Innovations and unique opportunities
When the going gets tough, the tough get going.
In the face of declining prescription drug reimbursements and changes in the marketplace, many regional pharmacy chains are heeding this maxim, as evidenced by the innovative strategies they have pursued to promote growth, enabling their pharmacists to practice at the top of their licenses.
The retailers that are having success because of their ability to innovate and become healthcare destinations include Fruth Pharmacy, Thrifty White Pharmacy, The Giant Co., Kinney Drugs, Hartig Drug and Lewis Drug.
Fruth Pharmacy serves West Virginia, Ohio and Kentucky with corporate headquarters in Point Pleasant, W. Va. Drew Massey, Fruth’s director of pharmacy, said that among Fruth’s innovations is the partnership of eight retail healthcare clinics opened in conjunction with local providers.
“These clinics are staffed by mid-level providers providing convenient walk-in care to community based primary care patients,” Massey said.
Fruth also has been innovative in forging a partnership with the state of West Virginia and the West Virginia Drug Intervention Institute to provide Naloxone and drug disposal kits to patients, as well as age-appropriate teaching tools for children and parents.
What’s more, during the pandemic, Fruth Pharmacy worked with the Joint Interagency Task Force, local health departments and many other organizations that pharmacy hasn’t traditionally had a close working relationship.
“Through these collaborative efforts, we have forged the basis for ongoing strengthening of these relationships to serve the communities in our footprint and the states where we are located,” said President Lynne Fruth.
Additionally in West Virginia, pharmacists are permitted to work with smoking cessation and birth control as protocol-based dispensing. “While this isn’t something that is a chain- wide initiative, it is something that our pharmacists can do to serve their patients on a voluntary basis,” Massey said.
If that weren’t enough, Fruth offers a slew of services including prescription dispensing; vaccinations; COVID-19 testing, counseling and therapeutics; vital monitoring; diabetic/fasting blood glucose readings; and much more.
Maple Grove, Minn.-based Thrifty White Pharmacy also is a frontrunner in pursuing innovation to become a healthcare destination.
“We are a technology-enabled healthcare services company focused on utilizing patient engagement to improve outcomes and reduce the cost of care,” said Jeremy Faulks, vice president of pharmacy operations at Thrifty White. “By leveraging the unique capabilities of pharmacists, combined with focused technology and clinical care plans, Thrifty White Pharmacy creates better patient experiences and improved patient outcomes.”
The Thrifty White Pharmacy “suite of offerings” includes proprietary dispensing, clinical and operations technology. In addition, Thrifty White Pharmacy is licensed in all 50 states and offers retail, alternate care and URAC- and ACHC-accredited specialty pharmacy services across a network of 100 owned community pharmacy locations and 90 independently owned pharmacies throughout the Midwest.
Noting that Thrifty White Pharmacy committed to expanding its pharmacies into clinical destinations more than 10 years ago, Faulks said the company has invested in three strategic areas: physical layout, team member expertise and technology. The retailer has remodeled over 75% of its pharmacies in the last 10 years, transforming them into healthcare destinations, with an accessible pharmacist, professional environment and three medical provider-style clinical suites.
Thrifty White also has provided additional training for its teams around clinical activities, including clinical techniques, drug injection training, lab draws and immunizations.
“We’ve partnered closely with both national and local health plans to create programs which leverage our patient- pharmacist relationship, and help the plan achieve desired outcomes such as increasing adherence, closing gaps-in-care, such as missing A1C values and reducing other medical spending,” Faulks said.
Yet another Thrifty White innovation, Faulks said, is a proprietary clinical management platform, dubbed Patientricity, that enables its pharmacy teams to operate within workflow and access clinical interventions seamlessly during the course of their day.
“In the background, we partner with our health plans to create custom programs, then develop criteria, program interventions and desired outcomes within the Patientricity platform,” said Faulks. “The custom PharmacistAI solution combs our data warehouse nightly, identifying patients who are eligible for these services and enrolling them in the specific intervention in Patientricity.”
The Giant Co., which operates in Pennsylvania, Maryland, Virginia and West Virginia, supports 193 grocery stores and 132 pharmacies, also has innovated to become a healthcare destination.
“As a grocery retailer and pharmacy provider, Giant is uniquely positioned to help families live healthy lives. Our pharmacy and wellness teams continue to assist patients manage medical conditions, prevent disease and improve their well- being,” said Leigh Shirley, director of pharmacy operations at The Giant Co.
Giant pharmacy offers vaccinations, medication adherence, medication therapy management, health screenings and more. The retailer also has expanded travel health offerings, such as OTC recommendations and travel vaccines, and increased the number of consultation rooms in its stores.
Kinney Drugs, which has 96 pharmacies in upstate New York and Vermont, is focusing on innovating in the area of medication adherence. Shannon Miller, senior director of healthcare operations, pointed out that the evolution of community pharmacy has ushered in new metrics, technologies and platforms that can be challenging for pharmacists to navigate. “Addressing patient adherence required our pharmacists to interface with multiple platforms,” she added.
Miller explained that Kinney wanted a single, user-friendly platform that would allow its pharmacists to identify non-adherent patients and document their interventions in a consistent, searchable manner. The end goal was to streamline processes while enhancing patient service and improving adherence rates.
The Kinney clinical team worked closely with the development team of its long-time partner, Outcomes, to add a variety of filters and functionality tailored to the needs of community pharmacy.
Kinney served as a beta customer for the solutions Outcomes developed. For the first time, the platform enabled one of its pharmacies to create targeted patient interventions based on its own claims data.
“2022 was our first full year in which our own targeted interventions were co-mingled with third-party interventions within the OutcomesOne platform,” said John Marraffa, Jr., president of Kinney Drugs. “We now have a much more holistic view of our overall intervention and adherence performance.”
Hartig Drug Co., which has 24 retail pharmacies throughout Iowa, Illinois and Wisconsin, and three long-term care pharmacy locations, also is taking the lead in innovating new products and services.
Hartig’s patient-facing services include disease management; automatic refills for maintenance prescriptions; blood pressure checks; and hearing checks.
Charlie Hartig, CEO of Hartig Drug, said the company quickly pivoted to delivering COVID tests, sample collection and vaccines during the coronavirus pandemic. In addition, Hartig Drug continues to provide much-needed regularly scheduled vaccines, from yellow fever to influenza vaccinations.
“With the availability of over-the-counter COVID tests and patient eligibility, Hartig Drug has provided tens of thousands of OTC tests covered under patients’ insurance benefits,” Hartig said.
Another innovative move for Hartig Drug is the expansion of its partnership with InnerScope Hearing Technologies, and the addition of five more kiosks, giving access to free hearing checks and more affordable hearing aid options.
Hartig Drug’s Redi-Refill program also is unique. The program helps ensure maintenance prescriptions are readily available on time and notifies patients that their prescription is ready.
Innovating to become a healthcare destination also is the bailiwick of Lewis Drug, which has 60 locations in South Dakota, Minnesota and Iowa, serving urban and rural areas.
“We currently have six pharmacists embedded in clinics across our footprint, with hopes to continue to expand,” said Bill Ladwig, senior vice president of professional services at Lewis Drug. “They spend their day interacting with patients and providers.
The connections these pharmacists make with patients in the clinic make the transition to our community pharmacy seamless.”
Another important offering is multi-dose adherence packaging, dubbed Lewis Drug SmartPacks, which sort monthly medications into daily, easy-to-open packs. All SmartPacks are color-coded for the time of day when dosing is needed.
Addressing disparities in health is a major focus of regional pharmacy chains. Fruth is a frontrunner in this area.
“We have a single source discount card for uninsured individuals, offer reasonable cash pricing and offer solutions that put us on even footing with competitors,” Massey said. “We work with our communities, state and local government agencies to provide pharmacy services where needed.”
Fruth also provides services for organizations that serve indigent and homeless individuals. This includes delivering hepatitis C prescriptions to homeless shelters and working with shelters to provide vaccinations to patients who are “hard to capture in the retail space.”
“Both Fruth as a company and myself as both a healthcare provider and resident of West Virginia, recognize the need to serve the disproportionately affected
urban areas and our underserved rural communities,” Massey said. “The spot- light shone on this during the pandemic when pharmacy mobilized Boots on the Ground and took patient care directly to those who needed it most, and showed the true capabilities of local pharmacy.”
Massey said he is very concerned about “the growing shortage of pharmacists, the continued closure of local pharmacies due to inadequate reimbursement and recognition of services and allowing these communities to fall by the wayside with widening pharmacy deserts causing the already disproportionate care to move farther and farther away.”
Thrifty White is not sitting on the side- lines when addressing health disparities.
“One of the largest ways we are able to address disparities is by increasing access and availability of care,” said Faulks, noting that data shows that over 50% of patients don’t have a primary care provider.
“Thrifty White partners with our health plans to identify these members, then supports the health plan in closing gaps- in-care, gathering SDOH and HRA data and creating plans to better manage these patients,” Faulks said.
Giant also is no stranger to addressing health disparities.
“The Giant Co. pharmacy teams seek community partnerships to offer clinics and health screenings to underserved populations,” Shirley said.
Over the past two years, the company has partnered with state and federal governments to administer free COVID-19 vaccinations. It also extended its reach beyond its pharmacy walls to provide necessary services in a variety of locations, including schools, churches and even a local zoo to serve underserved populations.
Lastly, Giant offers Guiding Stars, a free, accessible tool for customers to make healthier grocery shopping decisions. “This easy, accessible program helps customers make healthier choices without needing an extensive knowledge of nutritional labels. All items receive a rating from one to three stars with three being the best nutritional value. Customers can see the rating on the shelf tag or product packaging,” Shirley said.
Hartig Drug also is responding with urgency to health disparities. “Most Hartig Drug pharmacies are located in rural communities,” Hartig said, adding that the retailer will continue to expand testing services and vaccination clinics to ensure rural communities have access to vaccines and testing as quickly as large urban centers.
Addressing health disparities also is on Lewis Drug’s radar.
“Lewis Drug has numerous locations where we are the only pharmacy in the entire county in these rural areas,” Ladwig said. “These locations serve as a health- care destination in small communities by providing immunizations, adherence packaging and counseling and medication therapy management.”
So what does the future hold for regional chain players?
Fruth plans to expand its health services to include a point-of-care (test-to-treat) pilot with flu/strep/COVID/rhinovirus.
Faulks said Thrifty White will continue to increase investments in its clinical operations, while Giant’s future entails continuing to explore opportunities to expand health services.
Hartig said the future includes piloting clinical programs through Medicare Demonstration projects, state-sponsored medication management reviews or other clinical programs where pharmacists can impact the community.
Ladwig said Lewis Drug is working on expanding its services to underserved communities by teaming up with a Community Health Clinic to provide medications through the Dispensary of Hope program.
Lastly, Justin Heiser, Thrifty White’s chief operating officer, offered his view of the future: “The ability of the pharmacist to help patients stay-in-home longer and receive appropriate care and interventions will be game-changing in the upcoming several years.”