Tracing the growth of a pharmacy juggernaut

BY Jim Frederick

In 2006, Health Mart was a loosely cohesive buying and marketing group of 268 independently owned and operated drug stores, falling under McKesson Corp.’s store-support umbrella via its purchase of the old FoxMeyer wholesale business in the mid-1990s. Today, just seven years after its reinvention and relaunch by McKesson, Health Mart is the nation’s biggest independent pharmacy franchise and one of the fastest-growing drug store networks of any kind, with more than 3,100 member stores doing business in thousands of communities across the United States.

It was an idea whose time had come, said Kevin Kettler, SVP marketing for McKesson U.S. Pharmaceutical. Given the massive challenges confronting independents — daunting competition from chain pharmacy, mounting operating and marketing costs, and a shifting healthcare reimbursement system, to name a few — the conditions were ripe for a new kind of high-concept, comprehensive store-support model. One that blended the traditional strengths of independent pharmacy with the sophisticated marketing, merchandising, technology and the kind of clout with payers and pharmacy benefit managers that McKesson could provide through Health Mart.

The concept “clearly resonated” with independents and met “a need in the marketplace,” Kettler said. “When Health Mart relaunched, we had a goal of bringing the local identity and personalized service of an independent together with the recognition of a national brand for payers, patients and manufacturers,” he explained.

Health Mart’s success, Kettler added, derives from “the anchor that is independent pharmacy, and from supporting the core aspects of what our individual pharmacists and pharmacies do in terms of serving their patients.”

The economies of scale provided by corporate parent McKesson are clear in many segments of Health Mart’s business. For instance, Kettler said, “we didn’t have to go build a private-label team” when Health Mart introduced its own line of store-brand OTC products and vitamins in November 2011. McKesson’s store-support team already had developed a very successful private label, Sunmark, and was able to “leverage the capability” to launch the Health Mart brand, he told DSN.

Kettler oversees market strategy, product development and customer programs for all McKesson market segments, totaling more than $90 billion in annual sales, as well as development of store-support programs for both Health Mart and McKesson’s complete universe of independent pharmacy customers.

It’s a growing menu of capabilities, including programs specific to Health Mart — such as the revamped Local Marketing Support program and the consumer-facing online platform and mobile app, Your Pharmacy Online — and the broader suite of services available to all McKesson customers.

“We’re able to leverage the scale of our 6,000-plus independents in certain circumstances where appropriate, and we’re also able to use those capabilities to tailor solutions specifically for Health Mart,” Kettler explained. “So it’s the best of both worlds.”

It goes without saying that the franchisees under the Health Mart umbrella participate more fully in McKesson’s full menu of store-support services, and thus are eligible for the highest level of commitment and services the company has to offer. “There are some [support services] that naturally fall into the Health Mart-only bucket,” Kettler acknowledged.

Examples include the Health Mart private-label program and the newly revamped Local Marketing Support program, “where we’re able to leverage the brand of Health Mart and create the design, writing and advertisements that support our Health Mart franchise.” Also included in that bucket is a variety of recently revamped store design options that puts the focus even more sharply on pharmacy and health services.

Another major benefit available to Health Mart franchisees is priority access to a still-growing arsenal of technological solutions that extend their reach to patients and their peers via mobile, social and online tools. For instance, the Your Pharmacy Online offering provides a turnkey website, a mobile website and a smart-phone app for pharmacy owners, letting patients order refills, receive reminders, or check store information. While the web-site option is available to all independent customers, the smartphone app is currently only available to Health Mart customers.

What’s next for Health Mart? Kettler sees the transformations currently upending the U.S. health system as ultimately of huge potential benefit to pharmacy. Health Mart, he said, “is very well-positioned” for the shift to what he calls an “evidence-based” reimbursement system and “the payer evolution, whether it’s narrow or exclusive networks, or some other system,” he told DSN. “If you look at the relationship and trust our Health Mart pharmacists have established as care providers in the community, combined with the value they bring from a clinical support perspective, we’re very optimistic.”

Seven years into its transformation, Health Mart has grown into a major force in community pharmacy. And with the changes coming under health reform, and the strong leverage McKesson gives Health Mart members among patients, payers and physicians, the next seven years could be even more transformational.


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Health Mart’s operations chief tracks build-up in local support

BY Jim Frederick

Like politics, retailing is local. That inescapable fact is behind the ongoing build-up of Health Mart’s local marketing and patient care initiatives as McKesson shifts more store support muscle to the more than 3,100 independent pharmacies allied with the Health Mart network through its Local Marketing Support Program.

“In the past, we’ve focused a little more on Health Mart as a national brand,” acknowledged Chuck Wilson, VP operations for Health Mart. But this year, he said, Health Mart has modified its national outreach based on its understanding “that our customers have a local presence, so the goal is to take our energies and put them toward supporting them on a local basis.”

To help its franchisees take advantage of Health Mart’s new local marketing offerings, the company modernized its content and provided new tools to let store owners “talk to the population more where they are.” For instance, he said, “we’ve added a lot of social media tools, so if they have patients they want to reach that way, we’ve given them content they can use to make that link with the customer.”

“It’s really important for our customers to get to their patients in the way that they’re used to receiving information, and if that happens to be via the digital medium, then we need to make sure we have the tools for our customers,” Wilson added. “Our pharmacists and owners don’t have the time to invest to figure out how to do it, so we can provide them with the tools to make it easier for them to contact their patients.”

In addition, he said, “we’ve made access to the local marketing support tools a lot easier, and we’ve simplified the process for taking advantage of advertising matching funds that help support some of their initiatives.”

The more links that store owners have with their patients, Wilson added, the more they can “help patients understand all the services available to them.”

In turn, the stronger emphasis on each franchisee’s presence as a locally based community health provider helps drive Health Mart’s national presence, as well. “Our customers are all locally owned, so their identity really exists within their community,” Wilson said. “This helps the brand grow nationally one store and one local market at a time. And, the easier we make it for them to get their messages out, the more we can grow nationally.”

Health Mart owner-franchisees are facing competition that is “bigger and better than ever” in a crowded marketplace, said the operations chief. So defining their presence in the marketplace demands a balanced marketing effort that deftly blends Health Mart’s advantages as a national pharmacy network with the emphasis on each store’s unique characteristics. “It’s important for us to enable our stores to compete in their marketplace, but do it in a way that’s going to match the services they offer, as well as the community in which they operate,” Wilson agreed. “It wouldn’t do a lot of good for us to go out there with some national message that wouldn’t necessarily pertain to the practice they run.”

At the McKesson ideaShare conference in June, Wilson talked about the company’s effort to sharpen the focus on Health Mart owners’ local marketing prowess — and to strengthen their ability to deliver on three key performance metrics:

  • Improving patient adherence, including providing refill reminders and medication synchronization programs that simplify the refill process;
  • Identifying gaps in care — specifically among diabetic patients; and
  • Boosting generic dispensing rates to boost profitability and lower overall health costs.

“We’ve tried to focus on moving beyond transactional health care for a long time,” Wilson told franchisees. “We decided what we needed to focus on were three critical components of health reform.”

Recently, Health Mart also gave its store design its first major, comprehensive upgrade in seven or eight years. “We’ve been operating under the same store design since Health Mart relaunched in 2005 and 2006,” Wilson said. “There have been a lot of changes within retail pharmacy since then — not only on the consumer side and the demands they’re making on the retail setting, but also in the delivery of health care. So we wanted to step back and take a fresh look at this.”

In its bid to modernize the Health Mart prototype, McKesson followed a couple of basic principles — making the store easier to shop and making the pharmacist more accessible.

As the healthcare delivery model evolves, Health Mart continues to focus on supporting its customers’ ability to take advantage of the changes. Simplifying execution and making it easier to advertise the stores’ services is helping to position these pharmacies as an integral part of improving patient outcomes.


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Merging pharmacies’ strengths with an arsenal of McKesson support tools

BY Jim Frederick

“The best of a chain combined with the best of an independent pharmacy.”

That’s how Health Mart president Steve Courtman describes Health Mart’s “unique value proposition in the marketplace.” That value, he added, is defined every day in thousands of communities across the United States by the pharmacy owner-operators who serve as the most accessible and most-utilized patient care providers in their local healthcare networks.

“Local is critical,” Courtman said. “Having a local relationship with a patient is a critical component to improving patient health. Independent pharmacies have the strong relationships that can impact patient care.”

McKesson and its Health Mart support team, he added, are “providing tools for our independent pharmacies to be able to effectively have conversations with their patients about care. But, in order to do that, you have to have that relationship first.”

Courtman said establishing and maintaining those personal relationships at the local level is “very much independent pharmacy’s strength.”

Courtman spoke with Drug Store News in an exclusive dual-interview that also included Mark Walchirk, president of McKesson U.S. Pharmaceutical. Walchirk acknowledged the “tough business climate” that independent pharmacy owners find themselves in as they confront chain competitors, the uncertainties of health reform and the rise of accountable care organizations. However, he told DSN, “it’s also an opportunity to be very optimistic with ‘trends that are going to continue to drive growth for retail and independent pharmacy.’” Among them:

  • Basic demographics, which Walchirk said “are continuing to drive script growth;”
  • The continued conversion of branded pharmaceuticals to generic status, which eats into top-line sales but boosts profit margins; and
  • The trend toward accountable care and rewarding positive outcomes will be a positive impact for independent pharmacy.

McKesson’s task, Walchirk said, is “helping our customers succeed in this evolving environment by providing them with a variety of products and services to improve their pharmacy’s business health and their patient’s health.”

An example product is McKesson’s automated pharmacy management systems, which boost independent operators’ productivity and efficiency, freeing their time to provide better service for their customers.

Allying with such partners as McKesson and Health Mart, Walchirk added, becomes even more urgent in today’s fast-changing healthcare landscape, “as reimbursement moves from fee-for-service to this concept of value-based reimbursement. There’s still some questions about how quickly that’s going to happen and what that is going to look like, but certainly over time there will be a transition to more of an outcomes-based reimbursement system.”

Despite the uncertainty spawned by that fundamental shift, they remain optimistic. “When there are incentives built into the system for pharmacists to play a more active role in caring for those patients and ensuring that they are staying adherent to their medications, there is a tremendous opportunity for independent pharmacy because of the unique relationship those owners have with their patients,” Walchirk said.

Boosting patients’ adherence rates alone, Walchirk added, could generate huge returns — not just for the more than 3,100 Health Mart pharmacies, but for all independents and for a U.S. health system in desperate need of more cost-effective ways of delivering care and keeping patients out of hospitals. “Even small gains in adherence could have very positive impacts for pharmacy, patient’s health and the cost of health care in our country,” Walchirk said.

In addition, he said, the rise of preferred pharmacy networks at the hands of managed care plans will drive changes as “payers, ACOs and physician groups are looking to send their patients to locations that can care for them. And that, again, is the sweet spot for Health Mart.”


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