Ep 36 - Integrating Pharmacists: Revolutionizing Healthcare Practices with Dr. Ashley Pendrick

Ever wondered how integrating pharmacists into primary care could revolutionize healthcare practices? Join us as we explore this game-changing concept with Dr. Ashley Pendrick, a visionary pharmacist and founder of Prosper Rx Consulting. Dr. Pendrick shares her compelling journey from pharmacy school to becoming a leading advocate for the enhanced role of pharmacists in managing chronic diseases like diabetes. Gain insights into her trailblazing strategies that can not only ease the workload on physicians but also boost patient outcomes and financial performance in healthcare settings.

Discover the transformative potential of keeping healthcare services in-house by harnessing the unique skills of pharmacists. We discuss how this innovative approach can lead to improved patient satisfaction and a more streamlined workflow. Dr. Pendrick walks us through the advantages of a physician-pharmacist co-model, offering a fresh perspective on how to maximize practice revenue and efficiency. Listen in to learn how these collaborative efforts can create a win-win scenario for both patients and healthcare providers, paving the way for a more sustainable and effective healthcare ecosystem.

Dr. Ashley Kay Pendrick, PharmD
Prosper Rx Consulting
https://www.linkedin.com/in/ashleykaypharmd/
https://prosperrxconsulting.com/

THE ANGRY BILLER, powered by J3 Revenue Cycle Management

Phone: (954) 544-2706

Website: https://www.j3rcm.com/

LinkedIn: https://www.linkedin.com/company/the-angry-biller/


Production of Podcast: VISUALS BY MOMO

Transcript

Josh Fertel

00:04

Welcome to the Angry Biller, a show where we explore the people and the businesses behind the scenes of healthcare, those men and women that are the catalysts that allow providers to concentrate on delivering exceptional patient care. Welcome to the Angry Biller. My name is Josh Fertel, I'm the owner of J3 Medical Billing and I am your host. We are at the Visuals by Momo studio. The one thing I always love about what I do is that I'm always learning things, and the things that I like to learn most is how a practice can really increase their revenue, increase their profitability and still maintain great patient care. And I became friends with Dr Ashley Pendrick patient care. And I became friends with Dr Ashley Pendrick. Her company is Prosper Rx Consulting and she opened up a whole new world for me that I can actually share with some of my clients, and I wanted to bring her on and let her tell her story and really get into the details of what she does and how she helps. Thank you, ashley for coming on. Yeah, I appreciate the opportunity. Thank you, ashley for coming on. 

Dr. Ashley Pendrick

01:02

Yeah, I appreciate the opportunity and, josh, it was a pleasure to be able to even meet you and learn more, and I know you're making such a huge impact on all of these practices and making sure that they prosper is also one of my specialties, but on the front. So I'm Dr Ashley K Pendrick. I'm a pharmacist by trade and I started Prosper REC Consulting four or five years ago with the mission to help pharmacists stand and showcase the skills, and that's a lot to do with the clinical aspects and so my goal is to help in not only pharmacists, but really the practitioners. These days, the physicians, the burden that they have A lot of that is medications and disease management can actually support practices as well as being able to bill for services that they're providing, to then remove a lot of that friction that currently lays on just about every practice the amount of follow-up and the care you mentioned. 

Josh Fertel

02:17

Tell me about your background a little bit. How did you get into healthcare Something early on? 

Dr. Ashley Pendrick

02:23

Years and years ago, of course, as a kid, I knew I was going to come into healthcare. 

02:27

I wanted to help people and help them in a healthy lifestyle, and so it was trying to find where I fit. 

02:36

And I landed after working in a bank and going to school for some time, trying to find my place on pharmacy, and with that I was able to go through the program and opened up a whole nother realm of the typical pharmacist behind the retail counter, and so grew a passion for the knowledge that the pharmacists have, a passion for the knowledge that the pharmacists have, but then also, you know, being able to showcase that. 

03:08

And I was so excited to be able to not just learn these skills but then kind of share that, because not everybody understands and so background that they have as far as training, you know, is exponential and disease management Found myself throughout the program knowing I was not someone that was really feeling called to work in the standard or typical pharmacy, but one that was working hands-on with patients and then also with the business side of things. I was really eager to see how I could take that further, and so I love helping patients live a healthier lifestyle, so much that I have a holistic diabetes practice as well, and so the goal to prevent diabetes is huge on my heart. It is an untapped area that not enough are speaking on. 

Josh Fertel

04:06

That's perfect. And, yeah, just from the time that we know I would expect that from you, that kind of thinking, and I never knew what this existed. I never knew what a benefit it is and that's why I love doing this is connecting with people and say, wow, here's another avenue where patients are being taken care of and it's a benefit to a practice and private practices or a business that struggle at times, and so you're able to do that. When did it really like click when you so you were behind the counter when you first graduated with your education? When did it really click to you and say you know what? There's something more here. 

Dr. Ashley Pendrick

04:47

That's a great question because really one. I've never worked behind a counter as a pharmacist. I have been in clinical roles and training and education and more collaborative practice as well, and so it clicked as I really ventured out my first year after school I went through some programming on how to be an entrepreneur and I learned those billing modalities. This is you know where it should be, and throughout the program itself you'll see pharmacists in every area. Whether that's oncology, you'll see them in intensive care, emergency care, but then in the VA I was able to work collaboratively as well and help manage diabetes and hypertension and it was like this is a huge need and I felt like it needed to be advocated for more, really brought to light, because pharmacists generally, you know it's not something that they're very good at showcasing for themselves. We speak about it in our walls. If the world doesn't know, then they're never going to actually open that up, and so more and more practices are currently looking to and adding pharmacists really to help with the continued care and reduce that burden. 

Josh Fertel

06:13

Okay, so let me ask you this when you're approaching a practice that you think you're a good fit for, what are you looking for? Is there a patient population that you're looking for? Demographics, area, location? Is there something particular that you're looking for that you said this is? You know this is a great fit for us. 

Dr. Ashley Pendrick

06:35

Absolutely. I know right now the grand scheme every primary care, family medicine, internal medicine, really truly should have a pharmacist, even if they're doing so with like a part-time where they're sharing a pharmacist. And as far as who we're focused in on working with, in general the pharmacist can see maybe 15 or so patients a day and so, thinking about the patient panel, you know how many patients they may have, but the opportunity to add services. And so right now we're really focusing on are you looking to help control maybe, say, two 300 patients, uncontrolled diabetes? If you're hanging around that and you're really struggling, bring a pharmacist in. And if you're looking to start a new program, a pharmacist in. 

07:24

And if you're looking to start a new program, you know, chronic care management, remote monitoring, or if you're in the realm of weight loss management, if you think about those new programs, a pharmacist can help with that as well. And so the couple of states we're looking at right now is Virginia and Nevada specifically, but all 50 states do have the ability and it's navigating those complexities of pharmacy law. We're here to help with navigating those laws and getting a pharmacist situated, and so we'll take clients right now as they come, depending on what their needs are. Every practice, I know, you know, is going to be different and so it's building it to fit whatever their needs may be. 

08:12

You said Virginia and you said Arizona, nevada, are the two we're working on right now really diligently. The plan is to expand. 

Josh Fertel

08:20

Sure Listen, you can be in every state I want you in. Is that because of the laws? Is that why those are targeted? 

Dr. Ashley Pendrick

08:28

That's because we're experts in that particular realm, but all 50 states allow it, and so we're working on a couple of practices at the very moment. Then make it a lot streamlined. You know, we've got their legal legalities and we've got all of the documentation ready for them. 

Josh Fertel

08:53

Who are you approaching at the office? Are you approaching the practice owner? Are you approaching the office manager, the controller? Tell me how that conversation getting your foot in the door, so to speak. 

Dr. Ashley Pendrick

09:03

So right now, we have been approaching, and also having warm leaves too, with both practice owners and many of them are physicians themselves and then also the innovators and practice managers that are looking, you know, and carrying some of the weight of what's our strategy here. How do we improve things? How can we, you know, maybe increase the revenue or even reducing the burden? And they're seeing the overwhelm for the practice and the team itself. 

Josh Fertel

09:33

Okay, and so then you say I have this pharmacist who's in your area, right, who can come and work with you, and then how does that transition go? 

Dr. Ashley Pendrick

09:43

Yeah, so what we do is we help with qualifying a pharmacist for the practice and then we go forward with providing some guidance with the legalities, so the collaborative practice agreement and arrangement that's needed, as well as protocols, depending on what the physician and the practice itself is looking for. They may be really struggling with maybe behavioral health or weight loss or their asthma patients, and so we'll help with guiding them along that path and getting some protocols written up so that way the practice can utilize the pharmacist to the maximum capacity with prescribing authority. So the agreement allows that pharmacist to then adjust therapies and stop therapies and start them based on whatever that physician in the practice would prefer the pharmacist do. And then from that point we also provide some education content. 

Josh Fertel

10:44

The pharmacists that you employ or that you are recommending. What makes them want to say okay, I would rather be in an office atmosphere, as compared to CVS or you know that kind of pharmacist? 

Dr. Ashley Pendrick

11:00

The training really focuses on the clinical aspects, and that's the treatment, management education and the hands-on management of a patient under chronic illnesses, and non-pharmacological education as well. Non-pharmacological education as well and so, realistically speaking, if you ask just about any pharmacist, you would likely prefer to be in the team. It's just there's not as much clinical roles as we anticipate and the amount of graduates coming out, and so the opportunities aren't as open and broad. And there are residency programs that a lot of them will come out of as well, and so pharmacists are residency trained and multiple board certifications available. But the bottom line is is that most pharmacists are eager for new opportunities, like helping their teams, and that's what they were trained to do, and so I know there's shortages, but there's not really a shortage of pharmacists. There's a shortage of pharmacists that are willing and able to handle and manage the complexities of a retail pharmacy these days. 

Josh Fertel

12:15

On the pharmacist side, is there a difference in income potential being in an office as compared to being a behind the counter? 

Dr. Ashley Pendrick

12:24

That's oh yeah. So the pharmacist salary is hot topic right now, but retail and the different clinical roles, I know they do have varying salaries and so I know for us we do a little bit of an investigation and support the practice in a suggested rate, or at least here is, you know, the bottom and the top here, and so for the most part we would recommend them staying, you know, around the medium and a little bit higher the amount that a pharmacist can bring and offer for the black days. One of the pharmacists that I've spoke with, she straight deals only with her diabetes in this clinical practice and she's making more than what she was making in the retail realm. They see the value in the actual outcomes that are happening. You know outcomes is where it's at right. 

Josh Fertel

13:22

Yeah, absolutely. I want to take a couple minute break here and I'll call back on it. I got a bunch more questions I want to ask you. Military Recreational Divers is your nonprofit organization that exposes veterans in need to ocean therapy through scuba diving activities? Help our heroes in their healing journey. Support, follow and donate. Today at mrdflorg, we're back with Dr Ashley K Pendrick. We're talking about pharmacists and the value that they bring to a practice, Loving the conversation so far. Again, I love learning things that I never knew before and you've opened up a love, learning things that I never knew before, and this is you've opened up a whole new world that I want to be able to share. So, thank you, you know preemptively, thank you for coming on and telling us your story. Does it ever get specific with the practice owner and saying, okay, we're bringing this pharmacist on and I want them to concentrate on this, or is it more blanket? You know these patients or is it this specific disease? 

Dr. Ashley Pendrick

14:23

As far as focusing, I know, with our program and at least the introductory phase that is, one of the areas that we are looking to really shine is how to optimize the pharmacist role, and so that does take a little bit of some background. What is your current patient and your panel? Where are you struggling the most? Are you having you know again, to refer out for some things that we could bring back in-house and keep in-house? Are you looking at lowering your costs and your hospitalizations and your adherence and so yeah, each practice depending on their needs and where they're struggling. 

15:05

You know you can target that pharmacist and their capabilities and their skills towards that to help with again achieving our metrics and achieving our outcomes, but opening up some new opportunities for patients and removing some of those potential. You know chronic management visits from the physician, so oftentimes you'll see I mentioned behavioral health, so depression, asthma, diabetes, hypertension, substance use actually is becoming a disorder. That particular realm is another new area that pharmacists are starting to shine in, like pharmacogenomics as well. So we're getting really nitty gritty and so that and I mean the plethora of disease, like the specialties that are out there there's pharmacists that are typically specialists in that as well. 

Josh Fertel

16:00

What are some of the services or procedures that are being outsourced that are now they can keep in-house? What are, like the top ones? 

Dr. Ashley Pendrick

16:09

Especially in the beginning phases, as you know, diabetes, and they're outsourcing that right. They're sending a lot of primary care, family medicine and internal medicine, whether it's they refer out right in the beginning or they refer out, you know, after it's. You know they've seen them for a couple visits and it's just not getting where they're needing and they need a little bit more TLC. They can bring that in-house and then the same thing for some of those other chronic diseases. But then I also would suggest, depending on their practice needs and where they're at right now, if they are outsourcing chronic care management, remote patient monitoring, transitions in care, behavioral health integration those are areas that a pharmacist could bring in in-house as well and help to those types of services. And then the new advanced practice care management. I know if that's the model they're looking to go. You know, utilizing and bringing a pharmacist on to try to keep some of that revenue more so in-house. 

Josh Fertel

17:13

No, that's perfect. How do you measure revenue? The success of having the pharmacists in there? How do you measure? What are you looking at? 

Dr. Ashley Pendrick

17:23

Pharmacists are great at measuring their metrics and their outcomes, and so, when it comes to what we're measuring, I know for us right now, it's going to continue to be looking at the amount of patients that start to become controlled prior to their arrival, for their diseases to become controlled prior to the you know, their arrival for their diseases, and then also the measurement of physician satisfaction. 

17:48

That's imperative, right? It's to make sure our physicians are happy and feeling more supported and that they're not, as you know, burdened with a lot of these maybe chronic conditions that they're currently managing, or even with the medication decision making, and so those are some of the outcomes. I know others, of course, were looking at the financials as well, and so goal is to give a plan for the practice. What's your plan and how to use this pharmacist to optimize them based on their goals and whether that is, you know, reductions in hospitalizations. Where are your hospitalizations at right now, how are they currently fitting in and what's the you know that bottom line that they're bringing in, and so I think the average is anywhere from two to one up to ten to 1, depending on how you're using the pharmacist, as far as potential revenue impact as well. 

Josh Fertel

18:47

So 2 to 1, 10 to 1, break that down. 

Dr. Ashley Pendrick

18:49

It depends on what the focus is and, of course, if there's accountable care organizations, then we've got the conversations on the metric bonuses as well. And so when you look at outcomes and the value add, when you look at that aspect, those studies will project outcomes for that. And so some of those studies have it to where, with a pharmacist involved in those reductions in the hospitalizations, achieving those aims with specific medications and the adherence rates to those and, of course, achieving the outcomes for the diseases themselves and more patients reaching those goals, that's where you're going to get, you know, a lot more bang for your buck. The average two, where the two to one, if we're doing a pharmacist-physician, the Covizit model, that's where you can bring in, you know, anywhere from two-to-one to four-to-one, potentially for more revenue when the pharmacist with that and increasing physician's access. So the physician sees the pharmacist After they see the physician and the physician, you know, has the diagnosis and the pharmacist does all of the management and adjusting therapies and things of that nature. 

Josh Fertel

20:10

So, if I understood this correctly, a pharmacist should be able to bring in twice as much as what their cost. 

Dr. Ashley Pendrick

20:17

It could be more. Yeah, and that is the goal. And with the physician pharmacist co-model, that's where you're going to see that in the brailling given pharmacist code, and we want to make sure that we're, you know, following the guidelines and care and those types of other services as well. So there's definitely room to grow. 

Josh Fertel

20:47

And the offshoot of that is that the provider right, the provider whose time is more valuable, right they're charging more for their time is freed up to see more patients. 

Dr. Ashley Pendrick

21:02

Yeah, absolutely. You want to see your patient and do whatever fits their strains. More so, physicians are really good at working up the patients and trying to find what's the problems here and how can we help, and diagnosing and some of those minor procedures. But let the pharmacist come in and help with some of those other tasks with adjusting the medication, starting the therapies. 

Josh Fertel

21:34

I'm a chronic care management fanatic. Where do you see the pharmacist employing that? They wouldn't necessarily be doing the monitoring themselves. Were they overseeing, how would you structure that program? 

Dr. Ashley Pendrick

21:48

Yeah. So the chronic care management, a pharmacist can actually man it and monitor it as well. And so, basically, whether they want to start it or kind of take over that chronic care management, I will say that a pharmacist has a different lens. But then there is the opportunity to employ some of the team-based approach as well. But pharmacy can oversee it and it has been proven to still be a potential know, a potential improvement in the revenue as well. And so there's opportunities. I would suggest that model. I know a couple companies, I know a couple, you know outsourcing ones too. So it's just what's the practice goals? Do we want to keep it in-house and build it because a pharmacist can help you do that, or do you want to, you know, use out other services and do that as well? So can you run that as well as having a pharmacist in their practice? And I say absolutely, you're still going to have those disease management visits and the control and the potential new services that are off. 

Josh Fertel

22:58

It's the greatest thing ever invented. Right, it is because it's win-win-win. Right, patients are getting, you know, taken care of, they're being kept out of the hospital, they have a closer tie to the practice because they're being contacted once a month and the practice benefits. Right, there's revenue for the practice. It comes down to the cost of running the program. Right, how is it best? The doctor's not going to do it themselves. If a pharmacist can do it and the expense is less because the pharmacist is doing it, then that's the way it should be. Or overseeing it. Or if there's even somebody else that's in the office that's doing it, or outsourced, that's the way to do it. But it has to be done. Any practice that's not doing it is foolish. How do people find you? How does a practice find you? 

Dr. Ashley Pendrick

23:45

So right now we're online, of course, on ProsperRx website, prosperrxconsultingcom. We're on LinkedIn quite actively. You can contact me and the website as well, with a direct email. We're taking clients right now and really helping them. 

Josh Fertel

24:08

What's the ramp-up time? If somebody contacted you today and says, okay, I'm ready to go, how long does it take to get everything boots on the ground? 

Dr. Ashley Pendrick

24:15

As far as the overall process, it can take anywhere from 30 to 90 days. Of course every practice is different, so anywhere from three to six months would definitely be the goal. Of course it's going to be navigating some of those complexities with the pharmacy law, so each state might be a little bit different, but I'd say for the most part we can. We've got an ambitious practice which we can kick up and say 30 days to 90 days. 

Josh Fertel

24:44

I guess the contracting with the payers has to be done, have to be added to the practice. I know that could be a time-consuming process too. That's the only part of the business I hate. Can you give a good success story? 

Dr. Ashley Pendrick

24:59

Yeah, right now. I'm working currently with one that has, I think, six or seven practices, and so we're looking to reduce the burden and improve their outcomes. Another success story would be a pharmacist currently working right now, and they are in a primary care practice just diabetes education and management for this physician. That at the moment was just one physician, but the goal is they're going to be looking at growing now as well, because the burden of, you know, some of that chronic management had been reduced and so now they're able to look at hiring not only another physician but another advanced practitioner as well. 

Josh Fertel

25:43

And the ability to bring on an extra professional staff. That eases the burden, helps the practice grow. It's exponential, right. It's exponential what you're doing. I always like to ask this, dr Ashley if I gave you a magic wand and I allowed you to use it on anything with your business or healthcare, what would you do with it? 

Dr. Ashley Pendrick

26:07

You know I would end chronic illness. 

Josh Fertel

26:09

So part-time is an option. 

Dr. Ashley Pendrick

26:11

That's one of the suggestions too is maybe even sharing, so maybe you know another practice down the road that's also smaller. 

Josh Fertel

26:18

That's a great idea. Also, smaller, that's a great idea. Thank you, you know, for coming on. Thank you for educating me again. I'm looking forward to watching you grow through more than all 50 states and, you know, spreading the, helping to us spread the word. I don't know you got this. You don't need to say it yourself. 

Dr. Ashley Pendrick

26:39

It's been an honor and a privilege, Josh. Thank you so much. 

Josh Fertel

26:42

You're very welcome and we hope you come on again next year. 

Dr. Ashley Pendrick

26:46

Absolutely. Thank you, Josh. 

Josh Fertel

26:49

Thank you for listening today. Please follow us on Facebook and LinkedIn, and you can check us out at theangrybiller.com.