Health plans

Here’s how to find a cash flow solution that works

Customers are looking for ways to save money on prescriptions, but charge cards and coupons could hurt your bottom line. Here’s how to find a sustainable spot pricing solution that works for you and your customers.

Seeing more customers paying cash at your counter? This scenario could be on the rise as more employers offer high-deductible health insurance plans (HDHPs). As patients continue to look for savvy ways to save money on their prescriptions, community pharmacists need to be ready with a cash-priced solution that satisfies price-sensitive customers without hurting the bottom line. Here’s what to look for in a spot pricing solution.

HDHPs are on the rise and customers are looking for alternative payment methods.

A recent analysis found a 13% increase in the number of people on HDHP in recent years. This means that more and more pharmacy customers are paying attention to the spot prices of their medicines. An HDHP is treated as a separate health plan in which more costs are paid out of pocket (the deductible) before the plan begins to cover eligible costs. The IRS sets minimum deductibles to define an HDHP; the minimum deductible in 2022 is $1,400 for an individual and $2,800 for a family.

And yet, studies have shown that actual franchises can be consistently over $4,500 for a family— greatly exceeding these minimums.

The rise of HDHPs could increase the need for a solution for cash-paying customers. A recent survey of consumer attitudes towards prescription drugs found that 57% of respondents had asked for the cash price at the pharmacy counter, even though they had insurance. And even with this assurance, 66% of respondents think they paid too much. Clearly, customers are likely looking for ways to save money, which could mean paying in cash or with popular savings cards.

Cash cards and coupons can hurt the pharmacy’s bottom line.

Many patients have likely turned to popular prescription savings cards, such as GoodRx, to offset high drug costs and their deductibles. But as so many pharmacists know, these cards can hurt business.

Many charge card programs charge processing fees, which can significantly reduce pharmacy profits, especially for small independent stores. And like some pharmacists and pharmacist-owners highlighted in 2021when Surescripts and GoodRx announced a partnership, coupon programs”enable PBMs (pharmaceutical benefit managers) to enter the cash payment marketworking within a system that has been accused of masking the true cost of drugs.

Taking the guesswork out of cash pricing will help pharmacies succeed.

But how do you find a solution that works for you and your customers? Look for the following attributes:

  • Transparent feesless than $1 per transaction/claim, billed only for paid claims with no additional voiding or hidden pharmacist fees.
  • Predictability through guarantees or risk minimization.
  • A sustainable model which offers competitive prices to patients while preserve the profitability of the pharmacy.
  • Security for patient data through technologies such as blockchain.

As consumers continue to look for ways to save money on their prescriptions and seek alternative payment methods, it is essential that pharmacists have a spot pricing solution. It’s just one more way for pharmacies to engage customers, win new ones, stay profitable, and continue to provide the essential community support that only trusted pharmacists can provide.

About the Author

Paige Clark, RPh, is Vice President of Pharmacy Programs and Policy at Pre-encrypted, overseeing the company’s policy work to increase awareness, use and reach of trusted independent pharmacists nationally. Prior to Prescryptive, Paige spent 11 years at Oregon State University’s College of Pharmacy leading policy initiatives for licensed pharmacists in the state, including prescribing birth control and smoking cessation services. Paige has also worked as a consulting pharmacist for the Oregon Pharmacy Board, managing rule writing, legislative efforts, and regional and national policy work. She is a frequent speaker and presenter at national industry conferences and the recipient of several awards, including multiple Pharmacist of the Year honors.

Sources

High-deductible health plans continue to grow in popularity, but are they right for you?Value Penguin by Lending Tree, accessed March 17, 2022.

What are HDHPs and HSAs? Healthcare.gov, accessed March 17, 2022.

2020 Employer Health Benefits Surveykff.org, accessed March 23, 2022.

High-deductible health plans and access to prescription drugsPAN Foundation, accessed March 17, 2022.

Consumers suffering from high prescription prices, ready to act and needing better tools, according to a survey by Scripta InsightsPRNewswire.com, accessed March 17, 2022.

Independent pharmacists are sounding the alarm over Surescripts, GoodRx partnershipmobihealthnews.com, accessed March 17, 2022.

Copy of letter to Surescripts board membersmedcitynews.com, accessed March 17, 2022.