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RxCompass Adds Vital Tool to Show Post-DIR
Script Profitability
► DIR Estimator Overview & Instructions
► RxCompass Inquiry Research
American Pharmacies has deployed a powerful new tool for RxCompass users that provides the critical ability to view drug reimbursement amounts adjusted for DIR fees.
The DIR Estimator and enhanced Profit Estimator tools were deployed on May 11 and work together to provide a post-rebate/post-DIR profit estimate, allowing members to gain a better understanding of true net profitability and impact to pharmacy business. Targeted evaluation and pursuit of net profitable business is increasingly critical in an era of declining reimbursements, and these tools give RxCompass users claim-level insight. The deployment of this new tool differed slightly from previous releases in that we couldn’t fully “test drive” the tools until they were released for all users; hence, the delay in this notification and release of a preliminary instructional guide.
APRx is eager to equip pharmacies to evolve beyond the traditional “fill and bill” dynamic to one of targeted pursuit of dispensing profitability by plan, by drug, and by patient or patient household. With these new tools and our recommended Inquiry & Research workflow, RxCompass continues to be a formidable tool with which to effectively evaluate and manage your dispensing business.
CMS has issued a final rule that eliminates PBMs' retroactive application of DIR fees in Medicare Part D, requiring that they be reflected in the patient’s cost at the point of sale starting in January 2024. The new rule increases transparency but does not curb PBMs' ability to assess or increase DIR fees at the POS. Impacts on dispensing revenue in 2024 are difficult to predict. In the meantime, PBM clawbacks from third- and fourth-quarter 2023 DIR assessments will hit pharmacies in the first quarter of 2024 as the new CMS rule kicks in, creating a potential "DIR Cliff."
There has never been a better time to use the power of RxCompass -- and the vital new DIR Estimator tool -- to start getting a better handle on your DIR-adjusted reimbursements.
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