November 15, 2024

Revolutionizing Community Pharmacy: Exploring RTM for Sustainable Revenue

The challenges facing community pharmacy are becoming increasingly apparent. Margins can be razor-thin, and traditional revenue streams like dispensing fees may no longer be enough to sustain the rising costs of operations. Services like medication synchronization and adherence packaging—bubble packs, strip packs, and other innovations—play a vital role in improving patient outcomes. However, these activities are often resource-intensive and expensive, and over time, such efforts may not be feasible without additional revenue streams.

So how does community pharmacy justify the cost of deploying these high-value services while staying financially viable? Remote Therapeutic Monitoring (RTM) could represent a practical solution, pairing the pharmacist’s expertise with collaborative care models to introduce new billable opportunities.

RTM: A Potential Revenue Stream for Community Pharmacy

RTM offers community pharmacists a possible way to monetize their cognitive services in ways that traditional dispensing services cannot. By partnering with billing providers like MDs, PAs, and NPs, community pharmacists can explore incident-to-billing opportunities, leveraging CMS-approved RTM codes. These services allow pharmacists to support adherence measures, manage therapies, and monitor patient progress—all while generating billable events that may help justify the cost of clinical counseling and adherence-focused activities.

Here’s how it could work:

  1. Collaborative Care: Pharmacists work with billing providers to optimize patient outcomes by contributing their drug expertise and clinical skills.
  2. Incident-to Billing: Under the supervision of MDs, PAs, or NPs, pharmacists provide RTM services that may be billable, introducing a potential new revenue stream.
  3. Digital Conversation Support: Tools like Digital Conversation’s Pathways are used for adherence tracking and patient engagement through customized therapeutic messaging which builds another layer of billable services.

Why Digital Conversation Could Be Part of the Solution

Navigating RTM opportunities might seem daunting without the right tools and expertise. Capturing non-physiological data for CPT 98976 and 98977 and documenting time for CPT 98980 and 98981, creating compliant reports, and ensuring adherence initiatives are effective are challenges that should not be overlooked. Digital Conversation aims to simplify this process.

  • Pathways for Adherence: Our messaging platform enables pharmacists to engage patients, reinforce adherence, and collect data that supports billable services CPT 98976 and 98977.
  • Simplified Reporting: We provide tools to document the time pharmacists spend on RTM, streamlining compliance and billing processes for CPT 98980 and 98981.
  • Billing Expertise: With experience in RTM billing models, Digital Conversation can help pharmacies understand and navigate incident-to billing practices.

Pharmacy’s Future: Adapting to New Models

Dispensing fees alone may no longer be sufficient to sustain community pharmacy operations, especially when paired with high-cost, time-intensive adherence measures. Community pharmacies must begin to strongly consider alternative revenue streams like RTM to offset these expenses and leverage the full value of their pharmacists’ expertise.

RTM could represent a path forward, allowing pharmacies to align their clinical activities with billable services. However, implementation requires careful planning, workflow integration, and tools that ensure compliance and efficiency.

Community pharmacy’s future may depend on adopting models that value cognitive services over dispensing volume. RTM has the potential to play a significant role in this shift, and Digital Conversation provides the tools and expertise to explore this opportunity.The question is: Can your pharmacy afford to ignore these exciting new revenue streams or is it time to rethink how you differentiate your community pharmacy and drive more income in this rapidly changing market?