Results underscore need for nationwide recognition of pharmacists as providers
OmniSYS, the pharmacy division of XiFin, Inc., announced the findings of its inaugural Pharmacy Transformation Research study which explores the evolving landscape of pharmacy services and efforts to meet consumer needs, and improve access and equity in healthcare. Launched in November 2023, the study delved into pharmacy expansion, garnering key insights from more than 500 respondents representing a wide array of pharmacy professionals and organizations.
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41% of respondents currently offering diabetes self-management training, 35% offering birth control, contraceptive, or hormonal consultations and 34% offering test and treat (Flu, COVID, Strep) services indicated collections rates of less than 50%. Moreover, this low average collection rate was pervasive across all reported clinical services. (Graphic: Business Wire)
- Nearly 75% of respondents tagged an expanded role for pharmacists to fill the primary care gaps as a top growth opportunity. A greater focus on pharmacies as health and wellness destinations was also highly touted.
- Excluding immunizations, 81% of participants indicated they had already started offering clinical services. However, over 70% of these respondents reported that reimbursement was a barrier to expansion, while 61% said medical billing capabilities were.
- 41% of respondents currently offering diabetes self-management training, 35% offering birth control, contraceptive, or hormonal consultations and 34% offering test and treat (Flu, COVID, Strep) services indicated collections rates of less than 50%. Moreover, this low average collection rate was pervasive across all reported clinical services.
“At XiFin, we recognize and advocate for the pivotal role pharmacists play in providing critical healthcare services, particularly for underserved communities, and we believe their potential for expanding access and care is immense,” said XiFin Chief Pharmacy Officer David Pope, PharmD, CDE. “But with billing collection often below 50% for clinical services, significant challenges remain. That’s why we are committed to investing in primary research to better advance our technology and services to effectively support the evolving role of pharmacists by gaining deeper insights into the challenges, opportunities, and trends shaping pharmacy practice.”
Key Highlights
The findings, including specific clinical service expansion that pharmacies are planning over the next three years, provide valuable insights for policymakers, industry professionals, and healthcare providers seeking to navigate the evolving landscape of pharmacy services.
Challenges and Opportunities: Financial challenges, medication shortages, medical billing reimbursement, and workforce concerns emerged as top challenges. At the same time, there was significant interest and optimism in the potential for pharmacists to play a larger role in supporting chronic care management and enhancing patient services.
Clinical Services Currently Offered: The study provided a baseline understanding of the state of clinical services in pharmacies, with nearly 75% of participants currently offering immunizations, nearly 43% providing chronic care management, 39% providing durable medical equipment, and 33% delivering health and wellness consultations.
Emerging Opportunities and Predictions: With pharmacists increasingly seen as filling primary care gaps and contributing to health and wellness destinations, the shift from fee-for-service to value-based care was cited as a significant opportunity. Additionally, respondents expressed interest in diabetic education classes covered by insurance, digital health and wearables, expanded telehealth and telemedicine services, long-term care at home, and pharmacists as clinical providers billing insurance carriers directly.
Barriers to Expansion: Reimbursement challenges, staff shortages, and regulatory limitations were identified as significant barriers to clinical service expansion. Free-form responses highlighted concerns including, workforce shortages and organizational resistance to clinical service expansion.
Revenue Impact of Clinical Services Expansion: A substantial 25% of respondents indicated a moderate to significant increase in revenue with the expansion of clinical services. Specialty pharmacy, chronic care management, diabetes self-management training, and health and wellness consultations were identified as areas with the highest revenue potential.
Access a webinar that discusses more survey results and recommended strategies, or request a copy of the report. Pharmacy organizations can also request a customized version of their results compared to the aggregated results.
Survey Methodology
The research was conducted using an enterprise-grade online survey. Responses were captured from 534 pharmacists and pharmacy professionals in operations, clinical services, revenue cycle management, finance, accounting, administration, executive management, payor relations or market access. They represent diverse pharmacy types (independent and small, medium, and large chains), specialty, ambulatory care, hospital outpatient, long-term care, and mail-order pharmacies.
About OmniSYS | XiFin Pharmacy Solutions
OmniSYS is the pharmacy division of XiFin, Inc. It is a technology provider focused on helping pharmacies achieve a stronger financial base and optimized and automated workflows. From stronger finances to streamlined operations and industry-leading business strategy, OmniSYS gives pharmacies THE POWER TO DO GOOD™ for the communities they serve. With over 25 years of experience, we leverage our unique market insight, pharmacy workflow expertise, and extensive industry knowledge to deliver valuable solutions to our customers. We provide medical billing, pharmacy workflow enabled solutions, and patient engagement software for pharmacies. Our patient engagement capabilities can identify immunization or other clinical service opportunities within the pharmacist’s workflow, which drives value and delivers real results. OmniSYS currently serves over 30,000 pharmacies, connects to hundreds of payors, and touches millions of patient lives. For more information, visit us at www.OmniSYS.com or XiFin.com, or follow us on LinkedIn.
About XiFin
XiFin is a healthcare information technology company that empowers healthcare organizations to navigate an increasingly complex and evolving healthcare landscape. Through innovative AI-enabled technologies and services, we deliver operational efficiency, interoperability, and simplicity. The company’s laboratory information system, revenue cycle management, clinical workflow enablement, and patient engagement solutions enable organizations to achieve stronger finances, streamline operations, and develop industry-leading business strategies. XiFin solutions deliver THE POWER TO DO GOOD™ so that healthcare organizations can do more good for more patients. Visit www.XiFin.com, follow XiFin on LinkedIn, or subscribe to the XiFin blog to learn more.
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Audrey Chang
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a.chang@togorun.com
