STRATEGY

Northern Maine Medical Center (NMMC) has always embraced a diversification strategy to help it stay independent and fiscally sound. NMMC serves a small rural community of 15,000 people in the St. John Valley along the Canadian border.

“Over the years, we have developed an inpatient psychiatric unit, purchased a long term care facility and partnered on a home health care agency,” said Alain Bois, chief operating officer. “When the owners of a retail pharmacy 20 miles away in a neighboring community approached us about buying it from them, we were open to looking at the business model. We already had a satellite facility there and it was in line with our goal of ensuring access to services that community needed.”

“For us, it was a convenience and continuity of care issue for our community,” said Scott Richards, director of pharmacy. “In today’s environment, it’s important to make our services as convenient for patients as possible. It’s also important to manage medications after discharge. We are one of the poorest counties in Maine, so, for some, it’s an affordability issue. When people are discharged from the hospital, they are tired and often don’t stop to pick up their prescriptions. They may not understand how to take them. Prescription abandonment is a big problem, not just here but across the country. We saw patients coming back to the hospital sicker than when they left. As a facility, we wanted an innovative solution that went beyond the hospital’s four walls.”

In order to execute the purchase, NMMC created a team comprised of human resources, information technology, finance, pharmacy, marketing and administration. NMMC’s auditing team looked at the books to ensure the financial aspects were in line with the medical center’s goals.

The more the team vetted the strategy, the more they began to realize the many benefits of acquiring a retail pharmacy. “Our plan was to implement a “beds to meds” pathway and get that started right away,” Richards said. In May 2018, NMMC’s purchase of the pharmacy was finalized. The transition included getting contracts signed with pharmacy benefit managers, converting staff to NMMC employees, ensuring compliance with Medicare and securing accreditation for durable medical equipment services. “It was a learning experience for us,” Bois noted.

One of the biggest advantages for the retail pharmacy was having full access to NMMC’s electronic medical record, allowing pharmacists to log on to review each patient’s health information. “This is a retail pharmacist’s dream,” said Richards. “Usually a drug store pharmacist only sees a prescription with the name of the patient and physician, the medication and dosage. Now they have access to all the information the clinical pharmacist sees in the hospital: diagnoses, the doctor’s progress notes, lab results, other medications and discharge instructions.

This information now allows them to close the loop on compliance to help them help the patient. Having access to the medical records also prevents many medication misadventures.” Pharmacy services are now integrated into discharge planning, helping to ensure that as patients leave the hospital, the retail pharmacy has the prescribed medications in stock. Equally important, hospital staff can assess in advance if patients can afford the medications and whether they have transportation to the pharmacy.

Service: A key differentiator

Bois said the retail enterprise is more of a boutique pharmacy than chain drug stores where the focus is on selling alcohol, cosmetics, lottery tickets and other high-profit items. “Our retail pharmacy is more private and personalized. It has consultation rooms where our pharmacists can educate patients on their prescriptions.” The pharmacy also serves as a community resource center where hospital staff provide a variety of free services in its conference room, including prevention and wellness education, immunizations and education on Medicare coverage options. An onsite financial counselor assists with affordability. “We can help patients qualify for 340-B cards for discounts on prescriptions if they don’t have insurance.

NMMC’s retail pharmacy offers a home delivery service to all cities within a 20 mile radius. Medication management is also a priority for NMMC’s retail pharmacists. Patients can request to have their medications packaged in dis-pill packets, which are blister packs that organize their pills by time of day and day of the week. When NMMC acquired it, the pharmacy was filling 800 prescriptions a week; it is now filling over 1,000 a week.

Promotion

To promote the launch of the pharmacy, the marketing team created a promotional brochure and scheduled an open house and ribbon cutting for the community. A series of educational programs on various health-related topics were also held at the retail pharmacy on an ongoing basis.

Plans for Expansion

Richards said the retail pharmacy has offered so many advantages to patients, there are now plans to add one onsite at the medical center. “Having our own retail pharmacy here will finally allow us to implement a ‘beds to meds’ care pathway. We will be able to educate patients on their prescriptions and how to use them before they leave, and they go home with the ones they need. They can also refill them here, if they so choose.”

NMMC plans to expand the prescription delivery service to employees at the hospital. In addition, it is developing a program for patients in the medical center’s 45-bed long-term care hospital and rehabilitation facility. NMMC also intends to enhance its medication therapy management program for high-risk patients, providing more individualized care to individuals with complex needs.
“Enhanced patient care is the main driver for this strategy, and, in that way it aligns very well with our organizational strategic plan.” Bois said. “By tracking quality measures such as medication reconciliation and readmission rates, we expect to see improvements in our population’s overall health status.”
 

This article features interviews with:
Alain Bois
Chief Operating Officer
Northern Maine Medical Center
Fort Kent, Maine

Scott Richards, D.Ph.
Director of the Pharmacy
Northern Maine Medical Center
Fort Kent, Maine