In a world that's gradually moving beyond the pandemic, the pharmacy sector is preparing for another significant disruption. The Centers for Medicare and Medicaid Services (CMS) are set to change the way Direct and Indirect Remuneration (DIR) fees are applied. Instead of being retroactive, these fees will be assessed at the point of sale starting next year. This shift means pharmacies will face a dual impact of DIR fees – a portion retroactively for late 2023 claims and point-of-sale fees from January 1, 2024. With many struggling community pharmacies already facing financial challenges, the question arises whether they can navigate these changes successfully.

The current system's pace of adaptation is insufficient for pharmacies facing burnout and understaffing. The solution isn't merely pushing harder against the headwinds of DIR fees; some innovative pharmacies are considering new business models. Amid this transformation, the concept of pharmacy AI emerges. It's not about adding new technology to existing systems but rather a comprehensive reimagining of how pharmacies operate. Pharmacy AI acts like a helicopter, lifting pharmacies above challenges like PBM control and regulatory shifts. Upgrading with AI can reduce administrative burdens, eliminate clawbacks, and enhance workflow efficiency. This allows pharmacies to refocus on providing care, improving patient outcomes, and boosting profits.

The adoption of pharmacy AI represents a revolutionary shift in healthcare management. For instance, in a Fall flu vaccine clinic, AI can automate tasks like eligibility assessment, appointment scheduling, documentation, and billing. This automation streamlines processes and frees up pharmacists to concentrate on patient care. Beyond clinic settings, AI can also enhance medication adherence by identifying patterns and high-risk cases. The integration of AI aligns patient care, operational efficiency, and profitability.

Embracing pharmacy AI allows pharmacies to overcome the constraints of PBMs and grasp control over their profitability. This transformation empowers them to navigate the upcoming challenges effectively. From enhancing clinic efficiency to improving medication adherence and affordability, AI-driven solutions offer a comprehensive approach. Automation becomes the key to success, relieving pharmacists from tedious tasks and allowing them to steer their businesses towards patient-centric care. With pharmacy AI guiding the way, pharmacies can redefine their role and thrive in this transformative era.


Full article from Pharmacy Times here.

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