DIR Fees – Here’s What You Can Do for Your Pharmacy Today
Direct and Indirect Remuneration (DIR) fees were created by the Center for Medicare and Medicaid Services (CMS) to keep tabs on events that could affect the overall cost of prescription medications for Medicare Part D plans and, ultimately, offset those costs. The end result of DIR Fees was to reduce wasteful expenses tied to Medicare Part D prescription costs and save patient’s money on their prescriptions.
Since their implementation, Pharmacy Benefit Managers (PBMs) have used these fees as a way to:
● Reduce administrative costs for insurers
● Validate a patient’s eligibility
● Administer plan benefits and
● Negotiate costs between pharmacies and health plans
However, with little transparency in how these fees are justified and applied, pharmacies, patients, and healthcare systems have seen a rapid rise in prescription medication costs.
The impact of DIR Fees on an independent pharmacy’s bottom line can be staggering but, to be perfectly transparent, some of these fees are directly tied to a pharmacy’s performance. And that means you can take an active role in helping to reduce these fees.
So, what can your pharmacy do? Well, we’ve done some digging and have a few suggestions on ways to protect your pharmacy –– and patients –– from increased prescription medication costs.
Do Understand the Contracts You Sign – Most contracts that include DIR fees contain language that’s meant to confuse. Be proactive in understanding the specific language included in your contracts so you can understand the DIR liability you’re accepting.
Offer Medication Therapy Management – Medication Therapy Management (MTM) is an in-depth, high-quality service that helps develop and strengthen relationships between your pharmacy and patients. When high-risk medications are managed, the pharmacist can touch on the importance of adherence with their patients, reducing the risk of non-compliance and increasing the likelihood of positive patient outcomes.
Offer Medication Synchronization – This is a big one. Medication Synchronization (MS) is another way to steer patients in the direction of medication adherence. This service reduces the patient’s risk of missing doses and forgetting refills while also working to develop better relationships and communication with customers. Medication synchronization is another tool that can help you decrease the risk of medication non-compliance and increase positive outcomes. And it’s one to which you should pay close attention
Cultivate Medication Adherence – One of the biggest factors in a patient’s readmission to a hospital setting is medication non-compliance. When medications aren’t taken on time, or as prescribed, their efficacy is greatly inhibited or negated all-together. By implementing MTM and MS services, your pharmacy can reduce the likelihood of readmission and increase the chances of a patient recovering (or successfully managing) their illness.
Improve Patient Outcomes – As stated in the preceding suggestions, improved patient outcomes can be a huge player in how a pharmacy’s performance might be ranked, ultimately affecting how DIR Fees are incurred. MTM and MS services help improve medication adherence which can lead to an increase in positive patient outcomes.
Pharmacists and pharmacies already understand the detrimental effect DIR Fees can have on their ability to provide quality patient care and still run their businesses. And, over the years, DIR Fees have grown, exacerbating the problem. But, with a little forethought and a lot of planning, you can improve your pharmacy’s standing in the healthcare community, bolster your patient communications and relationships, improve outcomes, and reduce your risk of being assessed additional DIR Fees.
If you’re a pharmacy dealing with runaway DIR Fees and would like to keep up-to-date with their legislation and changes, consider partnering up with companies like alliantRx. We’re dedicated to helping you maintain the health of your patients, keep your stakeholders satisfied, and improve your pharmacy’s bottom line.
If you’re not a member yet, join us. If you are a member, make sure you’re leveraging your benefits and maximizing your pharmacy’s success.