Video: Medicare Advantage & Your Patients: What Pharmacists Need to Know | Duration: 3600s | Summary: Medicare Advantage & Your Patients: What Pharmacists Need to Know

Transcript for "Medicare Advantage & Your Patients: What Pharmacists Need to Know": Welcome to today's webinar hosted by Enliven Health. Our topic today is Medicare Advantage and your patients, what pharmacists need to know. Thanks for joining us today. First, some housekeeping items. Please type your questions in the q and a tab to ask questions throughout the presentation. We'll be sure to answer your questions during the dedicated q and a session at the end of our time together. We are recording this webinar and will email the recording to all attendees. And now I'm delighted to introduce our webinar speakers. Marvin Gordado has worked with community pharmacies for over 10 years. He started at AmpliCare in 2015 where he held several notable roles. Marvin currently leads Enlivant Health's customer enablement team for Medicare match. He ensures customers are set up for success and contributes to the product road map by aligning market expectations with product capabilities. Greg McKenna is an accomplished healthcare executive, pharmacist, and attorney with extensive experience in pharmacy operations, healthcare consulting, and business leadership. As CEO of Nutmeg Pharmacy, he has grown a successful chain of independent pharmacies specializing in senior care and vaccinate vaccination services. With degrees in pharmacy, health care finance, and law, Greg combines clinical, financial, and legal expertise to drive innovation and operational excellence. Recognized with the National Immunizer Award, he's dedicated to advancing health care standards. And without further degree delay, I'll hand it over to Marvin. Jeez. Greg killed my resume. Yeah. Thank you. Hey, everyone, and thanks for for joining our Medicare Advantage webinar today. We're gonna talk about how pharmacies can help, patient with comparing and choosing medicare advantage plans and the timing is is right The Q1 of the year is when all medicare Advantage patients can switch to another medicare advantage plans. So you may not know about this special enrollment period Of course, everyone knows about the fall or it's annual enrollment period Everyone can switch but this Q1 of the year, it's called medicare advantage open enrollment period runs through March 31st And, you know, these plans can be nuanced. So, there's a little bit more to them than stand alone Part d. But with the right knowledge, the right strategies, the right talking points for your patients, they can have significant value for them, for patients, and then there's opportunity, for the pharmacy as well. So our guest today, as Nikki said, is Greg McKenna from Nutmeg Pharmacy in Connecticut, has a lot of experience, not only with our application and doing medicare plans, but also medicare advantage plans. So greg If, you wanted to tell us a bit about yourself and your pharmacies So, you know, again, greg McKenna and, we have we started off as a retail pharmacy and quickly advanced into, the assisted living, group home, you know, residential care space. I have previously run the, actually, the largest long term care practice in, the northeast at one point in time under the medicine center concept. You know, but I really truly saw as when we started the retail side, you could see the importance and the value of, of, you know, getting involved with people and making these decisions. So, you know, really, it was a natural evolution to begin to start understanding, you know, how I could sit there and talk with people. And quite frankly, that's where Amplicare you know, I know you weren't expecting me to say this, but, you know, that's where Amplicare actually became, you know, really, a wonderful, partner in helping us, now become more to our clients than just dispensers of medication and information. So that's what we're about. Absolutely. Yeah. Thanks, Greg. And to all of you, you know, some of you may know us as AmpliCare, so we're on the Enliven Health. Yeah. Yeah. I'm sorry about that. No. No. Definitely a good opportunity to connect the 2. I know there's a lot of consolidation in the industry. So, yeah, we're a product within the product suite of, Enlivant Health. So so, yeah, I mean, AmpliCare, you go that's how far you go back. Right? That's exactly right. But, yeah, Greg, we'll dig a little deeper into your expertise in in just a few minutes. And, before that, let's take a quick look at the agenda so everyone knows what to expect during the next few minutes. Learn a little bit about us at enliven health kind of gave a little bit there with the enliven suite and then understanding the basics of different types of medicare options And how to help patients find a suitable plan, and then we'll conclude and close out with some q and a. So feel free to, type up some questions in the chat that we'll, either address through the web throughout the webinar or or at the end. And, so so the mission, you know is is simply put is we want to, be the innovation hub right that bridges health and care at the pharmacy and we have a lot of pharmacists Pharmacy techs on the team with a ton of retail experience, right? So they're bringing that experience and looking to solve those same problems and are passionate about empowering, their peers and, you know with that, let's dive into the the basics and the difference between original medicare and medicare advantage just wanted to kind of set those those basics up and Again original medicare includes part a that covers hospital care part b covers medical care It provides a broad access to providers so patients can see any doctor who accepts Medicare. But it doesn't include prescription coverage. So patients often need to add a separate a part d plan, which they, purchase through private insurers like Humana united health wellcare and the medicare advantage, is a private alternative that bundles all of that right part a part b part d Into one plan and, these plans could have additional perks like dental vision wellness OTC benefits and the trade off Is that advantage plans operate within provider networks right similar to like maybe how your insurance where you have to go to a particular doctor that's in the plan's network. And one of the standout benefits, I'd say, of Medicare Advantage and why it's grown so much is the maximum out of pocket limit. So with original Medicare, you don't have that. The cap it helps protect patients from catastrophic Financial situations, so you know on their original medicare part b covers 80 of medical cost but that leaves patients responsible for 20% that 20% could be based off a very high number if a patient needs extensive surgeries Or hospital stays again that becomes a very large number that can potentially drain Resources or you know, we've heard stories of how some people have gone bankrupt because of health costs as they age, right? So that's an important consideration when looking at advantage plans and and from what I've seen It's rare for pharmacies to rose for I'm sorry for people to really just be on original medicare without having a medigap plan or medicaid. And, you know, advantage advantage plan can provide that out of pocket cap so patients know, hey, I'm not gonna pay any more above this amount, and that's a peace of mind for them. But if you're speaking to patients on original medicare that don't have a medicap don't have medicaid It's important for them to understand that advantage plans do have this cap and, they have an advantage in this in this area. So, you know, break it down simply. If you can afford as a Medicare beneficiary, if you can afford a patient the premiums for traditional Medicare and Medigap, that's typically gonna be the best coverage. You can have freedom to see any doctor who accepts Medicare. And then most Medigap plans offer coinsurance costs and sometimes even the deductible. So that really doesn't leave you with any out of pocket cost, but the downsides is that premium cost. Right? So you're paying for security in that sense. So monthly premiums can be significant and they rise each year. So for example in 2025 the part b premium is 185 Part d premiums then they've increased right? We've seen them go up 50, 60, 70, $80 the last couple of years. And WellCare offers a $0 premium option for Part d, but it's only a good fit for patients that are taking common, generics. So if you have a patient that's has more complex needs, especially with brand name drugs, there's gonna be an AARP plan, which has a higher premium but a more expansive, formularies. So so, again, really breaking it down to, these options that Medicare Advantage can be more affordable for many patients, that can afford the higher premiums. And a lot of people can afford close to 4 or $5,000 in premiums over the course of the year for that sense of security. Right? So Medicare Advantage is gonna have lower premiums. In fact, 75% of patients that are on an an advantage plan are enrolled in a $0 premium plan. So having those caps, having those premiums, Those are going to be very important to driving. Advantage enrollments and and again ultimately plan selection It's going to dramatically impact both the patient's coverage and their financial situation. So, that's going to lead me to this question greg is is you know, why do you think? It's important for pharmacies to assist patients with with comparisons? Well, I think the first and foremost reason is it it totally changes the way people feel about you as a pharmacist. You are now expanding and actually helping them deal with some of the financial you brought up the financial arguments. And and quite frankly, you said, you know, not only would it be, you know, probably in the $1,000 a year range for a Medicare d plan, but you're gonna have a $3,000 per year, you know, supplement charge. So you're looking at a guaranteed expenditure of $4,000. Well, remember, we're talking to people now 65 and older. They've most of them stopped working. A lot of your clientele that are in the eighties nineties, these were people that actually weren't even getting paid a significant amount of money in their lifetimes. And now you're gonna have to double it because they're both they're both I was both spouses are still living together. So it's not just $4,000 per individual. It's really $8,000 per couple. And and it becomes really significant. So when you start now empathizing and understanding their total situation, And, I mean, I can tell you from, you know, in my area where I have a, in where I'm, you know, just my area I'm speaking with you right now, you know, which is a relatively, you know, well-to-do, you know, area in relation to Connecticut. And but they were definitely older, and I have been astounded now at really the conversations that I've started having with people and starting to understand the impact. And you learn a whole bunch of things of why it was inflation, the impact of inflation over long periods of time. And people that you think had a lot of money, maybe don't have as much money as you thought they used to have. And, you know, it's important not to sit there and judge them, but just sit there and help them understand their situation and how do they deal with it, you know. And it gives another thing. There's an another reason and it's the way I start off my my approaches are, you start getting to talk to them about the conversations that not everybody likes to have all the time. Okay? What do you wanna do if you were faced with a severe illness? How much do you wanna find that, you know, that great provider? You know, like, if it's cancer. You know? You know, do you wanna go and travel to Texas to to get care, you know, and then find a doctor there that will accept, you know, Medicare. You know, some people will. Some people can afford it and and, you know, and the people that want to and can afford it, they should be able to have the opportunity to understand that. Okay? Versus and and not saying that a Medicare Advantage Plan can't be national, but are they in that network? You know? So, you know, so I think I think, you know, it it allows me to be, you know, a financial counselor, a person that sits there and helps them both together decide what they wanna do in a particular bad situation ahead of time and talk about it. You know? And then I'm the pharmacist and, you know, and I'm watching out for their dollars. Okay? And we'll we'll I'm sure we're gonna get into that later, but, you know, how do you sit there and why is there an advantage to a pharmacist doing it versus someone else who doesn't understand it? No. Absolutely. And patients, you know, they're coming to you, to your staff with with issues. Right? And a lot of these issues, you can connect back to a financial concern that often comes from their insurance, their coverage. Right? How how how well covered are they? Where are their shortcomings with their coverage? So having those conversations. Right? This sort of thing opens you up. You're wanting as the pharmacies are looking to get more into clinical services. Right? This is really adjacent to that conversation of looking at a more coach more, cohesively. Yeah. Yeah. In fact, I, you know, I bring that up. I was prepared to bring that up later talking about that because really when you start looking at stuff now we we, become the 1st diabetic accredited pharmacy in Connecticut. And, you know, during these reviews now, we've started now recruiting people into our diabetic classes because if you start looking at the cost of things and where they're going and we're we're now on the other side of it saying, okay. Let's help educate you so that we can use your dollars effectively. And really important because when you're looking at these plans, you know, what drugs are covered and which aren't. You know? So huge. Yeah. No. Absolutely. And and the things have have evolved within Medicare. Right? So if you looked at the the breakdown 4 or 5 years ago, there was only about 30, 35% of beneficiaries that are were on a Medicare Advantage Plan. So most of them were still going for original Medicare, but now that shifted dramatically. That's now at 54% of patients. So that's when we're looking at this Q1 of the year, if we're just taking national numbers Yeah. About half of your patients are eligible to switch plans, currently. So speaking, you know, of which, Greg, you know, did you always include Medicare Advantage into your comparisons, or did you initially just focus on part d plans? Okay. So like I said, Dia, really, my first approach is really trying to find out what is best for them and what they can afford. Okay? Before I even open a plan, I sit there and make sure they understand what you went through as far as, you know, what is original, you know, a and b. You know, the fact that they're gonna need a d plan, they're gonna need a supplement. I don't even talk to somebody. I say to them, look, you're not gonna do this if you're not buying the supplement because you can't afford you can't you can't take the risk on the 20%. And, you know, when I start with that process then, you know, I will say, that, you know and I can't make the decision for them, but I definitely had a bias too. And I personally, you know, do a med d plan with a supplement, you know, because I like the flexibility and I will do whatever it takes, you know, in order to keep, you know, keep cooking and find the best doc. So I do have a bias towards starting somebody and having them think about a d plan, but really, understanding now and and and, you know, as I alluded to the fact of knowing your different clientele because with 5 locations, I have different, you know, different financial and, you know, really age groups in in different locations, and it you do have to think about that. Okay? And, I mean, we're here we're talking about age groups in in retired people, 65 and older. You know? But but it is true. Is are you are you heavily located in the a very young side of the coin where, you know, one of the things that I did when I originally got started was I started I read the whole, Medicare, gov supplement book. Okay? So it sorta gave me a feeling for things, and I really got a great, you know, a great background for it. And I and I found a a agent that, who and it was very easy to find. Quite frankly, it turned out to be a very good friend of mine who was who was one of the, you know, senior accredited analysts and and helped, you know, understand some of the LIS stuff, supporting stuff. And, you know, even though now you offer all that, which is fantastic, you know, initially, my understanding, I wanted to get that. So you then find that, you know, you're we are talking to people more and more, much more about the about the advantage plans just out of truly financial concerns that are are starting to, you know, creep on people. That, absolutely. And they're you know, it's not a monolith. Right? There's gonna be different patients that are seniors that have different needs, different resources. So, yeah, certainly, I think with your, you know, your number of some patients that are going to be great fits for original medicare plus a supplement plan and and again the advantage plan is not truth is not so many people are able to afford again all those premiums and then that's Where these advantage plans are more appealing to them. Right? Having that low premium, having that max out of pocket cost, just to be a main driver for enrollments in in these type of plans. And, I mean, I I'm not sure the the the numbers, and I'm sorry to cut you off, but I'm not sure the the the the actual number when and number when I'm talking about age where people start to tend to get a little bit more sick. My understanding is up until 71, 72, you can really with, you know, a good statistical, balance, really take advantage of the savings on the Medicare Advantage Plans. And then the next year, as you start hearing cancer or heart disease, you could switch into a part d plan the next year. Yeah. Right. Absolutely. And there's you know, I think we can probably double a little deeper in a future webinar, but there's different, like, assurances between states. Like, it depends how. Like, I think Connecticut's one of the more, flexible ones where you can, come back to a a med sup plan without, paying Okay. Just yeah. Yeah. Yeah. So, yeah, that definitely and and that that, you know, that definitely is a a big consideration for patients too when they're selecting between the types of of Medicare plans. And, you know, building on that, you know, this has been a really staple for you and your pharmacies and your communities. Can you share an example of how, helping a patient switch their plan made a significant impact on their health or their finances? I I I I'll tell you. I have a few, but I will tell you one that really brought tears to my heart. We I had a person that and and in fact, I got into this because of of a broker that was a little too significantly invested in the money that they were making on it. And, you know, I had this woman that was promised a plan for a year, and and she was in it. And, you know, I I'd asked her, jeez, how, you know, how come you chose this? Well, you know, this her friend told her about this guy and got her in into this plan. And I said, well, look at October, we're gonna take a look at it. Well, we took a look at it. And here's a woman, and this is what I'm talking about about the age and the financial side of it, where she was really capped at a social security of about 24 $24100 a month. I'm relatively a a little extra. By making that switch over from that d plan to the Medicare Advantage Plan, she saved enough to pay for all of her her fuel bill for the year. She was she was just she just couldn't believe that the differentials that she was, you know, that she was saving. And in fact, in the next year, we saved enough not only for her health care, I mean, for a view bill but also for electricity. And these are the peep this is what I'm talking about about really getting involved in with someone, you know. You you you make impacts and that, you know you know, look at you do it because you feel great about it, but, you you know, but they're telling people about it, you know. And and in fact in fact, I saw almost, I think I think a 15% increase in the number of people that I did the next year because, you know, she was talking about this. So Yeah. No. I mean, that's a great example of helping a patient switch their plan. It has a meaningful difference on their well-being. Right? So there's barriers. These patients, a lot of them have barriers. And, again, to to point you know, to an earlier point, they're they're bringing these issues to you some way or another. It just takes digging into, you know, what exactly is that issue. And we'll get into some discovery questions in a couple of slides that really help, you know, finding out what's important to the patient, what's bothering them, what they do they want more of from their plan, what do they want, less of. So let's let's dive into some key factors that play a role in determining, the better options for for each patients. And, you know, the major thing a major key is gonna be provider networks. Again, that's one of the nuances with advantage plans is that there's gonna be doctor and provider networks that, you're gonna wanna look at, and, they're gonna play a big role in determining which plans would be an option for a patient. So, you know, if a patient tells you, here are my 6, 7 doctors, I need to keep seeing them all, that's going to be a major factor. So, you have urban areas, where networks can be really challenging, you know because there's just a sheer number of providers available so there's a customer tell me in south florida there was about 20 25 medicare advantage carriers and only a handful of them cover all of the patients' preferred, doctors. So it's gonna be critical to check their provider networks. And, you know, patients have these long standing relationships with their providers just like they do with your pharmacy. So the last thing you need to do is disrupt that, and that means not only reviewing their primary care physician, but also specialists. Hospital. What facilities did they use? You know, in the software, we have a detailed breakdown of every doctor who sent the prescription to, for the patient, including the address, and that's gonna be important to identify again, not only the doctors, but the facilities where they receive the care. Because you can have a doctor across multiple locations, but maybe 2 of them are network and 3 aren't. So, you know, recommend reviewing the prescription and doctor list before speaking with the patient. And and that way, you can pre check which plans are gonna work with, existing providers. With prescription coverage, you know, what's covered? What's the premium? How do pharmacy reimbursements differ by plan, for this particular patient's drug list? Lifestyle factors. Is the patient a frequent traveler? That's something could be important to that to take into consideration. And, and don't overlook the enrollment period. Again, I we started this by saying, hey. We're in the Medicare Advantage open enrollment period, and it could be seen as a safety net, so to speak. Right? So, you know, encourage patients to sign up for a plan during annual enrollment period, which is in the fall, knowing that if something doesn't work out, you know, we have this Q1 to adjust. So there's probably a lot of patients who didn't look at their plan options in the fall, and then because of the IRA, there was a lot of changes to formularies. They may be coming to your pharmacy now and saying, hey. Why isn't this covered? This was covered last year. We'll use this opportunity during this period of time to optimize, which plans, and, you know, see who needs to, adjust. So, Greg, how do you, you know, how do you train your staff to handle these conversations? Well, you know, that I'm you know, that's I I think that's a big point. Right? You can't be there every single moment of the day that everybody needs you. So it is it's very critical to sit there. And, and in fact, as as you sent me, something just a couple weeks ago, you know, you know, getting and constantly reinforcing to your staff, you know, how do you get a little bit better at this? You know, how do you you know, and what one number 1, what's the value? Right? Who wants to be involved? Okay. So I have technicians as well as pharmacists that get involved. And, usually, when I have a technician involved, I also will have them dovetail so that the pharmacist, you know, steps in in the, you know, 5, 6 minute period and just saying, hey. Look at how does that look? What do what do you see as the other issues? But it gives the technician and and look at the role of that that you just escalated the technician to. It gives them a great career path. Okay? They feel very important. They're out there when they're talking to the customers, you know, later on and customers can talk with them. So you get a little bit you get you get a different insights from different people because, obviously, you know, you know, some people just like talking to others, you know, and, you know, not just you. And, you know, and I think it it also does a, it does a great thing as far as understanding, you know, that, you know, you really let people know that, you know, this place is something that we're gonna create a, you know, a great career advancement. So so it's wonderful. Yeah. No. Yeah. Absolutely. And that's what we train our customers too is if there is, someone on your staff, right, a technician, someone else at the pharmacy who wants more visibility, added responsibility, then this is a great opportunity for them to step in and and, again, beyond your pharmacy. You know, perhaps, again, they want that visibility within the community, and this is a way for them to to help patients through some very personal situations and and scenarios. Yep. Yep. And, and and again, it really starts well, like you said, it's training your staff, right, to actively listen to patients and, again, connecting their issues with their insurance. You know, asking the right open ended questions is important. So starting off with something like, what do you wish your plan did more of? That could uncover what's what's important to them, what's really driving their decision. Sometimes it's something positive, like, I love the a t otc benefit. I have with my plan and I saw curtis On the chat he had asked about otc benefits so he his question is, if they had just started in even though we're just starting in 2025 Have you heard about advantage plans not offering medicare advantage? OTC cards in 2026 and I I have not heard of that and I would expect, you know, if you saw the recent release for cms, medicare advantage numbers for next year is that they're gonna get a raise basically a rate, increase in what the government is paying per Beneficiaries so that comes out an estimate, potentially $21,000,000,000 in additional benefits in additional payments for Medicare Advantage Insurers. So they're gonna use that money to really make some of these plans more compelling because they did come back a bit on the event on the OTC benefits, for 2025. So I think it's quite the opposite, Curtis. They're gonna go even further with some of these, benefits. Money on these shrink. So they're making money they've gotta differentiate themselves. You know? Absolutely. Yep. And then for your pharmacy, you know, I know, like like you said, Greg, it really depends. You have some areas that, you know, this could be a good fit for. Some others, maybe not so much. But, you know, for pharmacies, if you're in a good demographic, work with these OTC card vendors. There's about 3 of them that I know of that offer these these scanners and process these cards so that instead of them seeing that benefit and using it at a chain, or otherwise, they can bring it to you, and you run the risk of if they go to a chain with that OTC card, maybe you just lose the patient completely. Right? Because they were driven to that competitor, due to their Vantage benefits. So I'd reach out to them. There's some there's one called INCOM, that's based out of Atlanta. They offer the they process the OTC network cards. There's one, called Nations Benefit, and they have some sort of partnership or integration with Pioneer, which is new. Not quite sure how that integration works. Maybe you just don't need an additional scanner device. It just processes through your system. And then there's a company called s 3 that's owned by UnitedHealth. So UnitedHealth plans are processed through them. So it's unfortunate there's 3 that I know of. Right? I mean, you know, you you'd want a monopoly, I guess. But, otherwise, you need 3 devices potentially. Yeah. Yeah. And and, you know, other times, they're gonna share frustrations with you. Right? Instead of saying, I love the OTC benefit, they're gonna say, you know, I wish my plan did this, or, you know, it doesn't cover this. I wish it did. You know? And then you could dig deeper with some follow-up, questions. And then the pharmacy, you know, it evolves into understanding their their their life, you know, their providers their primary care physicians their specialists their hospitals their facilities and, it's going to be especially important in areas with fewer options, right? We have a lot of rural customers pharmacies in rural communities. Over time, you get familiar with the networks and the providers in the area. It can gets easier to kinda have these conversations and guide patients through these scenarios. If a patient says, I'm seeing doctor Patel. Well, you know doctor Patel is in network at United, so you could connect that pretty quickly. Yeah. So as you get to know these situations, you'll you'll you'll again, you'll you'll get a better understanding, especially in those, smaller, communities. And so the real takeaway here is to, you know, listen to your patients, listen to the issues they bring to you and your staff, understand how the different plans work. And over time, you're gonna learn the ins and outs, and you're gonna be able to connect these dots, provide solutions, and it's a win win. Right? Your patients get the care they need. Your pharmacy strengthens the relationships, increasing profitability. And what really stands out is having these conversations are gonna really deepen the trust and connections, with your patients. And and with that in mind, Greg, you know, I'd love to hear from you. How has, you know, offering plan reviews influenced your relationship within So, I I think plan reviews have you you you said that magic word, really, evolution. You know, the relationship continues to evolve in a very positive manner. And in fact, I mean, right now, we've been busy in January with these conversions because, you know, you know, you have can't sit there and say, okay. Look at they're looking at you as a 100% the source. Right? People are always constantly saying, okay. I've got an agent. It's telling me one thing. What do you saying, okay. I've got an agent. It's telling me one thing. What do you think? We had a very similar situation in Connecticut where Connecticut actually said on their website that we were involved in their plan, in their med d plan. We're not. We're not. Okay? And I kept on telling people and and, you know, people said, no. My agent said they were involved. I said, well, I'm gonna tell you. I know we're not. But, you know, but, you know, look it. We can, in January, make a switch. Well, we've switched over 35 people just in these 1st couple weeks of January that were that went processed the plan, found out we weren't in network, and they're switching. They're switching to a network that is you know, that we are participating in. It gives me as the pharmacist the ability to sit there and say, you know what? When I'm looking at these plans, everyone looks at it and says, I'm I'm helpless. I you know, we know we can't negotiate. They're, They're one-sided, you know, it's an awful negotiation process, but it allows us to sit there and say, and we did say we're not taking that anymore. And that wakes up people to start that. That actually does another thing because it wakes people up to say, hey. Hold on here. Why aren't you taking this? You know, you know, I mean, we want it. Why aren't you taking it? Well, you want it, but they're not being good to me. And, you know, I can't be here, you know, you know, on a negative margin side. You know? So I, you know, I need to pick plans that are at least gonna keep me, you know, keep my head above water. You know? So, it it created a a tremendous it's been a tremendous thing being able to sit there and now look at these plans because we do like you said, we do have the ability to fix what what are our problems, you know, beforehand. And, you know, and, again, you know, it's truly just an evolution. We have gone from and we've been doing it now 8, 9 years. I I I forget which one, to be frank. But, you know, the the integration that we've become in our customers' lives is so much more significant than it ever was previously in other locations that I run. So you know, because we are now a different part of their lives. So Yeah. No. Absolutely. And that really highlights the value of taking the time for them and and for you, as you said, right, there's these plans that are not financially viable for the pharmacy. We had a question here actually from Melanie. She she asked, are other pharmacies losing money on filling, brands prescriptions on Medicare Advantage Plans? So, she continues to say it is reimbursing different depending on which part of the country you're you're in. So, so the answer to that last part is yes. I don't know if you saw the wall street journal article that came out in November or December that said, woah medicare's paying different amounts for the same drug across different pharmacies, just different patients. It's all over the place, and you know that firsthand, and we'll show those reimbursement estimates in the app that that do, highlight that as as well. But in terms of advantage plans and reimbursements to from from what I know, they're not on different networks. Like, WellCare Medicare Advantage will be on the same network as WellCare PDP on the same ESI network, and it's the same contracted rate. Right? So if you're switching from WellCare MA to WellCare PDP, you're still paying that same I think it's anywhere between EWP minus 21 to 27% on brands. Right? Yeah. So So so the also, the other thing to tell you know, to talk to Melanie's point on this, one of the great reasons for doing this and in fact, you know, and I talked about the diabetes side, but, you know, we started understanding moving people from, like, say, Jardiance to Farissa. Okay? You know, start understanding, using what they're on. I'll give you a great a better example. We had, people with Spiriva. And, Spiriva became you know, it was just out of sight as far as we were getting you know, the person was getting killed and we weren't getting great reimbursement. But it gave me the opportunity to understand that, okay, what if we switch people over to a niprotropium albuterol nebulizer solution? First of all, we take it right out of the, Medicare, the prescription drug spend, and we put it over on b. Okay. Well, this is on the original guys. Right? And, but it saved everybody a fortune. The, you know, the albuterol epetropion albuterol is cheap. Okay. And, you know, that person buys a nebulizer from you. They actually find they feel better because when they're using it. And I I will tell you as an asthmatic, you feel much better using a nebulizer, you know, than a handheld, you know, device like a Spiriva or something. And in fact, in the Spiriva, you had to count on the fact that the person's draw in and their ability to to to really inhale in and hold it versus the person that was on a, an, one of those nebulizer compressor machines, and and it works like it works wonderfully because it's pushing it right in for you. So we weren't really counting on the person's one manual ability to do it, but also their physical ability to inhale the medication and saved a bloody fortune. I I had a doc call me and say, Greg, what are you doing? And I explained it to him. He saw it. Now he doesn't even prescribe SPIRIVA. He only prescribes the nebulizer solutions because he's seen the impact and listened to some of his patients that he wasn't listening to beforehand. So, you know, it really created a heck of I mean, you know, this opportunity to sit down and review stuff and start looking at it from a financial eye as well as from a efficacy side, it it gives you and and you're spending 5 to 7 minutes per client. Okay? They have concentrated time with you, you know, you're listening to them. You're trying the ins and outs. It doesn't take any longer than that, you know. And once you get the groove of it, once you get, you know, I start understanding some more and hearing some more of the questions, you you you can handle it easily. So it's it really is. It's, you know, it's a great opportunity to connect with your client. And, you know, you get 5 to 7 minutes with someone. And if you can't make a meaningful impact, well, then you shouldn't be doing this anyways. Right? You know, and and they and they they feel it. Okay? And and they appreciate it, and they tell others. And so, you know, that's what you count on Yeah, no look there's there's local brokers who certainly have a value and they understand the nuances of insurance But you understand the patient to a a different level to a deeper level and again can make all these connections and you know melanie your question about the advantage plans the well care example I used is because, again, if they're well care pdp or well care ma, you're paying the same you're getting reimbursed the same amount, but what happened this aep Was that well care Their pdp was the really only one that was at $0 across the country on the pdp side So if you're limiting your comparisons to just pdp That's the only $0 they're looking at if they're non, dwelling. I don't even take them. I don't even take them. It's a plan I don't even take. Right. And my customers my customers choose not to even buy it. Right. Okay? So I won't take it. And then if you if you look at the advantage side, you know, we touched on before. One of their big draws is lower premiums, $0 premiums. So if you're including advantage plans, now you have a greater selection of plans to choose from. There's gonna be some AARP plans, some other plans that have a $0 premium for the patient and a much better reimbursement for you. I think AWP was about AWP minus 19% on brands. So, you know, I think you'd rather want someone on that than the, WellCare plans, whether it's MA or PDP. Correct. Correct. Yeah. So let me, so thanks for that, Greg. And that's great insight into, again, looking at that patient, holistically. And and, you know, you've used match for, like you said, 8, 9 years, and, you know, it's helped strengthen and expand and retain those relationships with with high value patients. And, you know, if you look at what we looked at is, patients who get a comparison versus patients who don't. So patients who get a comparison at their pharmacy using match, 97% of them continue filling the following year compared to 76% who did not. So, you know, again, back to evolution. You know, as pharmacies are evolving into clinical services, you know, keeping and growing the Medicare base is gonna be critical because it often clinical revenue, it often comes from patients with chronic conditions who take the most medications, and those are typically gonna be, seniors. So, you know, match and doing comparison. It isn't just about prescription revenue. It's gonna be a key driver for, clinical success as well. So before we head into the q and a, you know, if you, if you're ready to see, you know, how match can make an impact to your pharmacy, we're gonna be hosting a walk through and a demo, to show you how it works next week, next Wednesday, so you can see if you're ready to get started. Again, we're in the middle of this open enrollment period for Medicare Advantage. You can also talk to dual eligibles the 1st 3 quarter of the year, and then you got people aging into Medicare throughout the year. And those, you certainly wanna speak to before they pick a plan that you know, like you said, Greg, you're not even taking WellCare. If you don't involve yourself in a conversation with people aging in, they can sign up for WellCare and then you can't fill. And then you're out. Yeah. Yeah. And then next month, we're gonna be hosting a roundtable about boosting your pharmacy's financial health. So it's gonna be a great opportunity to, dive into some actionable strategies and see how we can help with increasing profitability and and optimizing, your operations. So now let's open it up for questions, see what's on the chat's mind. Let me see. Got I'm sorry. What is the name of the Heather asked what's the name of the company, who works with Pioneer? So this was about the OTC Benefits. So it's Nations Benefits, I believe, is the name of the company. So they had a press release sometime last year that they're doing this partnership or integration with Pioneer. Perhaps Pioneer could, could direct you to, someone there as well. Some other ones we have is during open enrollment, Carly said during open enrollment, can someone who had selected a part d plan in the fall switch to an Advantage plan now, or are you only allowed to switch from advantage, To advantage. To advantage plan during q one. So so yes. So if they have an advantage, they can switch to any other advantage plan. If they were on Part d and then this past open enrollment, AAP in the fall, they pick the Medicare Advantage Plan for the first time, they can, during this period, kinda use it as a grace period and go back to, Part d. So those are the the, the parameters, of, what this enrollment period means now. Have, you have anything to add on that, Greg? No. No. No. No. You hit it. Okay. Another question is, this one's for you. Greg is, how do you optimize plan comparisons across multiple store locations? So, that is an interesting thing that we do very early on. And one of the things that I do is I actually try to hold off any of my appointments until the last week of October. And the reason why I do that is because I take my top 100 clients in every one of my stores, and I do a quick review and try to find out where the plans are and and and where we're where we're where we're gonna be headed and what questions we're gonna start seeing when we actually do the reviews for the people. So, it is different it is different for every location. And, again, part of one of the problems is is that you're also going against some people that might be, you know, brokers that are very well entrenched in areas. And, you know, they're not looking at it with the same critical eye that we are. And and, in fact, you know what? I would tell you as that I've reached out to those brokers, to try to actually, you know, talk about what kind of plans are out there and how we're both thinking about this and try to get some discussion. Obviously, it's always the patient's choice. You've gotta show them everything, you know, but they're listening to you. And, you know, you get to, you know, really think about your your your your discussion beforehand. And we use that time period because one of the questions you asked me before that I didn't really effectively answer, how do I train my client, my staff, is I train my staff utilizing those 100 reviews. So when they start going through these reviews, they're understanding, and we're talking about it. And I'll be the patient. You know, I might, you know, you know, you know, you know, ask them things or look for them for for my staff to bring up, other things. So I usually use 5 days in the start in October to just understand and train, and then we go forward. You know? Yeah. I wanna give you one thing that Enlivant does that I re really remention. You know, going back over and maybe calling you and saying, hey. I don't understand this well enough. Can you show me how to use the system? I can never do that enough with people. I mean, you know, you think your staff knows everything. You know? Look at and they're gonna yes you to death sometimes. You know? And, you know, you know, and they need they need to, you know, fail maybe in front of you rather than fail in front of me. You know? And so, you know you know, and and, you know, and I think that's kind of unfortunate because you try to stay open and create an an atmosphere to, you know, really grow. But, you know, people need to hear different and they hear things differently, you know, you know, through my voices versus your your voice. You know? So I think it's a, you know, it's a great time to to do that. And that's, again, why I really use, you know, the start of October to just get the lay of the land. Yep. And, you know, delegate what you can to those trusted staff members at each location and, see how you can, improve things operationally. Right? Also, like, if you have a scheduler right now for clinical services for vaccines, you know, create slot, couple slots a week, during outside of AEP, couple you know, an hour a day or something where you're taking these appointments from patients and then ramp those up as we get into the fall. And send out some text messages with patients and then have this link. And, again, that could just be something that's going on automatically in the background. So delegate, leverage your staff, leverage technology. You again, probably have technology right now that you can leverage that you're using for other reasons. I mean, it's a good in classing Yep. See that you drive. Yeah. You're taking I have a question here from Kaye. What is the liability to the pharmacy? The pharmacies for assisting patients. So I think we touched on that a bit, Greg. It's like, you gotta show them everything. Right? You can't be saying, well, you signed up for this plan. You're showing them everything. You're you're showing them a comprehensive review, and it's similar to what they went on medicare.gov, except you're doing it in a streamlined way without having to load drugs automatically. And you're having conversation as someone that knows the patient and sees them on at least a monthly basis. And and one of the things that I do is I print out the whole thing. Okay? So when they sit there and we we print it out, and, you know, when they've sat there and made the choice, they made the choice. And in fact, that's the other thing down the bottom when you're getting into the getting into the, you know, enrollment period. You know, there's a point where, okay. Yes. I'm doing it as my own person, and you can have the person, you know, hit the button, or I'm assisting. And then you you put your name on there and and you assist. But I always print out every single one so that they can say they didn't see everything. You know? And, you know, it it it really and you will find, you know, the first 2, 3 years, I was doing that a real lot. And now people, I don't even want the copy, Greg. Please. I made the decision. Here's it is. Boom. We hit it. Let's go. You know, they get it because they see the savings. You know? They they see it. You know? And, you know, I can't tell you how many people, you know, in the 1st couple of years when, you know, you know, they get their 1st deductible side on the part d side, which were major deductibles. Right? And, you know, and people are saying, Greg, you know, I'm spending a few $100 here. I said, don't worry. It's gonna even out. We've showed you the math. It's gonna even out. And it does. And and they get it. At the end of the year, they're you know, they're they don't have any costs. You know? So, you know, it's, you know, it's going over this and having having that, you know, doing it a number of times, they really you get a different level of trust that you even see as a pharmacist. You know? It's just awesome. Yeah. No. Absolutely. And to the, you know, earlier point we had about this opens up clinical opportunities or it's really in the same in that same conversation at times and that when you're when you're taking, advantage of some of these clinical opportunities, they're mostly gonna come from Medicare patients. So, you know, one of the products in our suite is is is med bill, medical billing, right, farm for pharmacies. And, over the past 12 months, 74% of successful claims were for seniors. Right? So you're talking to this this population already about some of these really important, personal, issues that they have or, you know, things they wish that they had that they're they're not getting coverage for. So it all marries together into looking at that patient in a very comprehensive way. And and this is if you're getting clinical into clinical practices, you talking insurance is, like, the gatekeeper to that or or the gateway to that. Right? He is the gatekeeper. Yeah. Yeah. Yeah. Absolutely. Another question we had. I know people are really interested about the OTC cards. Yeah. I told you this is great. Pauline asked, what was the first OTC card you mentioned? So s3 you you said you you're familiar with Pauline and that's the one with united healthcare. Nations benefit is the one that has a partnership with With pioneer and then the last one or the first one I mentioned was incommin comm and they run the OTC network. It's called so last question we have here was from David and he asked if you've ever considered becoming a broker Yeah. I absolutely don't want to. You know, there's something great to be able to say. I'm not getting one nickel from this, but helping you maximize, you know, your benefit. And, you know, honestly, you know, for a few $100 to to gather a tremendous different sense of trust from everybody, you know, I mean, I am just doing this. I am spending these 5 to 7 minutes, and I don't tell them it's 5 to 7 because they think it's longer. You know? And, you know, but I'm spending that quality time for them, not charging them 1 nickel. Okay? And they're getting analyze their situation and really delve deep into a couple of big issues. You know? And not you know? I I wouldn't I would never I would never, you know, take money for it, ever. Okay? Ever. They you know, I get so much more in return from, you know, how they feel about us and how they refer us, etcetera. So never I would never do it. Yeah. And and we've gotten that question a lot. And, you know, I'd say it it it depends. Right? There's margin pressures. Absolutely. We've heard them for years for over a decade on on prescriptions, and and pharmacies are looking for different ways to grow profitability and and grow revenue. And I think, you know, if if if you have a pharmacy staff that is used to doing this, you know, maybe it makes sense for one of them to, you know, get their license and, you know, it could depending on your community and the relationship you wanna have with them. Yeah. It it could be. But, you know, it gets trickier sometimes when you're you're really, like, losing sight of your core business and really chasing that, you know, $500 enrollment or whatever it is. But but then you're signing up someone for WellCare. Right? So that, like, you know, you're exactly you're doing. You know? Because you're the big ones are are gonna be big numbers, but I I don't know. I don't know. I Yeah. So I think personal decision. You know? Absolutely. At the end of the day, I'd say, you know, your your core business, you know, is pharmacy. So you probably intend and not just you, Greg, just you, the audience in general. It's like, intend to sell the pharmacy in the future. Right? And you wanna have the best revenue profitability behind that pharmacy business to get the best valuation in the future. And are you really gonna go chasing enrollments today to undermine, you know, potentially your profitability across your core business? I think that's something to to consider. Yeah. Tell you what. Get somebody enrolled in a diabetic education program, you know, and and make, you know, 6 or $700 and educate them and, you know, actually improve your profitability on prescriptions. I mean, to me, there's there's the there's the there's the play. Absolutely. And, yeah, I'll say that. You know, we're we're just at the hour, so that's gonna wrap up the content for today. And, hopefully, you know, this gives, you more confidence in helping patients with Medicare Advantage Plans. Remember, you're not just helping them choose a plan. Right? You're you're supporting their overall health and really strengthening that relationship and expanding your, business opportunities. So, Greg, thank you so much for your time. And thank you everyone else for your time, and we'll see you soon. Thank you. Thank you, guys. I thank you, Aliven. Thank you.