Examining The Value Trade Between Pharmacies & Diagnostic Providers

The similarities between the pharmacy industry and diagnostic laboratory space are apparent – both provide essential healthcare services, are crucial to maintaining healthy communities, and have a significant presence in America.

Pharmacists in more than 60,000 pharmacies and laboratory professionals in approximately 260,000 CLIA-certified laboratories nationwide work tirelessly to improve patient outcomes. Although professionals from both industries are likely to cross paths, some experts say establishing defined partnerships should be the next step in the evolution of healthcare.

David Pope, Chief Pharmacy Officer, XiFin Pharmacy Solutions met with Molecular Testing Labs‘ Chief Commercial Officer James York and XiFin’s Chief Operating Officer Kyle Fetter to discuss how collaboration between pharmacies and diagnostic providers can improve community health and revenue goals for both industries. The leaders explored the topic at the XiConnect Leadership Conference (XLC).

The XLC is an annual customer conference that delivers market insights, trends, new areas for growth and best practices in revenue cycle management. This year’s conference featured a session on the topic of pharmacies and labs building partnerships called, The Value Trade Between Pharmacies & Diagnostic Providers.

Leveraging Scale and Reach

Although the US may face a shortage of up to 124,000 physicians by 2034, nearly 90% of the population currently live within five miles of a pharmacy, and 83% of pharmacy customers are strongly interested in receiving health and wellness services from their local pharmacists.

“There is something very, very clear in our country, and that is that we have a healthcare desert problem,” David Pope said. “There certainly is a need to leverage the pharmacist – they have scale, reach, and honestly, they’re seeing the patient a consistent number of times per year.”

Despite patients’ openness to visiting pharmacies for essential care, 70% of medical decisions require lab test results. This fact is a primary reason Pope said pharmacies and labs must build solid connections.

“We have an opportunity to leverage the pharmacy. But, as a pharmacist myself, I can truly say that we can’t do that as a pharmacy without certain labs,” Pope added.

Payors Push to Close Gaps in Care

The negative impact of health disparities is apparent to those who work directly with patients. However, payors also face consequences when their customers have gaps in care.

The Healthcare Effectiveness Data and Information Set (HEDIS) score is the most used measure of healthcare performance and improvement for healthcare providers and insurers. Health plan providers risk losing millions of dollars if their records consistently indicate that their members face gaps in care.

“There’s a huge desire right now from payors to establish gap-in-care relationships with the largest retail pharmacies in the country,” Kyle Fetter said. “Payors have recognized that many patients routinely show up at their pharmacies, even if they didn’t go to their primary care doctor.”

Fetter added that payors are actively working to ensure their members do not have gaps in care. But ultimately, pharmacies and labs need committed relationships to close those gaps.

“Payors are going to work up deals with those pharmacies to get a test from a laboratory, prescribe medications, and do other things,” Fetter said. “There is a lot of demand on the payor side to have relationships with pharmacies to cover these gaps – and guess what – those pharmacies need lab relationships to do that.”

Pharmacies & Labs: A Partnership that Could Define the Future of Healthcare

The importance of collaboration between pharmacies and labs became evident during the COVID-19 pandemic. James York said patients’ confidence in pharmacy teams demonstrated the need for labs to establish relationships with pharmacies.

“I think that it’s important to understand that healthcare requires trust, and trust requires good outcomes, and pharmacies have both of those,” York said. “Their ability to engage consumers is at epic levels compared to other traditional healthcare systems. Any lab should place high value in operating where you can seamlessly integrate the delivery of care.”

York added that healthcare innovation depends on pharmacies and labs building defined partnerships.

“With the opportunity in the pharmacies currently, there’s a chance to reimagine how healthcare can occur and how it can engage diagnostics. Pharmacies are currently developing their strategies on how to do that, and labs are part of the strategy. Helping pharmacies understand the workflows on how they engage with the lab on logistics, tech, and R&D is the important next step.”

The Value Trade Between Pharmacies & Diagnostic Providers

The evolution of the healthcare landscape has pharmacy teams and diagnostic providers seeking new ways to provide a seamless patient experience, increase revenue, and maximize reimbursement. One promising avenue for achieving these goals is partnerships between pharmacies and diagnostic providers. Watch our webinar, The Value Trade Between Pharmacies & Diagnostic Providers, to learn more.

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