS, “DIR Fees,” https://www.nacds.org/dir-fees/.