Archive | February, 2012

Note to Pharmacists re: Charging for MTM and Cognitive Services

18 Feb

A pharmacy colleague recently posted a LinkedIn discussion revolving around the topic of  how much to charge for a face-to-face comprehensive medication review with a patient. A few days later I noticed one of my Twitter colleagues, Carrie Wilkerson aka The Barefoot Executive, also posted on her blog a discussion simply titled ‘What Are You Worth?’ and shared the following story:

“A woman in Paris spots Picasso in a cafe. She begs and pleads him to sketch her…he finally relents, whips out his pad and draws a sketch of her.

She’s delighted. “How much do I owe you?” she asks.

“$5,000,” he replies. 

“$5,000!” she exclaims. “But it only took you 2 minutes!”

“No madam,” he replies. “It took me my life”.

This is what your clients are paying you for… not your time, not your ‘effort’ – rather, your WEALTH of experience, knowledge, information and networks which you have built up over YEARS of study, practice, failures, successes and experience.”

For the most part, pharmacists know what their value is with regards to the pharmacy dispensing function. They know what they currently get paid or can check out salary surveys or just ask around to find out what the going hourly rate is for pharmacists in retail or hospital settings.

When it comes to payment for cognitive services it’s a different ballgame. This is a new and unexplored area for most pharmacists who are starting an independent medication therapy management MTM consulting business. First of all, we’re told by others, even those associated with MTM training sessions, that we should not discuss fees for MTM services. This creates a very nebulous picture of what the going rate for MTM services is or what others are charging. But even more important is the fact that most pharmacists undervalue the cognitive services they provide. After all, we’ve been giving it away for free far too long. How patients value our services, if it’s seen only as ‘free advice’ for the most part, will be very misleading, especially if they don’t understand we could be saving them untold cost and misery from adverse drug events, improving their physical health and well being, or possibly even saving their life.

Another problem is pharmacists tend to look at the ‘market place’ and only see what Medicare part D is reimbursing for MTM comprehensive drug reviews. It’s easy to be pulled into the mindset that this sets the true value of MTM services. Why not look at this as a 75% reimbursement level and charge the balance to the patient as a copay?

It’s like the story of a factory manufacturing consultant who charged $10,000 for getting the equipment operating properly. The factory owner complained that all he did was turn one screw to get it working right. The consultant re-writes his bill to the factory owner showing a $1 charge for turning a screw and $9,999 for knowing which screw to turn.

Other health care team members can provide a comprehensive drug review. But pharmacists are the health care team member trained to know ‘what screw to turn’ when there are problems with a patient’s medication therapy. And they should get paid at a rate compensating them for their life spent learning and practicing the art of pharmacy.

So ask yourself this question… What Are You Worth?