Getting Paid for Performance-Based Care

Independent pharmacy owners Richard Stryker, RPh., (Bayshore Pharmacy) and Theresa Tolle, BPharm, FAPhA,  (Bay Street Pharmacy) join PQS host Rosalyn Otting, PharmD, to break down how performance-based care is reshaping pharmacy revenue. They cover the three keys to getting paid for clinical programs: prioritizing opportunities, fitting them into daily workflow, and scaling them for growth. Topics include MedSync as the anchor for clinical billing, quarterly check-ins and on-time-fill bonuses, point-of-care testing (blood pressure, A1c), pay-for-performance networks tied to Medicare Star measures, and staff buy-in strategies for rolling out new programs. The episode closes with a look ahead to 2027 Star Rating changes, including a new depression screening measure, and where pharmacists see the biggest opportunities over the next 3-5 years, from cardiovascular screenings to maternal health and community-based care.