According to a recent survey, Direct and Indirect Remuneration (DIR) fees are the number one issue facing community pharmacy owners, and a top concern when it comes to business planning.* While DIRs come in various shapes and sizes, they are consistent in their ability to cause confusion and frustration—especially since DIRs are processed several months after the point of sale, forcing pharmacy owners to guess how the adjustments to their reimbursements may affect their business.
But here’s the good news: by understanding the issue and leveraging the proper support tools, pharmacy owners can finally flip the script and actually make DIRs work for you.
What to know about DIR Fees 2022
We previously provided the DIR origin story, but now want to help you understand your specific DIR situation. The first step is knowing the plans your PSAO is, and is not, contracted with (preferred vs. non-preferred network). Next, you must determine your DIR criteria. Most DIRs are calculated based on network or individual pharmacy performance, with funds clawed back for the pharmacy (or network) failing to hit certain performance-based standards.
This is actually good news. When reimbursements are a direct reflection of your performance, that is a scenario you can control. Also, many payers offer pay-for-performance incentives, so by recognizing and understanding which plans are grading your pharmacy’s performance, and prioritizing incentives, you can mitigate the impact DIRs have on your business—while improving patient outcomes.
Especially when utilizing the tools available through PrescribeWellness365(PW365).
PW365—comprehensive DIR support
One of the most common DIR pay-for-performance incentives is tied to patient adherence. PW365 helps your practice grow and sustain a Med Sync program, which directly helps mitigate the impact of DIRs by improving the adherence of your patient population, which in turn raises your performance metrics, and leads to a reduction in your DIRs.
To take the guesswork out of how to best use the solution, PW365 assigns your pharmacy a designated consultant who provides DIR Mitigation reviews that not only help you understand which patients are most negatively impacting your adherence measures but will actually take action in your Patient Engagement Center (PEC) by specifically targeting these patients to enroll in Med Sync.
We understand that implementing and growing your clinical service programs is a great way to make up for lost margins—especially with patients increasingly turning to pharmacists for non-emergent care. But doing so, effectively, requires strategy.
This is why PW365 consultants conduct a comprehensive in-take analysis of your business—to develop a game plan on how to prioritize your business offerings. And your consultant continues to work with you on a quarterly basis to ensure you see results with new revenue opportunities uncovered. From Medicare plan reviews to immunizations for COVID-19 and beyond, your consultant will help identify the revenue-generating opportunities—not subject to DIR fees—that make the most sense for your pharmacy.
Want to learn more about how PrescribeWellness365 can help you take control of your business by mitigating the negative impact of DIRs through actionable solutions? Contact us today – we love hearing from you!
*PrescribeWellness internal data