PharmacyNow Podcast: Getting Paid for Clinical Services

Scott Vondeylen: 0:02

Helping pharmacists grow themselves, their business and driving outcomes. This is PharmacyNow.

Welcome back to the PharmacyNow podcast. Excited to have you here today. Episode number seven. I’m your host, as always, Scott Vondeylen. We are joined by a special guest today to talk about the wild wacky world of pharmacy as things continue to develop here on the home front. Really, really honored though to have Tracy Tran PharmD with us, who is the Director of Pharmacy Clinical Operations for the Epic network of pharmacies. And so Tracy, so excited to have you. Thank you for taking time out of your busy day to spend a little bit of time with us and our listeners talking about pharmacy, pharmacy practice, innovation, all that fun stuff we’re going to dive into today. How are you doing today?

Tracy Tran: 1:10

Hi there, Scott. Thanks so much for having me. I’m really excited to be here and I’m great.

Scott Vondeylen: 1:17

Awesome. Glad to hear. You’re working from home these days like many of us?

Tracy Tran: 1:22

It’s definitely a very interesting world for pharmacy. You know, in terms of being a pharmacist, I definitely miss that patient interaction. So working from home has been a very interesting experience, but I think that is the new norm for us, for most of us. And so it’s definitely learning to adapt and embrace this exciting new environment that we’re going through right now.

Scott Vondeylen: 1:46

I hear you. You know, you miss the patient interaction. As I tell the listeners all the time here on PharmacyNow, I’m not a pharmacist. I’m a sales guy by background. And so I just missed any interaction. I was just thrilled to have somebody to talk to today. So, but no, I hear you loud and clear. I’m sure you do miss that patient interaction. I do want to dive into your role over there at the Epic network as the Director of Pharmacy Clinical Operations. Give us a little bit of background. I know we’ve talked through some things, you have a really interesting story. I think if you wouldn’t mind sharing that with the listeners.

Tracy Tran: 2:24

So Scott, I am a pharmacist by background. I earned my doctor pharmacy and masters in business administration from Roseman University of Health Sciences in Nevada. So I pretty much started my career as a pharmacy manager for Walmart pharmacy, where I really learned and grew a lot in my profession, developing skills for managing and running a profitable pharmacy. I later transitioned to become the pharmacy clinical services manager, supporting 14 Walmart locations in expansion of pharmacist’s role in clinical services and enhanced patient care activities that lead to five star performance, having been in the retail roles for quite some time. You know, I thought it’d be fun to step out of my comfort zone and took on another role as an outpatient transition of care pharmacy at PIH Health Hospital in California. And then just this past January of this year, I joined Epic as the Director of Pharmacy Clinical Operations, where I was able to build upon my professional background and took on additional roles and responsibility in really spearheading ethics clinical program. In my current role, I had the privilege of supporting many independent pharmacies in developing, implementing, and expanding clinical services that improve patient outcomes and increase pharmacy revenue. You know, really what the changing pharmacy landscape. And as we know it, the impact of coronavirus, we definitely see many opportunities for community pharmacists to be involved in clinical services while generating new revenue streams. And it’s got, you may be wondering, you know, what kind of drove me to pursuing pharmacy and especially this during this time, you know, in my view, all healthcare disciplines are really involved in direct patient care, but pharmacists are truly the most trusted and accessible healthcare professional, and they play an imperative role in achieving positive patient health outcomes through their expanded roles. And there’s always so much things to learn in the field of pharmacy. It keeps me on my toes, Scott, and then that’s what I think I enjoy most about pharmacy.

Scott Vondeylen: 4:42

Great, love it. Thank you for sharing the background with our listeners here. And so you started off at Walmart and then you, you mentioned, so at one point, let me back up a second. I’m always amazed by what people are capable of because I’m not one of them, but at Walmart you were running 14 locations, is that correct?

Tracy Tran: 5:04

In my role at Walmart, it’s definitely a new role that, obviously with the changing landscape of pharmacy, we see the importance of clinical services really come into play. I, and so that’s when Walmart really developed the new role for a pharmacy clinical services manager. And I took on that role and it was very an exciting, interesting experience because I, similarly to what I do here with Epic, I support 14 different Walmart locations in Southern California to help the pharmacists and the pharmacy teams drive clinical services as it relates to, you know, medication therapy management or health screenings or immunizations, and be able to successfully these services and really turn a traditional retail pharmacy to a healthcare destination. And that really was what most of the gist of my roles there.

Scott Vondeylen: 6:08

I love it. So talking about the importance of clinical services and community pharmacies, and this is a topic we dove into a couple of different times with some of our other esteemed guests. The industry is shifting from that fee for service model to value based. Talk to me if you could a little bit about what independent pharmacies can get involved with today in terms of clinical services and the other thing that I wanted to ask you about as well, because of the challenge that I understand it is that even though there are these different clinical initiatives that are available in the marketplace, the pharmacies can execute on. There still is a little bit of a hindrance when it comes to the payment model and actually getting pharmacies paid fairly for their time that they would be dedicating to a patient for these types of initiatives.

Tracy Tran: 6:57

Yeah. So if you look at the whole scheme of things, but really it’s one of the biggest challenges for pharmacists is really we are healthcare providers, but there are definitely in a retail setting. There’s definitely a lot of opportunities as it relates to pharmacists, really getting paid for the services that we provide on a daily basis. And that being, because through, for example, Medicare part B some of the services provided by pharmacists are not recognized as a medical service and support that reason. It has put a lot of limitations in the capabilities of pharmacists being able to be reimbursed for the services that they provide. So then with that, now is the time it’s so important for pharmacists to now be able to consider a different clinical services avenue that will allow them to tap into services beyond just the traditional prescribing and the traditional role of dispensing medications. And that’s the only way that really to be able to bill for the services, because as pharmacists are providing a lot of new and expanding the roles, I think now, as we see it, Medicare Part D they’re starting to really recognize the contributions that pharmacists make to the wellbeing of the patients. And so now we’re seeing health plans reimbursing a lot or a pharmacist who are, for example, you know, conducting point of care testing. They are CLIA waived tests that can be provided in a pharmacy setting, including strep and flu test, which are particularly attractive to patients. And some states allow collaborative practices agreements with physicians where the pharmacists are allowed to prescribe antibiotics and antivirals for patients with a positive point of care testing result. So these expanded roles of the pharmacist really allow pharmacists now to be able to tap into these different revenue drivers for the pharmacy, and now be reimbursed for the services they provide.

Scott Vondeylen: 9:16

So, do you know the numbers of how many pharmacies are involved in point of care testing that are actually getting paid for those services today?

Tracy Tran: 9:23

Through our partnership with PrescribeWellness, I personally for myself, at Walmart pharmacy, I don’t have a number for you to be honest with you, Scott. But definitely, especially at Walmart, we were looking into really expanding that. And I know in like big chain pharmacies, they’re really adopting that. And so, from an independent pharmacy standpoint, it’s definitely something that, to be competitive and to stay competitive in this marketplace, independent pharmacies need to really embrace this new services that are provided for in the big chains. And so for that, you know, I don’t know at the top of my head, as far as the numbers, but I know in terms of the trend, we’re definitely pharmacies are catching up to this concept and we’re definitely seeing a positive trend on pharmacies providing these types of services to patients.

Scott Vondeylen: 10:23

Awesome. And I wanted to ask what can pharmacies do to achieve higher clinical performance in terms of, you know, the technologies that they can adopt, or what types of activities can they kind of best practices if you will, to improve medication adherence. And some of the things you were mentioning earlier.

Tracy Tran: 10:43

Yeah. Great question, Scott. I think you’ve hit the nail on the head. I mean, that’s really the million dollar question that as pharmacists — and really I can spend all day talking about what pharmacies can and should be doing to improve clinical performance. However, the first and best advice I can give pharmacies is to utilize and maximize on benefits provided by several clinical platforms. You know, the two clinical dashboards that pharmacies need to be actively engaged in are your Equip and outcomes, MTM platforms, which help pharmacies really manage medication related performance information, identify gaps in patient care and improve patient engagement. In addition, pharmacists need to be thinking about initiatives that drive adherence and safety. For example, providing medication therapy management, including comprehensive medication reviews, chronic disease management, and Med Sync are great ways to drive these metrics. Pharmacy can find clinical rewards in adopting technology for text messaging and adherence packaging to help adherence. In a nutshell, the focus of all clinical activities should surround adherence. As it’s linked to positive clinical outcomes for our patients who have chronic disease states like diabetes, hypertension, cholesterol, or cardiovascular disease. You know, believe it or not Scott, adherence can have a far more direct impact on patient outcomes than the specific treatment itself. However, patients are only 50% adherent to their chronic medications. The increase in adherence can have far reaching effects on both patient outcomes in pharmacy star performance. Lastly, I advise pharmacies to always document their encounters in whichever clinical system or platform they use so that they can really capture and document that their efforts in driving at UNC where their patients and that will make a huge impact on their overall clinical performance.

Scott Vondeylen: 12:55

So talk to me a little bit just to the lay person, when you talk about documentation of clinical encounters, why is that so important?

Tracy Tran: 13:03

Yeah, definitely. I think in terms when you were talking about healthcare, right, documentation is always key. So I think when you talk in a pharmacy setting, documenting your interactions with patients, for example, it’s important because it documents that you had consultation with a patient, but it also can produce new avenues for being able to build these interactions that you have with the patients or to get paid for the services that you provide. So, documenting, for example, if I am providing adherence consultation for patient regarding, you know, if there are smoke or smoking cessation, or if I’m providing consultation regarding hormonal contraceptives, these are definitely opportunities to document the intervention. Because eventually, like just a couple of years ago, you know, we have pharmacist that we’re providing opioid consultations to patients, and then they document these interventions. And later down the couple months down the line in the same year, health plans started to recognize the importance of pharmacist consultation in reducing opioid overdose. So they started reimbursing pharmacies or pharmacists for these consultation sessions. So by documenting this intervention, it now allows our pharmacists to submit these claims or these interventions to the pharmacies for reimbursement. And so it’s definitely something that’s always good to document, but then it also could be potential revenue opportunities down the line as health plans recognize the importance of these specific consultation sessions.

Scott Vondeylen: 14:48

Perfect segue to my next question that I have written here, because you’re talking about documentation now. I, from the patient perspective, think about myself going into the pharmacy to pick up an antibiotic or a prescription that I may need, you know, bi-annually or something, or an OTC product that I might get from my local independent pharmacy that I go to. And when I think about documentation of patient encounters, of course, as a patient for me, and I’m a little younger, we’re not talking about, I’m not a Medicare patient and I don’t have any maintenance medications currently that I’m taking. But when I think about documentation, I think about the documentation that takes place when I’m with my primary care physician, for my annual checkup, where he’s sitting on his little swivel chair, he’s typing away. As he’s asking me questions about how I’ve been feeling over the last year, am I taking any new medications? You know, what is my weight, my height, he’s listening to my heart, he’s doing my vitals and that sort of a thing. So this has to be a huge transformation for pharmacies to all of a sudden kind of incorporate that into their workflow, to where they’re now not just handing a pill bottle or a vile with medications as a dispensary, from a prescription that’s been written by the physician. But now they’re being asked to sit down with the patient and document thoroughly, that consultation and conversation that they’re having with the patient, how are pharmacies making this transformation from just passing out, you know, medications as a dispensary to now basically having a full on clinical interaction with a patient?

Tracy Tran: 16:19

Yeah, I think that the question you raised up is definitely, you know, a very practical question because it’s basically, you know, at this point, especially during the pandemic, being able to really adapt and pivot to the change and now incorporate clinical services into your traditional pharmacy workflow is definitely an interesting concept. You know, in the ideal world, there would be a one size model that fits all for driving clinical services in every pharmacy workflow. However, we know that retail pharmacy is far from that as pharmacy workflow and operations for each pharmacy is so dynamic depending on pharmacy staffing model services provided and script fault volume, just to name a few with that being said, pharmacists need to embrace innovative technologies that help streamline operations and support clinical services. In addition to technology, pharmacists need to really leverage their top performing staff, performing staffs to help drive different clinical services. For example, you know, to successfully incorporate clinical services into your workflow, you have to empower your high performing technicians to assume additional roles and responsibility and maybe champion your Med Sync or your immunization program. The key to a successful clinical program is total team engagement, each team member, a role and needs to be held accountable for meeting these team goals. And I think what’s so important, Scott, for a pharmacist to recognize is that clinical services should not be viewed as an additional service. It should be viewed as part of the prescription filling process. What that means is pharmacists should start now looking at clinical services as one of the steps in filling a prescription. For example, you know, when a patient drops off a prescription, you input the prescription, you send the prescription to the filling queue. Well now after the filling queue, the next step should be maybe doing complete comprehensive review and identify if there are clinical services that we need for this patient. So, if pharmacies can adopt this model, it can really impact and have a positive impact on operations and really help streamline the workflow. One of the ways that I find it, you know, from my past experiences that works great for pharmacies is to adopt what’s called an appointment based model. So this model can really positively impact pharmacy operations by streamlining workflow, predicting workload and leveraging the patient appointments for enhanced services. And so that kind of ties back to what I shared with earlier is now we need to view clinical services as part of the prescription filling process. For example, you know, coordinating all the patient’s prescriptions to be picked up on the same day each month, coupled with clinical services such as comprehensive med reviews or immunizations. You know, Scott, I can’t emphasize enough how implementing a seamless mixing program can really help pharmacies proactively address adherence opportunities and move the needle in clinical services. So in a nutshell, you know, to be successful in incorporating clinical services in your workflow, you first have to embrace technology, leverage your talent pool, engage the team, and really most importantly, adopt an appointment based model.

Scott Vondeylen: 20:04

So I have a list here in front of me of opportunities for expanding clinical services and community pharmacies. Now I’m not much of a researcher, but I did conduct a little bit before this interview today with you Tracy. And I’ve got, and you’ve already mentioned some of these point of care testing, uh, expanded immunization programs. And I think you mentioned that earlier, not just your standard flu shot, but perhaps travel vaccines and other things, smoking cessation counseling, hormonal contraceptive prescribing. And then the other one I saw that was really interesting as well was Medicare annual wellness visits. So I would assume based on the little that I know, that when I list those five there, I believe I listed five, vary from state to state or region to region as far as what the reimbursement looks like. And I wanted to hone in on that for a moment because a lot of the messages that we get here at PharmacyNow from pharmacy owners in the independent space is, you know, what can I do to get new revenue for my pharmacy? Are there opportunities out there that I’m unaware of? So when we talk about those opportunities or perhaps others that I haven’t mentioned, what is the reimbursement model look like right now nationwide? Is it state to state? Is there only a few States? Could you speak to that just a little bit?

Tracy Tran: 21:28

Yeah. So in terms of reimbursement, you know, we got to look at, for example, with Medicare there are some reimbursement that are based on state because it’s state specific, but when you look at Medicare or government funded health plans, they are standard across the board. And, so to answer your question, you know, about the Medicare annual wellness visit, and this is something that all pharmacies can adopt because it’s covered by Medicare for all their patients 65 years and older. So this is definitely not something that is state-specific and it’s something that all the pharmacies who are really interested in finding a new niche for their revenue is really the Medicare annual wellness visit is probably one of the most under utilized billable services that pharmacists can provide yet. It’s actually one of the most under-utilized billable services that pharmacists can provide. But it’s one of the ones. So what that happens is as part of that service pharmacist, when patients are enrolled in Medicare, they can complete a disease state management with the pharmacist and pharmacist can now bill for that service that they are providing for patients upon Medicare enrollment. So what that allows our pharmacists to do is now to be able to bill for the complete medication assessment for their patients. And this would be in a lot of our patients who are enrolled in Medicare Part D before enrollment, they need to have a health assessment to determine, you know, what their disease states are, what are the quick medications they are on. And I can see this as a great opportunity for a pharmacist to partner with physicians and have a collaborative practice agreement in place so that we can really help the physicians cover that piece, especially if they’re working under an integrated healthcare system. So I think that’s definitely an avenue for our pharmacies to tap into and grow their revenue.

Scott Vondeylen: 23:51

So what would that look like then to kind of walk through that journey? Because I’ve heard a lot of buzz around this particular subject when it comes to partnering with physicians. So if I own a pharmacy and I don’t know what the data says, you’re probably way more familiar with it than I am, Tracy. But if I own a pharmacy with say 3000 patients, it’s probably connected to at least dozens of providers, if not, you know, 50 plus docs that I might have patients connected to. So what does that look like for me as a pharmacy owner to say, I’m going to have a better relationship with a doctor to get a contract in place so I can get paid through their billing, which would be part B. Can you kind of walk through that with me?

Tracy Tran: 24:38

Yeah, absolutely. So, I can definitely share an example with you at the hospital where I used to work at. So for example, if pharmacies can collaborate in terms of billing with doctors is for example, if there are certain services such as, you know, you’ve got your immunizations that are covered by Medicare part B certain services that are covered by Medicare part B, which is a medical service. So if you have a collaborative practice agreement or a standing order with a physician that you were working with, you know, you draw up the contract and you have criteria that pharmacists have to follow us as it relates to policies, procedures that is established between the pharmacy and the physician. And then under that practice agreement, as long as the pharmacist follows the protocol and follows the guidelines, they can, what it looks like is they can perform physician related activities under the doctor, and then be able to bill for that service as a medical service and not a pharmacy service, because obviously through, there are services that we’re not able to bill, even though it’s provided at the pharmacy, or certain immunizations, like sometimes pneumonia, right? You got your pneumonia vaccines. And so, it’s a vaccine that’s covered under Medicare part B. And so if pharmacists have contracts with physicians, they can definitely bill for that service under the doctor as well and be provided for that service.

Scott Vondeylen: 26:29

Got it. So from your experience, how many pharmacies out there today, do you think outside of the CPA? Because I hear you loud and clear on the immunization that my understanding is 80 plus percent of pharmacies, at least the last statistic that I’ve seen from NCPA, 80% of independent pharmacies are offering immunization services. Now, the question of how many immunizations are they conducting annually is a completely separate question, but they’ve got that CPA in place, whether it’s from a vendor or a wholesaler or their PSAO, their GPO, wherever they’re getting that standing order for that CPA. Outside of the immunization piece and partnering with physicians for other clinical services where they’re actually billing through the doctor’s NPI because of another collaborative practice agreement for something like diabetes management, or smoking cessation, do you have a percentage or an idea in mind and how many pharmacies are actually contracted with doctors for those other services outside of immunizations?

Tracy Tran: 27:31

I think in terms of like independent pharmacies, I definitely don’t see– that percentage I would say is very low. I think we’re looking at like a low end of the spectrum. And that’s why it’s so important for independent pharmacy, because we’re looking at, I would say, I would say 10 to 20%. It’s gotta be, I have to throw a number at you in terms of the percentage that I see independent pharmacies. And so it’s so important because, you know, independent pharmacies are the ones that are very local to patients. You know, they are the ones that really provide that personal patient care and they may be just located down the street to the patients. And so from that perspective, I think it really opens up a new opportunity for independent pharmacies to really consider that avenue of partnering with their local physicians. And sometimes we have independent pharmacies in very small town, right? So that’s definitely an opportunity for independent pharmacies to consider working closely collaborating with local physicians to provide for that service. And ideally as more pharmacies and pharmacists embrace clinical services, we would hope to see that number increase, right? We would hope to see a closer collaboration between physicians and pharmacists to take care of the whole patient’s health and not just segmenting pharmacies to take care of prescriptions and physicians to take care of medical services. We definitely need to merge the two services and have a hybrid to focus our efforts.

Scott Vondeylen: 29:14

I agree. I agree with you. So great feedback really appreciate it. Tracy want to move on to, again that hundred pound elephant in the room or 400 pound elephant in the room? I don’t know the expression goes, Gary’s looking at me over there. COVID 19, it’s still here. It’s still going. Want to take a moment actually while we’re on that subject. And again, we always do here at PharmacyNow, but just sincerely thank all the first responders out there, across the country, who are doing their best every single day, risking their own health and safety, going to their jobs, doctors, hospitals, doctors, nurses, pharmacists, technicians, all of those. Sorry if I’m forgetting some of the different titles, but all of those individuals in our healthcare system who are serving on the front lines and we really, really do appreciate everything you all do for keeping us safe. So with that being said, we’ve talked to many of our past guests over the last few months, as you can imagine, Tracy, around the COVID-19. We’ve started with everything from, you know, a pharmacist in Texas who was creating his own hand sanitizer when there was a national shortage out of liquor from the local liquor store to what is the proper procedures and closing the pharmacy down the front end, but still being able to dispense medication and having your workflow set up to be non-touch as you’re delivering medications to patients. And then what that looks like from the operational side. But as we look forward into the opportunity, that will be the COVID-19 immunization when it becomes available. And of course the COVID testing that’s still continues to be a need, obviously as this pandemic continues to spread and needing to get testing. I just want to hand it over to you, Tracy. Tell me, what is that opportunity? What is the current state of that? Cause I know things have progressed since we talked to our last guest, but what is the current state of that? And what is the, I think second part of that question. What is the opportunity and the months moving forward with COVID-19 specifically related to pharmacy?

Tracy Tran: 31:25

Yeah. I think it’s definitely a very interesting time for all of us in the healthcare world and especially in pharmacy. The coronavirus epidemic really presents a unique opportunity for pharmacists to change the narrative role as providers, you know, recently with the help of the United States Health and Human Services, giving pharmacists the authorization to order and administer the COVID-19 testing to their patients. Community pharmacists are called on to support patient access to COVID-19 testing by serving as testing sites and to help with really advancing the fight against COVID. Recently, governor Newsom approved a waiver that it has allowed our California pharmacists and pharmacy technicians to perform end to end COVID-19 testing. What that means is now our pharmacy teams can order, collect and process test results for their patients. You know, so this is a huge movement. I think this is really a game changer for our pharmacy world because now we’re as a pharmacy has taken greater roles in moving and helping with the epidemic. I see now that pharmacists are taking a greater role, you know, before it was just us conducting the test, but now our role has really expanded to processing results for this test. And now in the future, looking at pharmacies, providing COVID vaccines, you know, so as part of that. In addition to COVID testing, our pharmacists can really contribute towards mass immunization. And so some of the statues States such as like California and New York, a law has passed that allow pharmacists to initiate and administer FDA COVID-19 vaccines, the patients and older. And also recently another exciting news, Scott, I don’t know if you heard about this, but the United States department of Health and Human Services also just issued an amendment, which enables our community pharmacists to order and administer childhood vaccines during the ongoing epidemic. You know, as such, we see pharmacists taking on a huge role in increasing community access to life saving childhood vaccines and decreasing the risk of vaccine preventable diseases. So this is so important because as we see children, you know, start, you know, the restrictions have been slowly lifted. And so now we see children taking more like a hybrid approach where they’re doing a couple of days via Zoom. And then now they’re going to school going back to school for a couple days a week. So I think this is especially a time for pharmacists to embrace that new amendment and be on board with helping immunize and keep our patients immunized as children are going back to schools and keeping them updated because, Scott, ever since the COVID-19 and the pandemic hits, we’ve seen across the board, a huge decrease in childhood vaccines. And so for that reason, this amendment was put in place to ensure that our pharmacists are being on the front lines here in ensuring that this opportunity is addressed because pharmacists are the ones that really come in contact with patients the most. So I think it really opens up with this epidemic. It really opens up a lot of different opportunities for pharmacists to support their community and to help the patients through this pandemic.

Scott Vondeylen: 35:32

Absolutely. I agree with you there 100%. I do want to shift gears for a second. You’re working for the Epic network of pharmacies. My understanding is according to my research, roughly about 1600 or so pharmacies, at any given time within that network, which is a really big number. So a huge network. What have you guys done really specifically or uniquely around COVID-19 to help support that pharmacy network over the past several months during this pandemic?

Tracy Tran: 36:04

Yeah, absolutely. So just to give you a little bit of background about Epic, so Epic is a PSAO. We have about 1400 pharmacies network with us. And so, as we’re looking into this whole hectic environment, yeah, we see independent pharmacies have really shown up in meaningful ways to support the communities. So as an organization that supports and represents independent pharmacies, Epic has a continued commitment to supporting our network with innovative solutions to help pharmacists pivot in this uncertain times. So the pharmacies can continue to take care of patients and some of the things to answer your questions, got some of the things that, Epic as an organization have done to support our pharmacists through this time is through our partnership with PrescribeWellness, we provide our pharmacies with patient communication tools that allowed them to send texts and voice campaigns related to COVID-19. And this is a great tool for our pharmacies because it allows them to effectively reach thousands of patients and especially share critical and time sensitive information as it relates to, you know, change in business hours, new delivery services, new procedures for picking up prescriptions, as well as, you know, social distancing requirements. And so, we’ve also as an organization, want to ensure that our network pharmacies have an opportunity to play their part and support patients against COVID-19, which is why we have opened up our opportunities for our network pharmacies to conduct COVID-19 test through a partnership with PrescribeWellness. And from an operational perspective, Scott, our members are provided with new and robust resources to ensure patients continue getting the medications they need. For example, you know, we have a source drug shortages and provide relevant information as it relates to protecting patients and the pharmacy staff while they’re keeping their doors open in servicing patients. So a lot of different things that we’re doing Scott, and we’re also wanting, we’re also looking to always provide whatever support, you know, and the environment is changing so quickly. So it’s definitely as an organization, we have to adapt well to this changing and dynamic environment to really support our pharmacies to stay and keep their doors open during this time.

Scott Vondeylen: 38:55

Yes, I think you said it best there. Keep their doors open. I’ve talked to dozens of independent pharmacy owners here over the past month or so just to kind of get my thumb on the pulse of how it’s going out there across the country for them as business owners and serving their communities and their patients. And that’s exactly what they’re trying to do right now is keep their doors open, keep people safe at the same time, not just their patients, but their staff. And so that all makes perfect sense to me. Well, we’re running up against the clock in terms of time. Tracy, I did want to kind of give you the floor though, to any final thoughts that you would like to share with us and our listeners within the PharmacyNow network.

Tracy Tran: 39:42

Yeah. You know, first and foremost, Scott, thank you so much for the invite to be here. It’s truly a pleasure and it’s been great talking to you, Scott, through our discussion today. One of the key takeaways that I hope our pharmacists recognize is that, you know, in order to really stay competitive in the marketplace at this time, and really looking towards how pharmacy looks like in the future, pharmacist needs to really embrace clinical services. And I know I’ve really drilled this down but it’s really being able to, because now as we know it, right, you’ve talked, we talked about reimbursement models. We’ve talked about a lot about payments and really, as we’re seeing how pharmacies are sourcing payments, they all surround billing for clinical services. And so for this reason, I really encourage pharmacies who are not currently implementing clinical services at that pharmacy to really look into what expanded services they can provide at that pharmacy, because this is definitely a huge opportunity for pharmacists to grow their revenue because outside with the current reimbursement model for prescription pills, we know that, you know, there’s a lot of scripts that pharmacist were reimbursed below cost. So for this reason, this is where we need that clinical services opportunity to come in and generate additional revenue. And community pharmacies have always been the integral part of the healthcare team. And especially during this unprecedented time, we see the pharmacies team stand up as pillars to support community and take care of patients. And one of the ways to do that is really to look into clinical services. And so I, again, you know, you said it already Scott, but I really also want to take the time to appreciate all of the frontline heroes that have really been the pillars that support the community. And for that, you know, I’m also so proud to be part of the healthcare team as well. And so for that, thank you everyone.

Scott Vondeylen: 42:05

Tracy, thank you so much, really do appreciate the time and thank you for everything that you do for your network. Serving the 1400 community pharmacies over there at Epic. And again, appreciate the time and really great information that you’ve shared with us and the listeners here at PharmacyNow here today on episode number seven. So with that, we appreciate you tuning in today. We will be back here in a couple of weeks with episode number eight. Until then, everyone stay safe out there. And to my best producer in the biz, Gary Feiner, we are out!