Sacramento, CA – A recently released study supports what pharmacists have long suspected: it costs more for California pharmacies to dispense prescriptions to workers’ compensation patients than to the state’s Medi-Cal recipients.
Conducted by MENTORx/PharmAccount, “A Comparison of Personnel Costs to Dispense Workers’ Compensation and Medi-Cal Prescriptions in California Community Pharmacies,” analyzed pharmacies’ personnel-related dispensing costs and bad-debt expenses. “It found expenses are $6 to $9.90 per script higher for workers’ compensation than Medi-Cal,” said Joseph Paduda, president of CompPharma, a consortium of workers’ compensation pharmacy benefit managers requesting the study.
Key findings:
- Pharmacies doing their own billing had personnel and bad-debt expenses totaling $10.38 for new workers’ compensation prescriptions and $8.98 per script for refills. Comparable Medi-Cal costs were $4.33 for a new prescription and $3.65 for refills. Therefore, it cost these pharmacies $6.05 more for a new workers’ compensation prescription and $5.33 more for refills.
- Pharmacies using a third-party billing service incurred costs of $12.87 for new workers’ compensation prescriptions and $11.94 for refills, which was $9.90 higher than Medi-Cal for a new script and $9.19 higher for a refill. The difference was the result of an average cost of $9.56 per prescription for the third-party billing service.
The study involved observing and recording the time required by pharmacy personnel to process, dispense and bill for a sample of workers’ compensation and Medi-Cal prescriptions. “It also factored in ‘bad debt’ as an expense, because pharmacies that do not use a third-party biller may incur it as a result of reversed or denied claims,” said Michael T. Rupp, PhD, managing partner of Mentor Rx/PharmAccount. “Bad debt generally doesn’t occur in Medi-Cal, where drug benefits are known up front.”
To download the survey report, click here: http://www.comppharma.com/CaliforniaDispensingStudy.pdf (PDF)
Source: CompPharma/King Knight