pretty annoying all these speculations is coming from people in the field. I would gladly rebuttal whatcu have got to say
exactly, poor target. CVS will be alrightI keep waiting for "CVS declares bankruptcy" headlines but I guess we are a long ways off from that. Poor Target staff...
See, you have it wrong, I don't want that, but unlike you, I understand why it is needed. There is no way independents would be able to handle the workflow of all the chains without incorporating all the problems that come along with a chain. There really is no need for independents these days unless they have some specialty niche like HRT.
probably the other way around, tbhAnd in North Dakota, we see basically no need for chain pharmacies.
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Don't they also require you to take a personality test? Yeah they only wanted to hire certain people. They were kinda like Abercrombie and Fitch of pharmacy.
Yes, absolutely. In my area, every Target RPh and DM is young, blonde and beautiful.
I keep waiting for "CVS declares bankruptcy" headlines but I guess we are a long ways off from that. Poor Target staff...
If all things are equal...hire the most attractive person. That's not a Target thing...that's an everywhere thing. Attractive people are generally given more leeway in life. And, most importantly, higher metric scores on customer satisfaction.
Right, but all things weren't equal. Imagine working for Target Pharmacy as a technician for 2 years, then an intern for 6 years, and not getting a job offer because you weren't blonde and beautiful. I'm not surprised at all about the sense of resent in this thread towards Target pharmacy.
When I had a rotation at Target, this fresh new grad, known as "Hurricane Natasha", had never touched their computer system before. This was when they used PDX, which was not user friendly at all. She could do literally nothing but verify. She got paid $120k+ to verify less than 100 scripts per day, and still left a mess for the Rph the next day. One of the things she left for the next day was a refill request for birth control. The customer had no more refills left for her Apri, and Hurricane Natasha didn't know what to do. But hey, at least the customer satisfaction metric scores are higher with her than the intern with 8 years experience, right?
Yup. That's life. Beautiful people get things.
Pretty much. Especially women...you can be an ugly ass guy and get promoted/get things; women for the most part have to be competent AND attractive to move up in a lot of different industries.
It goes like this:
Mike's Ease of Life Scale (easiest to hardest)
Pretty to incredibly beautiful white woman
Incredibly beautiful minority woman
Incredibly beautiful men
White men (non-hilljack)
Some minority men (Asian)
White women
Some minority women (Asian)
Minority whites (hilljack with accent, doesn't count if you can code shift like me and speak with a neutral accent)
Ugly/obese Woman
Hispanic people
Black woman
Arabic people, especially if wearing religious garb
Black man
Scary looking black man
If you read my comments I said SOME populations. Never said Medicaid. And I also never said anything about patients consuming their medications.
Health plan sponsors are the ones benefitting here. PBMs and community pharmacy are all downstream from yes fat Medicare bonuses. Hitting (or missing) a 5% bonus for large Medicare plans have big enough impact for Wall Street to notice. Take a look at stock activity for the big Medicare players during the times the CMS call letters are released. Change in rates or bonus calculations by CMS has impact.
In turn those Medicare sponsors pass on risk to the PBMs and for those of you that actually see pharmacy reimbursement contracts you are probably starting to see performance bonuses intertwined into script reimbursement through multiple methods including the DIR which has been mentioned in this thread a few times.
But then again what do I know, I just consult on managed care contracting.
But then again what do I know, I just consult on managed care contracting.
This guy is in managed care. Why are we arguing with him? He is part of the monopolized system. It's like the banker at Goldman-Sachs arguing against banking reform. This guy is making his living on managed care consulting. Of course he's going to be a die-hard advocate of CVS/Caremark ruling the world.
At the end this is all part of a process of monopolization. CVS will try to keep Target's Pharmacies open for a while and if they don't see the profits coming out of it they will close them down, which means the need for Pharmacists will continue to drop. Welcome to slavery you new graduates....Too bad for those who quit CVS to work for Target. Welcome back. Who is next? Ralphs? Vons?
We all know these pharmacies are not profitable. They are loss leader. Target is now getting out of the pharmacy business.
http://finance.yahoo.com/news/cvs-health-target-sign-agreement-110000092.html?.tsrc=applewf
That logic doesn't make any sense. Yes, let people like politicians make changes to a system when they dont know how it works.
How does that logic not make any sense? The guy that likely does contractual work with CVS/Caremark is the best person to give objective information regarding CVS/Caremark? What part of my skepticism is not based in logic?
My advocacy is for not having PBM's and pharmacies tied together at the hip. What is so wrong about this approach? Wouldn't it be beneficial to have them separate entities? Please elaborate with how this isn't sensible to you.
Yeah you already know so much about him and you know his true intention. Give me a break. If you disagree with him then that is fine but questioning his intention?
Yes, the PBMs suck for independent pharmacies. That is how businesses work. The big guys are always going try to squeeze the little guys.
Why stop there? Why not create laws that would prevent CVS from starting minute clinics. Don't you want to separate prescribing vs dispensing too?
Our politicians are not smart. They know how to get elected but they have proven again and again they are incapable to run this country. Now you want them to pass more laws?
Yeah you already know so much about him and you know his true intention. Give me a break. If you disagree with him then that is fine but questioning his intention?
Yes, the PBMs suck for independent pharmacies. That is how businesses work. The big guys are always going try to squeeze the little guys.
Why stop there? Why not create laws that would prevent CVS from starting minute clinics. Don't you want to separate prescribing vs dispensing too?
Our politicians are not smart. They know how to get elected but they have proven again and again they are incapable to run this country. Now you want them to pass more laws?
Please copy and paste where I said the government should pass more laws. The Sherman Anti-Trust law was passed in 1890. I'm advocating for more competition and more choice for consumers. Rather than having one behemoth trend towards being the sole retail pharmacy choice in this country.
How are you going to separate CVS retail from its PBM without major regulation? The regulators have looked at this and they have approved the merger.
It is easy to speculate this and that but what is the point? More competition can mean lower prices but it can also mean higher prices.
If you are getting married and if you to rent my banquet halls and hire my band then of course I am going to give you a better deal vs just renting my banquet halls.
If I get married and I want to use your banquet hall, then I reserve the right to use a different band. Especially if I think your band sucks. I don't want you forcing me to use your band just because I use your banquet hall. Then I'll just use a different banquet hall. And if you're the only person with a banquet hall for me to rent, then I'm going to dread my own wedding because I hate your band.
See how that works?
The solution is to eliminate PBMs from the equation except for a very small role in utilization management. PBMs exist solely to make money for the PBM. There would be a dramatic decrease in the cost of prescription drug delivery if PBMs were eliminated.
That will never happen. The next best thing is broad sweeping regulations that force PBMs into true transparency. No more secret MAC lists and spread pricing. PBMs should be regulated into charging a flat fee for each transaction. The plan sponsor will know exactly how much the pharmacy is being reimbursed and exactly the fee they are being charged by the PBM. PBMs should be bit players in all this not the driving force behind everything as they are now.
That is the whole problem. People like more choices but then complain when they have to pay more.
That is why CVS is able to offer a better rate for employers and therefore, employees. Their cost is obviously much lower (less administrative lost, drug rebates, etc) so they can offer a better deal. If you use their PBM, retail, minute clinic, etc then you would get a better price. This lets the consumers decide. More choices and pay more or less choices and pay less.
Excuse my ignorance, but why do PBMs exist? Aren't they just a middle man between the pharmacy and insurance company? Why can't pharmacies just bill the insurance directly?
Is Caremark an insurance company or PBM? What about United, Caresource, Atena, etc.
Are all of these PBMs or insurance companies?
Same thing with healthcare plans. Why do you need United Health, Blue Cross? Why not let doctors directly bill the employers whatever they feel is reasonable?
Can you manage the amount of resources each employers would need to process these claims?
CVS/Caremark does not offer a lower cost. CVS uses Caremark to unfairly manipulate the market in their favor and make it seem as if they are offering a lower cost. Remember the golden rule...He who has all the gold makes the rules. When you own a PBM you get to make the rules. It's like having a license to steal.
The whole situation with CVS and Caremark merging is absurd. It should have never been approved. It got approved because those in power know nothing about how PBMs and retail pharmacies work.
I don't know if this is funny or just ironic. The people who are against the PBMs are also the same people who were working for the PBMs until they got laid off.
Didn't you tell us know great it was to be working for a PBM? Things change so fast when you are on the other team.
Walmart has a similar model. They deal with the employers directly and cut out the PBM. You figure if the PBM doesn't provide any value, this model would have worked by now. Certainly Walmart has the resources to make it into a success.
I voluntarily testified in front of the State Board of Pharmacy concerning the need for State Board over site of PBMs. Believe me I was not quiet! That one prompted a visit from my department director who works in another city.
Excuse my ignorance, but why do PBMs exist? Aren't they just a middle man between the pharmacy and insurance company? Why can't pharmacies just bill the insurance directly?
Is Caremark an insurance company or PBM? What about United, Caresource, Atena, Express Scripts, Medco...
Are all of these PBMs or insurance companies?
I see united medicaid, caresource medicaid, buckeye medicaid, etc. The actual payer is Medicaid in all cases so does that mean these are all just PBMs?
Nice, what did you tell the board? Did Caremark pay you to keep your mouth shut?
It's a long story.
Believe me when I say PBMs are operating a scam for the sole purpose of massively profiting off a system they can operate in with impunity.
That is the whole problem. People like more choices but then complain when they have to pay more.
That is why CVS is able to offer a better rate for employers and therefore, employees. Their cost is obviously much lower (less administrative lost, drug rebates, etc) so they can offer a better deal. If you use their PBM, retail, minute clinic, etc then you would get a better price. This lets the consumers decide. More choices and pay more or less choices and pay less.
I am not going to disagree with you on that. I am not a fan of PBM myself but I understand it is a business and its sole purpose is to make money. They are going to squeeze the little guy, just like any other business.
However, what I don't get is all of these independent pharmacists complaining left and right. You know this is how the PBMs operate. You know they are not going to play fair but yet, you still decided to go head on with the 800 pound gorilla.
I am not going to disagree with you on that. I am not a fan of PBM myself but I understand it is a business and its sole purpose is to make money. They are going to squeeze the little guy, just like any other business.
However, what I don't get is all of these independent pharmacists complaining left and right. You know this is how the PBMs operate. You know they are not going to play fair but yet, you still decided to go head on with the 800 pound gorilla.
So all independent pharmacies should roll over and die? Close the doors, join CVS, and march in lock-step with the company that is trending toward monopolizing the market.
You aren't saying anything that people don't already know. The sole purpose of this argument is that PBM's and pharmacies shouldn't coincide as the same entity. I think independents are aware that giant retail chains are going to offer cheaper generics and certain services that they can't compete against. I don't think anyone is disputing that.
The question at hand is whether or not a PBM and a pharmacy forcing or incentivizing the use of only one pharmacy/mail order is good for health outcomes/the consumer at-large.
It really helps if you include these catchy searchable terms in your CV for the next job...just my advice.
What's the point? I already work for CVS. They'll just buy out whoever I move to anyway.
They really should just change the name to Umbrella corp.
Whether a company is a monopoly or not is not up to us to decide. It is up to the regulators and they have approved the merger. How long has it been? 8 years?
So go ahead and petition your congressional rep and have them pass new regulations so they can break up CVS and Caremark. Isn't that what it will take? Don't you need government intervention?
Isn't it funny how some people preach anti-government intervention until their livelihood depends on it?
It is like the people who are so anti-Obama but they don't want their government to take away their obamacare subsidies.