Women's Health and Community Pharmacies

Representing 50 percent of the population, women have unique needs that require unique products and services that DME pharmacies can provide. That said, pharmacies must also strive to provide knowledgeable, top-shelf care. What goes into accomplishing that?

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The primary business imperative for today’s DME pharmacies is ensuring that they diversify their revenues and services and reinforce their status as a healthcare hub for communities. Moreover, they can’t properly execute on those initiatives without providing the right mix of women’s health products and services.

Pharmacies must create a business that strives to provide top-shelf care and products for patients and referral partners alike. And that means laying a solid foundation in terms of market understanding, staff expertise, customer care and resources.

To help us take a closer look at what’s involved, Nikki Jensen, vice president of Essentially Women (www.essentiallywomen. com), the division of VGM & Associates that providers education, networking and group purchasing for businesses that provides women’s healthcare products, shares some insights and expertise.

IDEAL MARKET POSITION

To begin with, DME pharmacies are in a unique position to serve women’s DME/HME needs. Assuming a community pharmacy has a good reputation for providing DME and HME products and services, they already have established a solid connection with the women in their local market. Now they just have to follow through and be that primary resource for women.

“More than anything, women are seeking a trusted resource,” Jensen Says. “They want a compassionate, educated person who will listen and help them understand options. Women are also looking for one place to serve all their needs; they don’t want to go to several different locations if they can get everything they need on one stop.”

There are a variety of customer constituencies that pharmacies can better service by catering to care and product needs, such as those for mastectomy, maternity and women’s compression needs.

MASTECTOMY

For starters, DME pharmacies are “uniquely positioned” to offer assistance to women before and after mastectomy surgery, according to Jensen.

“It’s possible these women are already customers using pharmacy services,” she says. “One in eight women will be diagnosed with breast cancer in her lifetime, which sadly, is not expected to change anytime soon.”

Bearing that in mind, a pharmacy looking to help these clients should aim be a one-stop-shop for post-mastectomy patients. Now that the patient has found a friendly, reliable, supportive resource, the last thing she wants to do is have to go somewhere else for one single item. Simply by providing the full spectrum of post-mastectomy products, you are establishing your pharmacy as a resource.

The more “central” products related to this group include post-mastectomy bras and prosthetics, but there is a wide variety of products and issues related to breast cancer patients that women’s healthcare providers should stock. Because those patients can be exposed to radiation treatment, there are various skincare product lines available to those patients. Wigs, hats, scarves and other head coverings are also important to patients undergoing chemotherapy.

“As women prepare for mastectomy surgery, there are items she should have in advance to help make her recovery more comfortable,” Jensen says. “Items such as the Contour Flip pillow are very useful since women who’ve had mastectomy surgery will have limited range of motion using her arms or using her arms to get in and out of bed or rising from a seated position for several days.

“There’s also a need for wound management,” she adds. “Women may need to resupply bandages and dressings for their surgical areas.”

MATERNITY

Obviously, new and expecting moms need a variety of products and services ranging from pregnancy support products to breast pumps and everything in between. So, this is a cornerstone women’s health category.

Furthermore, it represents a solid retail reimbursement category with a wide variety of products. And that list gets even larger if you factor in items such as infant nutrition. A pharmacy aiming to specialize in women’s healthcare should offer these items along with a wide array of other maternity- and baby-related products.

It’s worth noting that one of the more expensive maternity items, breast pumps, is a key maternity offering, but it is one that might trend increasingly toward retail purchase due to softening reimbursement rates. (Of course, new moms have been opting to purchase breast pumps when insurance hasn’t covered them for years.)

“Over the past few years, we’ve heard some of our members tell us the reimbursement has been declining for breast pumps, so they wonder whether they want to continue offering them,” Jensen says. “For those people, I urge them to reconsider and call Essentially Women so we can help you identify where you can make adjustments to your business model for breast pumps business. There are opportunities to be successful in this area.”

COMPRESSION

Compression products, such as hosiery, socks and arm sleeves, are used for many reasons, from relieving pain to helping to prevent severe varicose veins and deep vein thrombosis (DVT). Compression is also used in the treatment of lymphedema and in wound care.

Moreover, compression is a key women’s health offering with women representing the lion’s share of the market.

And compression needs are often related to the previous categories, mastectomy and maternity. In fact, Jensen notes that as many as 40 percent of women who have experienced breast cancer will develop secondary lymphedema following cancer treatment.

“Women who’ve had lymph nodes removed as part of their treatment will be at higher risk,” he says. “Lymphedema can appear weeks, months or even years later. Treatment with prescribed gradient compression therapy will be needed.”

“Pharmacies are uniquely positioned because many patients, before they know what they lymphedema is, may be coming to your stores seeking wraps or sleeves to help control the swelling,” she adds.

It’s important to add that women buying compression products might need custom compression garments, or they might be prescribed overnight vs. daytime compression items. Also, most patients will be recommended to replace compression garments every six months since garments can get stretched out with use over time, Jensen adds.

The one thing to keep in mind is that even when prescribed, compression is almost always a retail product, except in some scenarios involving lymphedema.

“Currently, Medicare does not recognize compression garments as eligible for coverage so this will be an out-of-pocket expense,” Jensen says. “Check with local private payers as coverage may be allowed.”

A RELIABLE REVENUE BLEND

Looking at revenue more broadly, the products serving these groups represent a good blend of funded and retail revenue. Major items related to procedures — breast prostheses, for example — are billable, but they are connected to a range of other items.

“Pharmacies should keep in mind women’s health offers much more than one billable item and the transaction is over,” Jensen says. “Whether it’s a woman going through her breast cancer journey, lymphedema or she’s a pregnant mom, all of these offer an opportunity to help a woman with more than one item and in many cases she will be a recurring patient.”

That represents an excellent opportunity for incremental sales, Jensen says.

“In other words, a woman may come to you because you initially because you can bill her insurance carrier or Medicare,” she explains. “It’s the additional retail items you offer that may offer a more pleasant or comfortable experience.”

PRODUCT EXAMPLES

Bearing the patient groups and blended revenue in mind, there are multiple products that a DME pharmacy can stock to start to better cater to women’s healthcare needs while drive a mix of revenue. Jensen provides some great examples of product categories, specific products, and their revenue type:

  • Body pillows such as the Contour Flip pillow for positioning and support, as well as seat-belt cushions – retail
  • The Shower Shirt, a post-surgical, water-resistant garment designed to protect chest surgery patients while showering, including mastectomy patients - retail
  • Post-surgical bras and camisoles – billable
  • Off-the-shelf breast prostheses – prescription, billable
  • Mastectomy bras – prescription, billable
  • Custom breast prosthesis – prescription, billable or out-of-pocket if not covered
  • Hats and turbans – retail
  • Mastectomy swimwear – retail
  • Wound care management – billable and retail, depending on the specific product
  • Skincare for radiation burns - retail
  • Compression garments for lymphedema – prescription, billable
  • Breast pumps – billable
  • Breastfeeding accessories such as replacement tubing – retails
  • Pre and post-natal support bands

SERVICE

Obviously, some women’s healthcare needs are very personal. How does a DME pharmacy ensure that they are serving those needs with the privacy, respect, consideration, etc. required?

“Having a private area to consult with patients is important,” Jensen says. “This goes beyond having a space at the counter for a prescription pick-up. Having a specific consult room is necessary.”

Also, Jensen advises that DME pharmacies offering postsurgical bras, breast prostheses, and mastectomy bras, should have dressing rooms.

“Creating a warm environment is critical to making patients feel welcome and comfortable during this very personal and sensitive visit,” she explains.

EDUCATION

When it comes to having the right expertise, training, education, or certification on the team so that a DME pharmacy best serves women’s healthcare needs, Jensen says a big focus is on post-mastectomy patients and fitting prostheses.

That starts with completing courses offered by breast prosthesis manufacturers for mastectomy fitting.

“These courses are instrumental in understanding the basics of off-the-shelf breast prosthesis and mastectomy bra fitting,” Jensen says. “American Breast Care (americanbreastcare.com/abcuniversity/onlinetraining) offers a great option for an online training option.”

Pharmacies that are accredited for Medicare DMEPOS need to factor that training into their accreditation, as well.

“With mastectomy fitting, if a DME pharmacy is already accredited through a Medicare-approved organization, let your accrediting organization know you are billing the mastectomy ‘L’ codes,” she advises. “Depending on the organization you’re accredited though, you may or may not be required to have a certified mastectomy fitter on staff. Check with your accreditation provider to confirm.”

On the maternity side of the business, breast pumps don’t require specific certification to bill payers for them, but Jensen recommends pharmacies do their research and have a solid understanding of what their local payers require for breast pump reimbursement.

DIVING IN

So, how can a community/DME pharmacy get started in better supporting local women’s healthcare needs? Jensen has some pro-tips for DME pharmacies looking to establish their market presence.

Starting with mastectomy patients, pharmacies should reach out to local oncology offices.

“Ask to speak to a nurse navigator,” Jensen says. “Most health systems have nurse navigators who are assigned to help patients by attending physician appointments and helping patients understand their options.

“Let them know you’re interested in assisting local patients and ask if there are any current unmet needs you could help provide,” she continues. “Let them know you’re wanting to become that trusted resource their patients need so the recovery process can be as comfortable as possible.”

For mother and baby, Jensen says pharmacies should communicate to their local OB/GYN offices that they have solutions for some of the challenges pregnant moms experience.

“Let them know you can provide compression stockings to help alleviate swollen, achy legs and ankles,” she advises. “You can provide pregnancy bands and support pillows. That same Contour Flip pillow I mentioned for post-surgical mastectomy patients is also great for women who’ve had C-section).

“Most importantly, you can provide breast pumps and accessories,” she adds.

DME community pharmacies looking for more information can contact Essentially Women at essentiallywomen@vgm.com or (800) 988-4484.

This article originally appeared in the DME Pharmacy April 2021 issue of HME Business.

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