As the next generation of Americans (“Baby Boomers”) turn 65, the beneficiary population is expected to surge from its current 59 million members to more than 80 million by 2030 with a staggering ten thousand people already becoming Medicare-eligible every day. This beneficiary proliferation presents a significant opportunity for community pharmacies to go #BeyondTheFill and take an active role in open enrollment by offering Medicare plan reviews. Community pharmacists are uniquely positioned to educate Medicare and Medicare-eligible patients about their options, and can help their customers find a plan that not only fits their health and financial needs but one that also ensures that they continue doing business at their favorite pharmacy – yours!
Help patients find their confidence
Choosing a Medicare plan is often a complicated and overwhelming process for patients, especially when taking into account variances in costs, drug coverages, and restrictions from one to plan to the next. In fact, the plans themselves often change from one year to the next. And while variety and change can be good, studies show seniors would actually prefer an easier selection process, as it causes them to feel less confident in their ability to choose the right plan.
As a result, there is a growing tendency for patients to stay on their current plan – even if it means overpaying for inadequate coverage. In fact, a recent study found approximately 90% of Medicare beneficiaries were not on the most cost-effective plan for their medications, and could save an average of $300 a year just by switching to the lowest-cost Part D plan that covers their medications.1 Situations like these are not only less than ideal for patients but for pharmacies as well. Low reimbursements and associated DIR fees can hurt your practice by turning high-impact customers into challenging ones. In fact, in some instances, plan restrictions can even prevent patients from being able to fill their prescriptions at your pharmacy.
So what can you do? Set your patients up for success by finding win-win opportunities through Medicare plan reviews.
Plan reviews matter
Medicare-eligible patients are often inundated with information about the medicare landscape and need the informed guidance of a trusted expert. Meanwhile, customers already on Medicare may need to reevaluate their options during open enrollment due to upcoming plan changes of which they may or may not be informed. For example, changes to plan costs, restrictions, and formularies can greatly affect out-of-pocket exposure, coverage, and access to care – all factors that may cause their current plan to no longer be the best option for their needs and your business.
Conducting Medicare plan reviews allows community pharmacists to further cement their status as the community’s most accessible and knowledgeable caregiver, and presents yet another opportunity to leverage the powerful patient-pharmacist relationship to increase loyalty and revenue growth. In fact, studies show patients who receive a plan review are 30% more likely to stay with that pharmacy.2
Work smarter with PrescribeWellness
Now that it’s clear why conducting Medicare plan reviews is so important, it is critical to have a proper plan for plan reviews. Keeping track of the patients in your population who are already on Medicare or who are within three months of their 65th birthday is time-prohibitive, and likely a nearly impossible task. However, by leveraging the power of the PrescribeWellness support tools, community pharmacists can easily filter to identify prime candidates for Medicare plan reviews. Next, utilize PrescribeWellness’ patient communication capabilities to send proactive, targeted communications to introduce patients to a Medicare plan review. In addition to patient identification, recruitment, and engagement, Prescribewellness also provides pharmacists with the tools needed to conduct side-by-side plan comparisons – an efficient and effective way to highlight the pros and cons of various options and help ensure patients choose the right plan.
To learn more about how PrescribeWellness can support your community pharmacy practice to implement and sustain a successful Medicare plan review program, please contact us today.
We look forward to hearing from you!
1 https://www.mymedicarematters.org/?SID=5d360a9b2c411933
2 https://amplicare.com/articles/what-pharmacists-should-know-before-2020-open-enrollment/
