Unlocking Revenue Potential with AB1114 Medi-Cal: Pharmacist Services

In recent years, the role of pharmacists has evolved from simply dispensing medications to becoming integral players in the delivery of healthcare services. This shift gained significant momentum in California with the passage of Assembly Bill 1114 (AB1114), signed into law in 2016 and enacted in 2017. AB1114 marks a pivotal moment for independent pharmacies, presenting an opportunity to expand their service offerings and revenue streams. Here’s what you need to know about AB1114 and how it can transform your business.

The History Behind AB1114

AB1114 was introduced to address a growing need for accessible, cost-effective healthcare solutions. Recognizing pharmacists as highly trained and often underutilized healthcare professionals, the California legislature aimed to integrate them more fully into the state’s Medi-Cal program. With widespread support from the pharmacy community, healthcare advocates, and policymakers, the bill was approved to compensate pharmacists for providing certain clinical services to Medi-Cal beneficiaries. This legislation officially went into effect on January 1, 2017, marking the beginning of a new era in pharmacy practice.

What Does AB1114 Mean for Pharmacist Services?

Under AB1114, Medi-Cal recognizes and reimburses pharmacists for providing specific clinical services. These services include:

• Medication Therapy Management (MTM): Ensuring patients’ medications are optimized for safety and efficacy.
• Tobacco Cessation Counseling: Providing guidance and support to help patients quit smoking.
• Immunizations: Administering vaccines beyond the seasonal flu shot.
• Diabetes and Hypertension Management: Monitoring and educating patients to better control chronic conditions.
• Naloxone Distribution: Educating patients and dispensing naloxone to combat opioid overdoses.

The reimbursement rates are comparable to those of other healthcare providers, ensuring fair compensation for the time and expertise pharmacists bring to patient care.

Adding Value to Independent Pharmacies

For independent pharmacies, AB1114 is not just a regulatory milestone—it’s a business opportunity. Here’s how it adds value:

1. Diversified Revenue Streams: By billing Medi-Cal for pharmacist-provided services, you can supplement your traditional dispensing revenue. This is especially crucial as profit margins on prescription drugs continue to shrink.
2. Enhanced Patient Loyalty: Offering clinical services builds stronger relationships with patients. When you become a trusted advisor for managing chronic conditions or administering vaccines, patients are more likely to choose your pharmacy over competitors.
3. Increased Foot Traffic: Promoting your new services can attract Medi-Cal patients who might not have visited your pharmacy otherwise. Once they’re in the door, there’s potential to cross-sell other products and services.
4. Community Health Leadership: By addressing local healthcare needs, independent pharmacies can position themselves as indispensable pillars of community health. This can lead to partnerships with local organizations and healthcare providers.

How to Maximize This Opportunity

To fully leverage AB1114, independent pharmacies should consider the following strategies:

1. Train Your Team: Ensure your pharmacists are equipped with the skills and knowledge to deliver eligible services. Offer continuing education and resources to keep them up to date.
2. Implement Billing Systems: Invest in software that simplifies Medi-Cal billing for clinical services. Efficient systems will reduce administrative burden and ensure timely reimbursements.
3. Market Your Services: Spread the word about your expanded offerings. Use in-store signage, social media, and local advertising to educate patients about the new services available to them.
4. Collaborate with Providers: Build relationships with local physicians and healthcare organizations. Referrals from providers can significantly boost service utilization.
5. Monitor Performance: Track the financial and clinical impact of these services. Use metrics to identify what works and refine your approach over time.

Thought-Provoking Ideas for Revenue Growth

AB1114 opens the door to numerous possibilities, but success requires a proactive approach. Here are some ideas to spark innovation:

• Group Clinics: Host regular group sessions for diabetes education, smoking cessation, or other common needs. These clinics are billable under Medi-Cal and foster community engagement.
• Telehealth Services: Partner with telehealth platforms to offer virtual consultations for Medi-Cal patients, expanding your reach beyond your immediate area.
• Specialized Programs: Develop niche programs for underserved populations, such as mental health medication management or maternal health support.
• Health Screenings: Offer screenings for blood pressure, cholesterol, and other conditions, creating an entry point for broader clinical services.

Conclusion

AB1114 is a transformative opportunity for independent pharmacies to expand their services, increase revenue, and enhance patient care. By embracing this legislation, you can redefine your pharmacy’s role in the healthcare ecosystem and ensure long-term success in a competitive market.

Get Started with RxBB

Navigating the complexities of AB1114 can be daunting, but you don’t have to do it alone. RxBB offers a comprehensive platform designed to help independent pharmacies implement and optimize services under AB1114. From streamlined Medi-Cal billing to tools for managing patient care and tracking performance, RxBB simplifies the process so you can focus on what matters most: your patients.

Ready to take the next step? Contact RxBB today to see how we can help your pharmacy thrive in this new era of healthcare.