Episode Details

Independent pharmacies are facing a brutal financial reality right now. Prescription reimbursements keep dropping, pharmacy benefit manager fees keep climbing, and profit margins that were already tight are getting squeezed even harder. Meanwhile, you're spending hours every single day doing clinical work that never shows up on any invoice. You review medications, answer questions about drug interactions, help patients manage their diabetes or high blood pressure, coordinate care between different doctors, and basically act as an unpaid healthcare consultant for everyone who walks through your door. Here's the frustrating part. You already know this work has value. Your patients depend on it. Their health outcomes improve because of it. But your business model has no way to capture that value, so you keep doing it for free while watching your bottom line suffer. What most pharmacy owners don't realize is that Medicare created programs specifically designed to pay for exactly this kind of work. Chronic care management and remote patient monitoring programs reimburse healthcare providers for time spent helping patients outside of regular office visits. The catch is that pharmacists can't bill Medicare directly under current rules. But physicians can, and they're allowed to partner with other organizations to deliver these services. That's where the opportunity sits. Doctors are dealing with their own version of the same problem. Their patients need regular check-ins and ongoing support to stay healthy, but insurance only pays for office visits. Growing paperwork requirements and staffing shortages make it nearly impossible for many practices to deliver this level of care without either losing money or burning out their teams completely. So here's how the partnership model works. Your pharmacy teams up with local physician practices to deliver chronic care management and remote patient monitoring services. The doctor maintains medical oversight and handles the billing side, while your pharmacy staff manages the day-to-day patient interactions. Then you split the revenue based on whatever terms you negotiate together. The beautiful thing about this setup is that patients already know and trust your staff. They're already coming in regularly to pick up prescriptions. These relationships feel natural and comfortable instead of forcing people to build new connections with strangers they've never met before. Your pharmacists understand medications better than almost anyone, and you already know each patient's health history, which puts you in a perfect position to spot problems early and provide education that actually improves how well people stick to their treatment plans. Now let's talk about real numbers, because that's what actually matters. Pharmacies running these partnerships typically bring in $40 to $100 per enrolled patient every month. If you have 200 patients enrolled, you're looking at $8,000 to $20,000 coming in each month from this work alone. That's not pocket change. That's a legitimate new revenue stream that exists completely outside the pharmacy benefit manager system. Most pharmacies start small with maybe 25 patients to learn the processes and work out any kinks before scaling up. 1 pharmacy grew to 80 patients in just 4 months and now earns about $6,500 monthly from their program, with plenty of room to grow even more as they refine their approach. Here's what makes this sustainable. The activities that become billable are things your staff already does with patients every single day. Reviewing medications, discussing lab results, connecting specialists with primary care doctors, and teaching patients about their conditions. All of that counts toward monthly billing requirements. Phone calls about medication concerns, care plan updates, checking blood pressure or glucose readings that patients transmit from home, and writing patient notes. It all qualifies as paid time once you set up the proper tracking and