Medicare Part D: Unconventional Strategies for Pharmacy Owners | Matt & Ben Coakley, Waypoint Rx

Speech to text:

Mike: Ben and Matt, for those that may not have come across you online, introduce yourself to our listeners.

Matt: I'm Matt Coakley. I'm the CEO of the Pharmacy Insurance Group, and then its parent company, the Waypoint Company, working with pharmacy owners and really just communities around the country for about 15 years and trying to do what we can to help pharmacies survive and not just survive, but actually thrive.

Ben: I'm Ben Coakley. I am Director of Business Development for the Waypoint Company in the Pharmacy Insurance Group. I do most of our marketing efforts, our outreach efforts have been serving pharmacies for about 20 years now and we're looking forward to finding new ways to continue to transform the business [00:14:00] and to find ways for pharmacy owners to thrive moving forward.

Mike: All right. So Ben and 

Matt, welcome back. We talked last time about you guys, setting up Medicare, insurance, uh, little stores inside a pharmacy and you advertise on the show for that. But I don't make anything the more people you sell to. 

You just pay me a flat fee for the ads.

Mike: reason I want you back on the show is not to 

Necessarily.

Mike: Push this product or this service, but for pharmacists to open our minds up about things that are possible, but we have to push a little bit sometimes to make them possible.

So in your case, I think you're a good example of that pushing. So tell me about your growth. I think you're up at a thousand 

 pharmacy owners [00:15:00] that are getting paid as a side business to sell the Medicare D plants. 

Ben: Well, Mike, I think it's a culmination of a couple things. Number one, I think pharmacies have been clamoring to be 

able to do this. I think it's something we heard numerous times throughout the years. Hey man, I wish I could figure out how to do that insurance thing. And I think the last time we were on the podcast, we we're coming out of COVID and really, what COVID did was buy us some time to really work on this model.

And it bought us some breathing room, right? Something we didn't have. The pressure has been turned up so much by the PBMs. We haven't had any breathing room to work on. And when you don't have a free market, like pharmacy is, you can't have innovation. How can innovation thrive in a market that's not free where you can't set your prices and do anything?

You're literally beholden to these big corporations who tell you how much you want to make. It's really insane. so I think that's part of it. [00:16:00] It's just this culmination of we got some breathing room, we're able to work on the model and Pharmacists have been clamoring for something like this for a long time.

And then you throw in the acceleration really these last few years, the PBM contracts, especially on the Medicare side have been abysmal. and I think people are starting to realize like, Hey, we better do this now or our very existence is threatened. And that's it. And people are motivated by

Matt: That's a good point, Ben, that you brought up the COVID stuff. Cause that's not initially my first thought was every pharmacist, pharmacy owner that I've ever spoken with Has said, and I'd say every, that's a qualifier, but almost all of them say, we do this work for free, and it's not really right that we do this work and somebody else gets paid that's either sitting right outside our door or something like that.

So, I think most people have been interested in it. What Ben made me think of with this COVID mention is, There was a lot of extra money that flowed through pharmacies between 2020 and 2023 [00:17:00] that maybe camouflaged some issues that were going on with cash flow. I mean, if you think about it, we had PPP dollars, we had CARES Act dollars, we had employee retention tax credits.

I'm missing at least one, we had vaccine dollars where basically we had no cost of goods, but we got paid on the back end. Now, I'm not trying to make light of anything that pharmacies are doing, but those were things that added to the bottom line or helped add to some cash flow that could be used to pay employees or offset expenses that they had.

So I think we had people jump in early. There's always going to be some early adopters. And then right now, like Ben said, it's really the snowballs going because people are realizing the payer mix is such a huge deal and getting any additional stream of revenue becomes huge. And then the one other thing that I would throw out that I love about pharmacy is just kind of how my brain works.

We do have your early adopters, but we also have a lot of people that say, I don't want to go first. Let me see somebody else that's [00:18:00] done it and done it well, that hasn't gotten in a lot of trouble, and then I'll jump in. We're in that phase now where we've got some extreme high achievers. We've had a lot of different ways that it's been set up and we've been able to figure out how to make it work each way.

So now this is the second or maybe even the third. Run of people that are jumping on board.

Mike: Well, and the problem with, I compare it to, let's say, McDonald's or something with pharmacy. Think of McDonald's all of a sudden They

start selling their Big Macs for eight or 9 and they're just crowds coming in and it looks great. And you don't have any time to even blink, because everything's happening.

And then all of a sudden they find out later that some insurance company or something is taking back 7 of that. And so here, the. The entrepreneurs, they're busy as hell. They're spending all their time thinking about where they're going to get the beef from and who they're going to hire and how they're going to grow their physical [00:19:00] building and do all this stuff.

In the meantime, they're making a buck, a big Mac. They think they're making eight. And their focus is wrong. I mean, if you think about the opposite way, think about businesses that are tied into finances. Well, let's say McDonald's that is tied into finances and they can raise their dollar menu up to 1.

89. Well, business is going to slow down a little bit. They're going to make a little bit more money, but it's going to slow down. They can feel that they can either say, we're going to take more time to think of the menu, or we're just going to lower prices and get busy again. They have that option with pharmacy though.

It's blind. People are blind to it and they end up jumping off a cliff basically. Right.

Ben: I mean, that's a great analogy. I love that because when I was in Texas, I was at Texas pharmacy day a couple of years ago and one of their Freshmen senators owned an electrician business. He was an electrician. And I went through, I said, imagine you don't know what you're going to pay for your stuff.

And then you've got this group [00:20:00] of people that tells you how much you're going to make on each job. And he's like, I wouldn't do that. And I said, well, that's what pharmacy is. And it was amazing to me when people started to see and understand how the market works. Like, well, that's not right. And again, we're expecting people to pay competitive wages and provide the livelihoods for families in an environment where they have no idea how much they're going to get paid next year. And that to me is you're right, Mike, they're kind of flying blind.

pharmacy owners and pharmacists and people that work with community pharmacy, most unbelievable human beings. They sacrifice so much to themselves and they even are willing to risk everything, not even knowing what they're going to get paid just to keep something going.

It's really a phenomenal thing. So when people like us see that and we have a heart and we see the impact, we grew up with pharmacy owners. We grew up. Hunting and fishing with the kids of pharmacy owners. We've seen Gene Phillips. Shout out to Mr. Phillips there We've seen him put kids through pharmacy school who were in his little [00:21:00] community who never would have had the chance to go to pharmacy School so when you have a heart and you see that you want to pitch in and start to find ways to help them and one of the things that we know is We cannot play the game That the PBMs want us to play.

we cannot play that game and we have to find a new game. If we want to thrive, 

Matt: I heard today, I don't, I'm not going to give an exact quote, so I won't say which manufacturer it is, but it's one of the high ups for a company that makes one of the GLP 1s, and he was getting grilled on why is this so expensive. Why is it three times the price in the United States that it is in other countries?

And he said, the dynamics of the U. S. healthcare, because of the large number of middlemen, make the price of all this stuff go up. And you're starting to hear that there's a congressman down in Georgia, everybody probably knows, I'd say it's Buddy Carter that I've had lots of conversations with.

 And Buddy's told me before that. When he first got to Congress, his [00:22:00] job was to educate, because nobody knew what a PBM was. 

People are educated. They're even educated in dc Nobody knows how to fix 'em 'cause they don't agree on anything in dc. But they know that there are a lot of problems with the finances of our healthcare, specifically our drug system where that problem lies. And it's just a matter of can they fix it?

And to Ben and IC out there in the world of community pharmacy, can they fix it soon enough? So if we're losing. 500 pharmacies a month, that's not an exact figure. I just pulled that one thin air, but I bet it's not too far off. If we're losing pharmacies that kind of clip, we don't have two years or four years or another presidential election cycle for them to figure it out.

We have to figure out something else to keep pharmacies afloat. 

When we get into these conversations and we're talking about taking pressure off the pharmacy I just want to make sure people are aware that we're not saying Joe's Pharmacy is going to get licensed as an insurance agency and it's going to be a one stop shop. Joe's, [00:23:00] the owner of Joe's Pharmacy might also own Joe's Pharmacy Insurance Agency.

And you might be able to get both services in the same building, there's going to be a clear separation there. But if we can use the insurance agency to provide a little bit of cash flow that takes some pressure off of the pharmacy or the pharmacy owner, the way I think about it is, if we can provide an extra through the insurance advice, let's say 20, 000, maybe that's one day a week of a relief pharmacist that can come in.

And then the pharmacy owner, especially if he's also a pharmacist. Can spend that day either with his family, which is highly important stuff, or marketing, going to find other profitable scripts that he can bring into the pharmacy. maybe that's half a tech for the year.

So that's half a tech then. There's additional cash flow that the pharmacy owner doesn't have to pull out of the business that can then be used to take pressure off of everybody and I think when people think about it like that, they really start to see the value of some of the [00:24:00] work that they're doing the financial component of it.

Mike: What have you guys found as far as the physicality of this? where does the happy medium line lie as far as a different desk, a separating wall, none of that. It's all kind of legally figurative. Where do you find the best line has been with the distinction between the two Companies that a pharmacist might have with the pharmacy and also an insurance agency.

Ben: I think that's a great question. The number one question we get is, we want to make sure, is this legal? Is this a conflict of interest? And what we tell people is following the rules really matters. Keeping it separate, like Matt said, separate accounting, separate marketing, all that separate.

Now, what's interesting is when we consulted our Medicare attorney, and asked him to kind of go through the entire process and make sure that we were doing it the right way [00:25:00] Basically, what he said is there's no guidance On who can actually do this as long as they're licensed.

So it doesn't matter if it's a pharmacist or if it's a technician As long as they're licensed they can help somebody enroll into a medicare plan and get paid commission now we want to protect things we want it to be paid to a llc bank account again separate from the pharmacy The big thing is where the actual enrollment is held

That was fascinating to me when that came back because we've always heard a pharmacist can't get paid commissions which according to our medicare attorney that's not accurate a pharmacist can be an agent and can get paid commission as long as they're operating as an agent, not as a pharmacist.

If they're behind the counter, they need to be offering objective advice, non biased advice. But if that patient needs help, that pharmacist can step out from behind the counter, go over to an area, It's got to be HIPAA secure. want to make sure, cause we're [00:26:00] talking about health information and actually do an enrollment and get paid commission for that work.

So that was the fascinating thing to me. I don't know about you, Matt, but the most fascinating thing was that it's more important where the enrollment is held than actually who does the enrollment. 

Matt: Tell us who can do this. So basically, when he came back and said, there's nothing anywhere that says the pharmacist can't refer people to an insurance agency. There's nothing anywhere that says a pharmacist or pharmacy owner can't own an insurance agency.

There is some stuff that says where a marketing appointment, which is an enrollment, can take place, what rules you have to follow for it to be a marketing appointment. So we have to have scope of appointment, we have to have permission to contact, although in this case it would be a walk in and we probably do not need an actual signed form.

But there are lots of rules like that and we can help people figure out how to navigate with them. There's still a comfort level. There are pharmacists that I talk to every day. They don't want to get licensed because they're not comfortable with it. That's fine. A lot of them will use [00:27:00] to have a spouse or a child or sometimes a technician. We've got some nieces and nephews and crazy uncles.

There's a lot of different ways you can set it up that you'll be comfortable with. And. To be clear there's not any real litigation on a lot of this stuff. This is something that usually what we get is who can own it. And what our attorney said, Walmart owns an insurance agency.

Some big grocery store chains own Medicare insurance agencies. They also own pharmacies. 

Ben: CVS just bought one. 

Mike: I think it'd be insane for the big guys to come looking for this and open up the can of worms of vertical integration let's say they think they're legit. Well, at least they think they're legit, how can they say somebody else is not legit?

Matt: What we tell people is the right plan is always the right answer. The right plan is always the right answer.

And if we help get the patient into the right plan, then it doesn't matter if it's the pharmacist, the technician, the pharmacy [00:28:00] owner, or a third party insurance agent that's doing it. If we're putting the patient's needs first, which pharmacy owners have always done, that's why they sign people up for terrible plans, knowing that they're going to lose money, and still encourage the person to come to the pharmacy because they're good people.

Pharmacy owners want to take care of their people. That's what they went to school for. Add in the love of their community and you've got a perfect storm for somebody to be taken advantage of. We want to flip that a little bit. Their PSAOs have gotten wise to that and are trying not to take those plans, trying to just opt out of them all together.

But as long as we're putting people on the right plan, then we should be good. So, then we should probably step back and say, Mike, this would be good for your benefit, too, that our attorney, we're very confident in him. He's a big DC attorney that specializes in government health care, Medicare, Medicaid. But one thing that he will say is you can ask a thousand different attorneys the same question and you might get a thousand different answers.

So, we've had a lot of people that [00:29:00] have consulted with their own healthcare attorneys and some are more conservative. A lot are more aggressive frankly, than what ours is going to be and that's okay. I tell him that we want to be, we want to be right. But he does reiterate that this stuff hasn't been litigated and as long as we continue to do the right stuff then Meaning, put people on the right plan and everybody should stay safe, but that is his big caveat that he throws out there.

I'm happy to pass along his information for anybody that might want to engage him. We do have an ongoing engagement, so we're able to answer popular questions. When we get into super specific stuff, that's something that, that a lot of times just applies to one agency and they probably want to check with their own attorney.

But we are very careful as a financial advisor. I always like to throw the caveat out there. I am not an attorney. So we're very careful to make sure that we pass along what we call best practices from our attorney. More so than what's legal and what's not legal, because again, it's not litigated.

But I feel very comfortable that our agencies and our [00:30:00] agents are out there doing the right thing, and we watch it. And if we see somebody, which has happened a couple of times, you would be shocked at how few instances there are with as many Medicare policies that we're doing. But if we see somebody out there that is not putting the patient's interest first then they'll be uncontracted.

. One other thing too, because it's come up, people say, are we being dishonest when we contract somebody? When you get contracted with an insurance company, through us, they'll ask you, do you represent, get paid for any, anyone that gets paid from Medicare? And I had an insurance agent ask me one time, do you just have people lie on that?

I said, no, we don't lie . We're not here to do anything dishonest. So I said, did we answer that? The pharmacist answers the person getting contracted, whether they're a pharmacist, technician, or the owner of a pharmacy, Any of those, but answer yes to that. They have to answer how they're going to manage that conflict of interest.

So it is out there. The carriers are aware of it and we just want to make sure everybody's doing the right thing, [00:31:00] which again, largely isn't that big of an issue.

Mike: Well, and the gift that you guys bring to this certainly the practicality of that, but guys are hitting the four minute mile, where you've passed it. And now what's that old story? Broke the four minute mile running, no one had done it and then he did it.

And I'm sure people were getting close, but then like so many people do it in the next year. it's just breaking that mental barrier a lot of times, if not exact step 

Ben: Matt and I are second generation. Okay. Our dad founded this company, the first I guess version of it in 1975 approximately. So we're going to celebrate 50 years. And one of the things that he instilled in us is this commitment to always do the right thing.

And I think that's really important. And he always told us there's two things that could get you shut down in this industry. First one is not doing the right thing for your client. Okay. So we have to do the right thing for the patient. That means if we're comparing two [00:32:00] Medicare plans and one of them is an absolute stinker for our pharmacy, but it's the only one that patient can afford, we better put them in that plan.

 Because the moment they've got to choose between food and drugs, we have a problem. We're going to have a problem. Okay. And the second thing is compliance. Compliance. So we want to make sure that we're marketing this thing the right way. We're having enrollment meetings, marketing meetings, as Matt called them, in the right place inside the pharmacy, those types of things.

Those are the two things that will get us shut down. And so, so that's where we focus. Matt's right. We have oversight. We see everything that's written through any of our agents through the pharmacies across America. We can see it. Okay. Who's really heavy on Medicare Advantage. So we can pick up the phone and call and be like, Hey, tell us what's going on.

You're way above our averages, the national averages, and maybe we found out, maybe they're in Charlotte, North Carolina, where there's two really popular Medicare Advantage, five star Medicare Advantage plans. And in both Novant Health [00:33:00] and Atrium Health, take that plan.

Okay. So we find that, okay, that makes sense. But what if we found out, Hey there's not a great Medicare Advantage network here and you're throwing everybody into that plan. Tell us what's going on. Oh, you know what? Maybe we need to go sit down with this person, do some more training, whatever.

 Like Matt said, this has not been litigated. We literally are creating a new way to do business. And it's a much better way to do business, by the way. This is much better done with pharmacies and the patients working together because you see examples where pharmacies are able to go and do certain things because they know the information, they know the drug costs 

it's a better fit for the patients.

Matt: I don't do that many enrollments . I do some But I'm only a backup plan, so we have a lot of agents who do significantly more than me. But I look at a person's prescription mix, and I say, there is not a good plan for this person.

And it's not even, it's not a good plan at the independent, but they could go to Walmart or CVS and save money. There's not a good plan. They're [00:34:00] just on a weird mix of prescriptions, so everything's gonna be really expensive. A conversation with the pharmacist says, well, they can switch, they can take two or half the dose of that, and it equals the same thing, and then their drug price comes way down.

Or, this drug is exactly the same as what it's made of, and they can switch over to that, the doctor will do that no problem. This one puts them in a plan that they can afford. That one keeps them out of a plan that they can afford. I don't know that. A typical Medicare agent isn't going to know that.

A lot of these agents are people, because Medicare payouts individually are so small, a lot of these are insurance agents that also do Medicare or investment guys that also do Medicare or property and casualty guys that also do Medicare. , they don't have those answers or the ability even to think through that where somebody associated with the pharmacist.

Would be able to, so

Mike: one Of my techs, my secondhand guy, I've gotten lazy and dependent on him for all the insurance questions and [00:35:00] things like that. And to hear him, Say some of the things to the patient that he's trying to dumb down as much as he can to help them find a good plan.

Sometimes I don't even pick up on it and sure as hell the broker insurance person's not going to be able to figure out the intricacies of this person's needs. I understand the laws between, not having your financial hand in it, in your own company and all that stuff.

But even there, I'd probably rather have that than. Just bad advice because if you have someone, I'm not saying this, but if you have someone nefarious, at least maybe they're nefarious with some good things for the person, too. But if you get someone that doesn't know a damn thing about it, they can even make it worse than the nefarious people, so there's just so much knowledge that's needed. I just can't picture someone outside of the pharmacy giving good advice on that.

Ben: There are a few of our partner Scott Amos, who does all of our Medicare training, I can tell [00:36:00] you that he is one of the good ones.

He has worked. His whole entire career to learn the Medicare space and to understand the drugs and which different therapy options classes and which drugs are in which. So they are out there, but it's rare to run into one, if you're one of the fortunate ones who run into one, that's great.

Everybody else out there, I say this 90 percent of Medicare agents are, either dumb or they're . sociopathic Ben mentioned Scott. We always try to guesstimate how many enrollments he's done. We think maybe six thousand ish. He made Medicare his business. Most agents, payouts are, can't make this their only source of business unless they can hit huge volume.

Matt: We actually have several agents in the pharmacy insurance group that can do that because they're getting large amounts of referrals from the pharmacy. But if you were just to set out on your own and say, I'm going to build a Medicare business, it's a really underpaid position at the [00:37:00] beginning and it's just hard to get there.

Scott has successfully done it. Him and his team, he and Travis, are two primary trainers. They're the best we've run into. That's why we have them as our primary trainers. It's not that, I love to say this, I've been an insurance agent for 20 years, so I feel like I can, but it's not that hard to become an insurance agent.

 It doesn't take eight years of school like it does to become a pharmacist. It doesn't even take a separate class like it takes to become a certified tech. It's a 20 hour class. It's not that much to do. Plus if you take that and factor it in with, most of us are split amongst what we do.

We're investment guys, or we're annuity guys, or we're life insurance guys, and we also sell Medicare. we don't have that much brain capacity that we can know at all, certainly not like a pharmacist or a technician. So it's very important that the Medicare agent, whomever he or she is, has that person that they can communicate with.

And a lot of the enrollments that I do are pretty straightforward. But [00:38:00] any of them that I have any questions on, I have to be able to pick up and call the pharmacist that Referred the patient to me and asked what was your thinking here, what are we looking at?

This one prescription is throwing them into a very expensive plan. Is there anything that works like that? And if I didn't have that open line of communication, I wouldn't be a very effective Medicare agent.

Mike: Ben talking about your dad's advice, about the two points. And this is dating myself with the newspaper, but I've always said to myself and my team, it's like, how is this going to look on the front page of the press? And the key to that is you don't have to be guilty and it doesn't have to even be illegal.

and the reporter doesn't even have to be right, but that doesn't necessarily keep it off the front page of the paper. just the questions of things that reporters can come up with. You want to be way far away from that because the guys that end up on the front page of the paper have done this.

And then four weeks later, it comes out in section E, down on the [00:39:00] bottom thing. It's like, Oh, we were wrong, or we retract that or something like that. And I know you guys do that you've got to be not just a distance away from something, but like two distances away from it to stay out of the paper.

Ben: Mike when you're going to launch something like we launched, one of the things that we did the very beginning is we spent nine months, 10 months Really vetting the idea. I mean really going over how this is going to work, picking up the phone.

We call it insurance departments. I mean those types of things to make sure this whole thing, any publicity is good publicity. no, I don't want bad publicity. I don't want people to say, Hey, my pharmacy got shut down because these guys from South Carolina started getting people licensed for it to become insurance agents.

And so that's why we invest a ton of our money and resources. And attorneys, healthcare attorneys and Medicare attorneys. And we will at least spend that money. So pharmacy owners don't have to do it. So we can go out and tell them, Hey, there is good news. You can do this as long as we [00:40:00] follow the rules and we're compliant.

 and that we always do the best thing for the patient, and that, that to me is a huge portion. We know that our legacy is on the line. I mean, we know that My dad started this business in 1975. The last thing that I would ever want to do is jeopardize what he built.

This is his legacy. So that's our commitment to maintaining this compliance culture. When we first did this, it was like unshackling the pharmacy owner. I mean, they've been so shackled up and chained to what they were doing and there was no freedom.

All of a sudden We give them this outlet. They go out and start marketing it like crazy and we're like, oh, hey, slow down a little bit. We don't need to get provocative in our messaging. we've got the thousand to 1500 people coming through the doors every month or every two months, let's just get them instead of saying, buy, from somebody out there who you don't know, and you don't trust, buy from our team, our people, because our [00:41:00] pharmacy friendly agent, as we call it.

Let's leverage that trust that we've built with these patients and really elevate the insurance buying experience for them. Cause that's what we've done.

 My wife, God bless her. But Let's say we're at dinner or something like that. And she says something that just doesn't sound right to me. Well, before I would get out my phone and fact check her right away. Now I do a little bit more subtly. It's under the table, you 

Ben: Yeah.Yeah. 

Mike: Her friend was saying that, Don McLean's American Pie, 

Matt: 

Mike: which is about the guys dying in the airplane crash, The big bopper and all that

kind of stuff. 

Matt: Buddy Holly. 

Mike: like, the American Pie was the name of the plane and it was bye bye to the plane.

And I'm like, that doesn't sound right. So I had to fact check it. Now, to my defense. Pharmacists are trained to be pessimistic, because unfortunately the main thrust of payment is to Check for errors. It's not a [00:42:00] proactive, pharmacies hope it gets there, but right now.

It's a lot of catching the negatives. And so I say, Margaret, that's just my, that's just my job, but I think a lot of pharmacists with this stuff, they're and they should be for the business part of it, but pharmacists are ultra cautious because that's our bread and butter to be ultra cautious and look for errors, not necessarily look for.

New plans of things.

Matt: In the pharmacy is the goose that lays the golden egg. So, I mean, the egg's not quite as golden or maybe it's not quite as big right now in community pharmacy. But Ben and I talk about our concept of the pharmacy of tomorrow, which is the center of healthcare and wealth care in communities.

And we talk about improving non PBM revenue for the pharmacy owner and the stakeholders in the pharmacy. None of that works if we don't have a pharmacy. We need a population, a pool of people that need our services. 

Ben: Yeah, Mike, I told this story the other day to a pharmacy owner [00:43:00] and we are cautious. Okay. Pharmacy owners are cautious and pharmacy owners have told themselves certain things. You know how you kind of speak truth to things or speak things into existence? Well, one of the things they've spoken into existence is that they can't do

this.I've asked a pharmacist, well, I can't do that. Well, show me where, anywhere. That it says you can't do this anywhere

And They're like, oh, you know what? I think I heard it from somebody. Yeah, you heard it from somebody who heard it from that person who heard it from that person It's become an urban legend Now the way I explain this is you remember the movie the village Did you ever see the movie the village?

Mike: The 

Matt: in Night Shyamalan 

Mike: Is that a horror movie?

my heart can't take that, Ben. I haven't watched a horror 

Ben: yeah, 

Matt: but you might you got to say spoiler alert

Mike: The last time I watched a horror movie, it was with my wife. We went on one date when I was a freshman in high school. Then we didn't date again for like four or [00:44:00] five years. And that's the last horror movie I saw Friday the 13th in 3d.

Ben: This one's not near as what I said though spoiler alert for anybody here Watching the village anytime soon. I'm gonna ruin it for you. But here's what happens It's about this village and they're based like in the 1800s and they're very Conservative and they teach all the kids that if they go outside the village, there are these monsters

Okay, well it turns out somebody like gets shot or stabbed or somebody and they actually need to get some modern medicine to save this person's life.

So they send this blind girl out and it turns out that this village is like in some kind of federally protected land 

It's really today. And those monsters they made up are fictitious because they don't want their kids getting out and getting out into the modern world.

Okay. So the whole point is we've made these monsters up. Okay. We've made these monsters in our head, these fictitious monsters. We can't do these things. We're not allowed to do these [00:45:00] things. And in reality, they're just figments of our imagination. And that's what we've learned through this process is that, okay.

No, it's nowhere, anywhere that we can find or our attorneys can find that we know of, again, that we know of, or that our attorneys would tell us if there were rules that said you can't do this, but there's none that exists that we know at this point. And so, I still talk to pharmacy owners to say, I can't do that.

I'm not allowed to do that. And it's amazing to me. I said, well, I got over a thousand now doing it. For almost four years, It's no secret now what we're doing. I mean, we're on the radar. Okay, people know we're big enough now that people know what we're doing and so 

so Mike doesn't go watch the village. It's that it's not really a horror movie, but

Mike: I have no doubt that you're a good storyteller. I don't doubt that, but I think I could handle that.

Ben: It's not really that

Mike: I think I could handle it. didn't even get sweaty palms or anything from your explanation of it. I think I could go there. Maybe that's my Monday night movie tonight.

Ben: [00:46:00] There you go, you know go for it

Matt: is it's not in a galaxy far away or anything it's really happening right now

Ben: Yeah, it's all made up. You're like, what? They live, they choose to they were choosing to live

like They 

Matt: protecting their future generations from the realities 

 of the modern world 

Mike: I was just talking to Anisha Pharmacy Diaries podcast this morning. I was on and she's from England, so I had to drag my ass out of bed this morning to make that work. But we were just talking about A lot of companies that think it's in their best interest to kind of scare other people or have these legends where you shouldn't do this because they're not pros like we are.

Whether it's, rust treatment on your car or water treatment on your house or something, they try to scare you into things. 

We were talking about, like, the The restaurant hubs, like in an airport or a mall, they're all together.

And in the old days, you'd think that wasn't good because they're going to eat their food instead of my food. But everybody knows now that when someone's interested they go somewhere with the most [00:47:00] choices. And we were talking about podcasts. It's like, I love to promote and talk about other people's podcasts.

And even more so if it's business, because you listen to one, it doesn't satisfy you, then you're more into it. You want to listen to others and so on. And there's a lot of things like that. And pharmacy sometimes rightfully so, but there's a lot of that fear. Don't touch this because we're the doctor's office and you can't do this because we're the dentist's office.

Matt: I think you might have touched on another really big thing that people say as a reason why I shouldn't do this, and that's because I'm gonna make Johnny the insurance agent down the street really angry at me. And again, we're talking about people who live in, a lot of times, small communities and don't like to upset people, the example we've used over and over. Put someone in a bad plan because it's a bad plan for the pharmacy because it's the best plan for the patient.

Same thing. I don't want to take business from this guy who maybe I see at the golf course, or maybe my kids go to school with his kids and there's something to that. And I think [00:48:00] everybody, you mentioned the doctor thing where the pharmacy and the doctors overlap in their advice, there is some of that.

And I think everybody's got to kind of make their own decision and how much they want to do. 

Ben: You can see which one of us is the more diplomatic one. This is why he's CEO you know what I say? That guy down the road doesn't give a crap about your pharmacy. Go put him out of 

Matt: Oh, that's true. That's true. Yeah. I'm not trying to undercut that. And I think pharmacy owners are just at a place where they say we're hemorrhaging if we're not, paying attention to our payer mix. not making money on this that we're working for, which happens in so many facets of our business, then we're really losing.

So I think they're past the point of trying to be nice, largely, Ben. But my point is, you can be nice. This says we're not trying to take food off of somebody else's table. All we're trying to do is take our patient population, give them the best advice possible, and for doing something that has financial compensation, get financially rewarded for it.

And if that makes my neighbor mad, then, my neighbor needs to get a little bit thicker 

Mike: Well 

the [00:49:00] first way to answer that question and I have to catch myself on this , my wife, maybe she's going to a different beautician because she likes how this lady cuts the hair more, and I might be thinking, and she might be thinking, well, how do you tell that person this or that?

My first question is: Are they a customer at our pharmacy? 99 percent of the time he answers no. So then that goes out the window. Now I've had some people that may be an insurance person or something. They've been customers for a long time. Those are few and far between in this world, so my first question now is always, are they a customer?

And if they're not, then all of that potential angst I go through is just inside of me. has no bearing in reality. It's just something inside of yourself. But it's like. If they want me to have that conversation in my head, they can come and be a customer. And then I'll really give that some thought.

Ben: That's right, Mike. So part of our job is we do get some, what I call fan mail from other agents who don't necessarily like what we're doing. 

there's two mindsets in this world. You can have an abundance mindset or a [00:50:00] scarcity mindset.

Okay, a lot of insurance agents have a scarcity mindset there's one big insurance company that deals with pharmacists right now I'm not gonna get into their name because I don't want to get sued but they have a Tremendous scarcity mindset and I think it's gonna be the end of their business I think scarcity mindsets will cause you to ultimately become very poor

Scarcity mindsets are destructive. . Instead of thinking about growing the pie, you're thinking about maintaining the pie, and you don't have a growth mindset . So, We get this fan mail. They don't like us. It's fine. And what we tell them is don't be a hater.

Don't hate us because we created a better model for patients. And that's what we tell them. You 

Matt: I was in Las Vegas at the AmerisourceBergen trade show, or whatever their name is now, last year, and I got a phone call that I kind of alluded to a little bit earlier, where the guy just point blank, he said, page 14 of the, this insurance company's contract says explicitly, are you, or do you get paid [00:51:00] by Medicare, in any other capacity, something along those lines, and you must just tell your people to lie on that, and there are a lot of things you can say to me, but.

I do not react well when people call me dishonest because there's nothing that I do that has ever been intended to be dishonest and I was like I said listen here. You can call me. You can ask me questions. You can probe me But if you start saying we're being dishonest We're going to have an issue because there's nothing that we're doing that's dishonest It sounds to me like you're not super happy that your pharmacist buddy Just figured out that he's going to be better at this than you are and I can't help that My suggestion to you is figure out a way to partner with him because you'll be better if you're working with him Than you are right now anyway, and right now he's probably doing 90 percent of the work and you're taking most of the money He's probably handling 90 percent of the service issues on the back end And you're still taking all the renewal money and that's just they're not going to do that anymore.

And that's my argument. There is a fun thing, kind of [00:52:00] slightly different line of business, but we have a long time financial services client that owns pharmacies and we do their retirement plan and stuff like that. And the waypoint company side of the business and he was working with his buddy, his high school buddy was doing their retirement account.

He said, I can never find out exactly how much he's charged me. He won't tell me and it doesn't come on my statements and I can never find out exactly what my return is. And those are my two main questions. And he said, I have a hard time asking this guy because he's my friend. He's been my friend for 25 years.

So I said, that's great. I said, send me other stuff. I'll take a look at it. He said, I don't even need to go there because today he got a letter in the mail that said his bank is going to have a mandatory mail order. So he is no longer going to be a customer of my pharmacy and that gives me the last straw that I need to say, I don't want to do this with my friend.

I want to do this with somebody that I can have a professional conversation with. So again, I think at some point when we're dealing with our money or with our healthcare, which is [00:53:00] every bit as important, getting the best advice starts to become much more important than getting advice from somebody that, that my kids play, my grandkids, I guess, in the Medicare space play baseball with, or that I play golf with, or something like that.

And

I think that's where our agents live. 

Ben: But the best thing about this model is they can do both. They can get their Medicare advice with somebody they trust 

I don't know if the level of trust is the same, but there is a massive level of trust with the pharmacy. so they can get the best of both worlds. They know that they're getting the best advice.

Matt: I saw a list of, somebody was telling me, I actually googled it and I don't remember exactly what it was. I might pull it up on my other screen here, but most trusted professionals, pharmacists, were always number one, and I think they dropped to like number three, but insurance agents are still way down at the bottom, so 

pharmacists would have to drop a long way before they get down to insurance

agents. 

Mike: You should tell the sole insurance guys to be happy. 'cause [00:54:00] our three might lift them up a little bit. 

Matt: There is a model where The insurance agent works with the pharmacy owner or someone in that space.

It's made a new agency the insurance agent can be part of and we've had great success with that and that's usually where I go If we're worried we're going to hurt somebody's feelings in the insurance agency side, or if the insurance agent calls me directly, which occasionally, I was a little bit peeved in this example that I gave in Las Vegas because the lady that answers my phone, who's also my mother gave this person my cell phone number.

Anyway, Long story short, I said if this is a better model, you need to partner with that person and show them you can bring value, save them time, and you guys can work together to make it work. We've got a few of those that are really absolutely crushing it

 I really thought it'd be fun to go back and listen to the previous podcast which like I said we appreciate, we still get people saying, heard you on the business pharmacy podcast which I think was from 2021, but I really thought this was going to be technicians mostly technicians [00:55:00] that did this what happened in 2021, had the COVID. Tech crunch, where we had a lot of techs going to do something else. We had staffing issues. Well, I guess it started in 2020 really because we had people out sick.

So technician hours are always valuable, but they became extremely valuable at that point and people said I can't sacrifice a technician for 10 hours a week or 2 hours a week.

So we started having nieces, nephews, sisters, aunts, spouses that got it. And we have a pretty wide mix, but I would guess technicians is probably the least of it. When you think about close family members, like spouse or children, and then maybe slightly distance like cousins or nieces, those are probably more popular.

And pharmacists still are pretty popular in getting licensed too. But it's been 

interesting. 

 It's not hard 

it takes time, and sacrificing time can be extremely difficult, when you're working 60 hours a week, you're running a business, you have family obligations like a lot of our agents do, so [00:56:00] everything that Ben's worked on, and he's real good about helping us, because Ben has three 

small children, Ben's real good about saying, we got to make this more efficient.

We gotta make it faster. We got to make it where it's simpler. 

We can't make the time commitment go away, but we spend a lot of our resources to try to make sure the efficiency of your time 

commitment is, is utilized as good as possible. 

Mike: I've had a couple Companies that will say to me, Hey, Mike this is our typical rate for this but if you would just try 

this 'll be free for you. And I'm like, there's no such thing as free. I mean, it's, it's, it's thinking 

about it, maybe. Pissing off an 

employee they're thinking this is going to happen maybe a customer gets mad because

it's more of a delay or something like that.

So there's no such thing as free always a time issue 

Ben: Mike. If you're a pharmaceutical right now You have to ask yourself the question, am I going to be okay [00:57:00] with other people determining which plants come into my drugstore?

The days of taking the random selection of choices out there that other agents are going to put people into, I think those days are over. In my opinion, I think they're over. I think if you're not having that conversation with the patient saying, Hey, listen, we've got two comparable plans here.

Um, this one's more pharmacy friendly than that one. I, I think you, you run the risk. We had how many stores this year, Matt, have we found out that have closed, that we had the conversation last year and we said, you better do this because if you get, if you're too heavy on ESI, Medicare, if you're too heavy on that.

You're gonna go out of business. 

Matt: There's one particular plan that if you take low cost medicine or the only expensive medication you take is a diabetic drug that most people are going to end up on and it's terrible for pharmacies. Now a lot of pharmacies through their PSAO do not take that but the ones [00:58:00] do, if they're not ready to have that conversation, sometimes that's just the best plan for the patient.

There's nothing you can do about it if you take it but a lot of times the disclaimer or disqualifier of, I want to go to the pharmacy that I go to will eliminate that plan if that pharmacy doesn't take it. But pharmacies have to be prepared to have those conversations and they have to figure out.

where they're comfortable with it and make sure that they're okay. I've seen a pharmacy owner say, this plan pays for delivery. This plan does not. If you want me to continue free delivery, you need to spend the extra 7 a month on this plan. And some patients will do that. Some patients can't afford to.

but my point is that I always tell pharmacies you have to have a plan for that because if you don't, The typical insurance agent is not going to think about you when they're helping somebody make that decision.

Mike: Golly, Ben and Matt, great seeing you guys again. Again, I like you guys, but for the listeners, I don't care if you sell [00:59:00] anything from the show, it means nothing to me. What I want to get across is that as pharmacy owners. We have to be thinking differently. We have to be thinking of new inventive ways to do stuff. And it's not easy. Sometimes it's shifting A whole industry around. To make those changes. So this is just an example, and I think it's a good example. Of having to reach and dig further and really think about the next steps. So thanks a lot, you guys. Thanks for your time. And thanks for being here. 

I appreciate it. 

Matt: I am a big believer and Ben is too, and we are, that nobody is in control. Nobody has more control over our future than we do. And that's really hard to get pharmacy owners to think like that because so much of their money is controlled by somebody else.

But what decisions can I make today that are going to put me in a better position tomorrow? And there's a lot of different ones, there's a lot of different things pharmacy [01:00:00] owners can do 

I'll go ahead and say Ben, I know you might have something else you want to say, but I appreciate the opportunity, appreciate what you do. Like I said, I know you have good reach because we continually hear people that say, I heard you on it and that, that's amazing.

I like podcasts. I know they've grown a lot, but it's not the easiest thing to do to grow a podcast. So we appreciate you having us on here and look forward to working with you in the future.

Ben: Absolutely, brother. We do appreciate everything you do, bud. 

You've been listening to the Business of Pharmacy podcast with me, your host, Mike Kelser. Please subscribe for all future episodes.