Independent pharmacists say managed care of Medicaid is putting the squeeze on them and many of their patients.
There are 560 independent, community pharmacies in Kentucky, many in small, rural communities. Pharmacists tell ABC 36 News of slashed reimbursements for their dispensing fees and drug costs since the state switched to a managed care approach November 1.
“Drugs that I lost money on, that I could not buy for what I gave to the patients for, anywhere from 70 cents to 90 dollars,” said Mac Bray, owner of Capital Pharmacy in Frankfort.
Several pharmacists told ABC 36 News about examples where patients were unable to get their medications in a timely manner. “Some times these are really high risk patients,” said Bray. “Cancer patients, mental health patients, diabetic patients, people on chronic pain medications. Once you disturb their therapy ... it can take weeks to months to get them back on a stable position."
The state now uses three private companies to manage the health care of more than a half million poor Kentuckians. Governor Steve Beshear, who is promising a savings of $375 million to the state’s general fund over the next three years, claims the new approach is working. "I'm amazed that we haven't had some much bigger problems than the small ones that we've experienced."
But the problems aren’t “small ones” to the owner of three pharmacies in rural Grant County. "You can't bludgeon pharmacies to death,” said pharmacist Jason Wallace. “You can't put them out of business. Independent, community pharmacy is a vital resource in the state of Kentucky."
Wallace is on the board of the Kentucky Independent Pharmacy Association. He says layoffs, and even store closings, have already occurred at a few pharmacies. He blames managed care for trying to balance Medicaid savings on their backs. "We're the low hanging fruit,” Wallace claimed. “We're the path of least resistance, so they can suck that money out of the pharmacy budget without actually managing care, which is what they were hired to do."
In other words, profits for the managed care companies over patient care or a fair profit margin for independent pharmacies, claim Wallace, Bray and other pharmacists.
"When an independent community pharmacy closes, game over,” said Wallace."