This is strange.
A pharmacy chain actually doing something to make sure that they aren't losing money. It's weird to see a pharmacy chain taking a stand on the reimbursement front. Everybody else is seeing how many drugs they can have on the old
el cheapo list and
Walgreens goes and stops being a provider for Delaware Medicaid due to poor reimbursement.
For that,
Walgreens earns the first Brass Balls Award from Pharmacy God. I couldn't find out how many pharmacies are in Delaware, but losing 66 pharmacy providers has to be significant.
Have you noticed that in the past, the chains that will actually take a stand on reimbursement issues are the ones who are pharmacies first? The mass merchandisers and grocery store operations will let pharmacy contracts slide because dropping an insurance will decrease the store's customer count, so pharmacy takes the hit in exchange for Mrs Jones hopefully buying a bag of chips and a few light bulbs. Pharmacy is the store's loss-leader, not the sale on Easy-Mac.
But
Walgreens, Rite Aid, and
CVS have been the ones to actually look at the contracts, run the numbers, and determine if the contract is worth the effort. I usually don't have a lot of good to say about these places, but maybe we could all learn from them when it comes time to sign the contracts next year.
Instead of looking over the terms and going
oh crap, we're going to screwed, dropping an insurance or two may be what is needed to keep a pharmacy profitable.
The least you should do is read the entire contract to see how your reimbursements are calculated. I just left a position where the contracts were signed for us by a representative employed by our wholesaler.
What does the wholesaler care about the reimbursements? They're selling us the medications.
The best contract that I saw involved the following generic reimbursement rates, the lowest being what we were reimbursed...
- AWP minus some percent (I don't have the contract in front of me, but it wasn't good), plus 2.25
- GEAP
- Federal MAC
- Insurance company MAC
The insurance company MAC is what caught my eye. They could arbitrarily add a drug to their MAC list, set the price to whatever they wanted, and reimburse at that rate.
And we agreed to accept it without even asking to see what their MAC list was.
So again I would like to congratulate Walgreens for taking a stand. Maybe the other pharmacies in Delaware will take a look at the reimbursement rates and make the same decision.
A pharmacy chain actually doing something to make sure that they aren't losing money. It's weird to see a pharmacy chain taking a stand on the reimbursement front. Everybody else is seeing how many drugs they can have on the old el cheapo list and Walgreens goes and stops being a provider for Delaware Medicaid due to poor reimbursement.
For that, Walgreens earns the first Brass Balls Award from Pharmacy God. I couldn't find out how many pharmacies are in Delaware, but losing 66 pharmacy providers has to be significant.
Have you noticed that in the past, the chains that will actually take a stand on reimbursement issues are the ones who are pharmacies first? The mass merchandisers and grocery store operations will let pharmacy contracts slide because dropping an insurance will decrease the store's customer count, so pharmacy takes the hit in exchange for Mrs Jones hopefully buying a bag of chips and a few light bulbs. Pharmacy is the store's loss-leader, not the sale on Easy-Mac.
But Walgreens, Rite Aid, and CVS have been the ones to actually look at the contracts, run the numbers, and determine if the contract is worth the effort. I usually don't have a lot of good to say about these places, but maybe we could all learn from them when it comes time to sign the contracts next year.
Instead of looking over the terms and going oh crap, we're going to screwed, dropping an insurance or two may be what is needed to keep a pharmacy profitable.
The least you should do is read the entire contract to see how your reimbursements are calculated. I just left a position where the contracts were signed for us by a representative employed by our wholesaler.
What does the wholesaler care about the reimbursements? They're selling us the medications.
The best contract that I saw involved the following generic reimbursement rates, the lowest being what we were reimbursed...
The insurance company MAC is what caught my eye. They could arbitrarily add a drug to their MAC list, set the price to whatever they wanted, and reimburse at that rate.
And we agreed to accept it without even asking to see what their MAC list was.
So again I would like to congratulate Walgreens for taking a stand. Maybe the other pharmacies in Delaware will take a look at the reimbursement rates and make the same decision.