Ohio's largest Medicaid provider cuts ties with Walgreens

[maria1oh]

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[MilknCheerios]

I'm not able to actually read the article because the site wants me to pay for a subscription. However, I assume Walgreens is leaving because reimbursements from the PBM (probably Caremark) is too low to break even on prescriptions. While this will allow Rx staff to do more productive work such as SATR and NTT calls or focus on more profitable RXs, the decrease in volume may lead to lower hours for staff as well. Unless other pharmacies plan to fill in the gaps found in rural areas, you may have decreased patient outcomes in the form of "pharmacy deserts." It's kind of a lose-lose for all parties except maybe independents can gain a small foothold.

 

[angelsplight]

I'm not able to actually read the article because the site wants me to pay for a subscription. However, I assume Walgreens is leaving because reimbursements from the PBM (probably Caremark) is too low to break even on prescriptions. While this will allow Rx staff to do more productive work such as SATR and NTT calls or focus on more profitable RXs, the decrease in volume may lead to lower hours for staff as well. Unless other pharmacies plan to fill in the gaps found in rural areas, you may have decreased patient outcomes in the form of "pharmacy deserts." It's kind of a lose-lose for all parties except maybe independents can gain a small foothold.

Pretty much. I read this by opening it on Firefox and stopping the load before that stupid popup appeared. All of these patients will probably end up being shifted to CVS because independents will not bother with those reimbursements also so CVS will further monopolize the pharmacy business at the cost of their pharmacist being extra miserable.

 

[PharFromNormal]

Caresource moves to express scripts after complaints about caremark.

 

[VictorOfHungerGames]

Good. Maybe this could be the start of abolishing PBMs and their secretive DIR fees.

 

[wagrxm2000]

Pretty much. I read this by opening it on Firefox and stopping the load before that stupid popup appeared. All of these patients will probably end up being shifted to CVS because independents will not bother with those reimbursements also so CVS will further monopolize the pharmacy business at the cost of their pharmacist being extra miserable.

I don't think you are using monopolize correctly.

You realize there are insurances CVS isn't contacted with too right?


State Sen. David Burke, R-Marysville, chairman of the Senate's Health, Human Services and Medicaid Committee, said the move sends a "very strong signal" that serving Medicaid patients is a money-losing proposition for Ohio pharmacies.

It was a very good read and shows how pharmacies and Independents are being screwed right now.

I'm proud of Walgreens saying no.

 

[MilknCheerios]

I'm proud of Walgreens saying no.

Seconded. The bottom line is that Walgreens is a business. Walgreens isn't a charity; it has to make more money than it spends to stay in business.

This is similar to how express scripts and Walgreens "broke up" in 2011 because of reimbursement rates, and it's high time the regulation hammer be dropped on these PBMs. I didn't vote for Trump in 2016 and I don't think he's doing a good job at all, but if he does something about these PBMs, he'd have my vote.

 

[Sine Cura]

The more accurate title would be "Walgreens cuts ties with Ohio's largest Medicaid provider"

I would suspect the fact that CareSource is switching to Express Scripts in 2020 is a major reason Walgreens won't take that Medicaid plan.

Walgreens in my county accepts only 1.8 percent of all Medicaid managed care enrollees (those enrolled in Aetna Better Health). n = 427,146 in a county of ~1,500,000 people. The one plan with ESI as the PBM represents ~40% of all managed care enrollments. Walgreens doesn't take that and doesn't take the other 3 "local" plans that use CVS Caremark as the PBM.

Again why would Walgreens give a crap about "access" or "pharmacy deserts." If you live in a rural area, you have a motor vehicle or else you won't be able to get around. If you live in an urban area, there are enough pharmacies around unless you think living over a mile away from a pharmacy means you live in a "pharmacy desert."

Let the competitors soak up those scripts they don't even want.

 

[PharFromNormal]

So since the dispatch started reporting on this has the situation gotten better or worse in Ohio? Seems express is offering even worse (but transparent?) reimbursement than caremark?