Magazine article Drug Topics

Free at Last

Magazine article Drug Topics

Free at Last

Article excerpt

Since Mike Leake went cold turkey with third-party health plans, he's discovered his pharmacy in Danville, Ky., makes just as much money as before, and he's a whole lot happier.

Leake is an example of the new breed of independent pharmacy owners who have decided to give Rx benefit plans the boot. They've found that there is life after third parties. Some of them spoke about their experiences recently in Pittsburgh at the annual Rx Expo sponsored by the National Community Pharmacists Association.

Taking the leap into the third-partyfree zone was accidental, Leake told Rx Expo attendees. He knew roughly what it cost him to fill an Rx, so when a Blue Cross contract came in with a reimbursement rate below his costs, he cut the cord on Dec. 23, 1994. By last September, he had managed to eliminate all other third-party plans, except Medicaid. He regards Medicaid as his contribution to unpaid public service, and he's thinking about axing that, too.

"With the Blue Cross patients, I had to explain why I couldn't afford to keep their card," said Leake. "Some had been customers of my father. Believe me, that's real, real hard. I was scared. A year later, I made $900 more real dollars on 300 fewer prescriptions. In 1996, I had $8,000 more gross profits. I'm having more fun and making more money than I ever made in my life. At night, I go home and I don't worry about those things anymore."

Just because he turns away Rx benefit cards doesn't mean Leake doesn't file claims. But now, the claims are on paper, and they're filed to help insured patients recoup their costs. Once a week, his bookkeeper sorts and bundles the paper claims and sends them off in bulk to the various processors.

"Some people let us fill out nonparticipating pharmacy claim forms," said Leake. "I'm not going to tell you it's an overwhelming number. I figure about one out of 20 stayed with me. Some of them ask me where's the nearest pharmacy. I say, 'Right around the corner there's a Revco. They'll be happy to take that insurance card.' I never thought that it would make me feel pretty good to have them walk out the door. I figure they just put dollars in my pocket."

Going third-party-free has also allowed Leake to spend more time with patients and to concentrate on other aspects of his pharmacy business. He specializes in compounding, diabetes, ostomy, and mastectomy and hosiery fittings as profitable niches. He also recently opened a compounding-only pharmacy in Louisville. …

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