CVS Verification Sharing Questions

[Mr. Corporate Pharmacist]

Hi all, Pharmacy Manager here.

My supervisor is giving me the opportunity to present about QV Sharing to my peers at our next pharmacy manager meeting.

Trying to prepare for all the questions and concerns they might have, so I've turned to Reddit and SDN to get some ideas.

What do you all think about verification sharing? What do you want to know?

Here's a link to some questions on subreddit that have arisen.

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[WVUPharm2007]

What the hell is verification sharing?

 

[Sine Cura]

In this type of situation the techs need to be really good at putting Rx on hold at input (we don't waste time filling stuff that Medicaid doesn't cover) instead of having a pharmacist that knows little about your store just ripping through data verification without consideration for store specific factors

 

[ericn2k3]

What the hell is verification sharing?

They went through some details with the recent RXM/FSM Cascade meeting.

1. Numeric waiting bin which is rolling out in < 1 month
2. New IVR! Rolling out in the summer. They say it would reduce total call volume by up to 50%.

3. Shared verification. To summarize. It's what been done at Walgreen (and Rite Aid?) for years. You will be either a SHARER or RECEIVER store, not both. Highly dependent on your volume. High volume store will have slower store do data verification and then Rx will bounce back for QP. Any DUR that requires MD F/U, the receiving pharmacist can send back to home store to get followed up with.

This is also limited by state line. Also seem to be clustered with local stores as well.


Now will this lead to reduced Rph hours? Reduced overlap? The DL doesn't even know.

 

[Mr. Corporate Pharmacist]

They went through some details with the recent RXM/FSM Cascade meeting.

1. Numeric waiting bin which is rolling out in < 1 month
2. New IVR! Rolling out in the summer. They say it would reduce total call volume by up to 50%.

3. Shared verification. To summarize. It's what been done at Walgreen (and Rite Aid?) for years. You will be either a SHARER or RECEIVER store, not both. Highly dependent on your volume. High volume store will have slower store do data verification and then Rx will bounce back for QP. Any DUR that requires MD F/U, the receiving pharmacist can send back to home store to get followed up with.

This is also limited by state line. Also seem to be clustered with local stores as well.


Now will this lead to reduced Rph hours? Reduced overlap? The DL doesn't even know.

I believe it will result in less RPh hours. Less verifying workload for the sender store.

 

[Mr. Corporate Pharmacist]

I guess I'm terrible at posting links. If this doesn't work, I give up.

 

[WVUPharm2007]

They went through some details with the recent RXM/FSM Cascade meeting.

1. Numeric waiting bin which is rolling out in < 1 month
2. New IVR! Rolling out in the summer. They say it would reduce total call volume by up to 50%.

3. Shared verification. To summarize. It's what been done at Walgreen (and Rite Aid?) for years. You will be either a SHARER or RECEIVER store, not both. Highly dependent on your volume. High volume store will have slower store do data verification and then Rx will bounce back for QP. Any DUR that requires MD F/U, the receiving pharmacist can send back to home store to get followed up with.

This is also limited by state line. Also seem to be clustered with local stores as well.


Now will this lead to reduced Rph hours? Reduced overlap? The DL doesn't even know.

Oh, ok. They told me about that. I didn't know it was called "verification sharing."

Also. apparently they are trialing taking away all the metrics except for OSAT. That's the one I'm excited about maybe coming down the pike.

 

[WVUPharm2007]

If someone else does QV wrong, am I allowed to name and shame the other pharmacist to avoid dealing with the patient's ire?

If I agree to reduce my pay to $45 an hour, can I sit at home in my pajamas and just do verification?

 

[Rouelle]

So CVS is doing what is essentially remote verification? And now does home delivery?

...doesn’t Caremark mail order already exist?

 

[Mr. Corporate Pharmacist]

Oh, ok. They told me about that. I didn't know it was called "verification sharing."

Also. apparently they are trialing taking away all the metrics except for OSAT. That's the one I'm excited about maybe coming down the pike.

I think they shouldn't remove the metrics, since they can be used for root cause analysis by managers.

But maybe removing them from the weighted scorecard and hopefully to prevent micromanagement.

 

[Mr. Corporate Pharmacist]

So CVS is doing what is essentially remote verification? And now does home delivery?

...doesn’t Caremark mail order already exist?

It's more about pharmacist workload equalization. Better to spread out the high level talent to all stores while spending more tech hours in place of pharmacist hours.

Pharmacy has to transform from dispensing to other value added health services in order to stay relevant. If people stop coming to the pharmacy, retail will continue to see decreased margins.

I foresee lots of changes to come this next year.

 

[rxJuggler]

3. Shared verification. To summarize. It's what been done at Walgreen (and Rite Aid?) for years. You will be either a SHARER or RECEIVER store, not both. Highly dependent on your volume. High volume store will have slower store do data verification and then Rx will bounce back for QP. Any DUR that requires MD F/U, the receiving pharmacist can send back to home store to get followed up with.

This is also limited by state line. Also seem to be clustered with local stores as well.


Now will this lead to reduced Rph hours? Reduced overlap? The DL doesn't even know.

Some stores will be non-participating.

The TLs know exactly how many hours their stores are losing. I work between districts. In 1 district, nobody knows anything. In the other district the TL told one of my stores how many hours of QV1 they will share per week and how many RPh hours they will lose.

 

[mentos]

So they're basically copying Walgreens, finally. "Shared verification" and numeric waiting bin are much better.

 

[Modest_anteater]

I believe it will result in less RPh hours. Less verifying workload for the sender store.

DING DING DING. Bingo it's about saving BIG RED money.

 

[mentos]

DING DING DING. Bingo it's about saving BIG RED money.

They'll try to get the slow Target stores to do more work.

 

[Modest_anteater]

They'll try to get the slow Target stores to do more work.

I predict CVS will close all target CVS within 5 years. They are just too slow with low script counts. CVS will transfer these client lists to their other standalone stores.

 

[mentos]

I predict CVS will close all target CVS within 5 years. They are just too slow with low script counts. CVS will transfer these client lists to their other standalone stores.

Will they close Omnicare too? That was an even bigger fail.

 

[rxJuggler]

So they're basically copying Walgreens, finally. "Shared verification" and numeric waiting bin are much better.

What is the theory behind the numeric waiting bins?

 

[Thoughtfulsinner]

What is the theory behind the numeric waiting bins?

For people who are suffer from dyslexia

 

[mentos]

What is the theory behind the numeric waiting bins?

The alphabet is hard for some people. Scripts get lost all the time cause "Ma" last names are found in "Na", "I"s are found in "L"s, "Q"s in "O"s etc. The lost scripts sit in the bin for months and CVS loses money cause the drugs are never returned.

 

[Modest_anteater]

Will they close Omnicare too? That was an even bigger fail.

Not sure what the 8 ball says on that friend

 

[Mr. Corporate Pharmacist]

I predict CVS will close all target CVS within 5 years. They are just too slow with low script counts. CVS will transfer these client lists to their other standalone stores.

That doesn't make sense to me. If each store is bringing in money after expenses (including 4 wall expenses, leasing, advertising, etc.), why would they give up real estate footprint?

I've heard that rent from Target is ridiculously low as long as certain conditions are met.

I know a Target store that does 1/4 volume of a core store, but makes half as much in net profit..

Profitability and volume don't always correlate

 

[mentos]

That doesn't make sense to me. If each store is bringing in money after expenses (including 4 wall expenses, leasing, advertising, etc.), why would they give up real estate footprint?

I've heard that rent from Target is ridiculously low as long as certain conditions are met.

I know a Target store that does 1/4 volume of a core store, but makes half as much in net profit..

Profitability and volume don't always correlate

If Target was so profitable then why did they sell to CVS?

 

[Mr. Corporate Pharmacist]

If Target was so profitable then why did they sell to CVS?

Target was hemorrhaging money because they weren't a healthcare company. Pharmacy was more of a loss leader to drive traffic to the rest of their store (much like grocery chains).

But I imagine with CVS technology, contracts, and scale, these stores would be doing much, much better.

 

[Modest_anteater]

That doesn't make sense to me. If each store is bringing in money after expenses (including 4 wall expenses, leasing, advertising, etc.), why would they give up real estate footprint?

I've heard that rent from Target is ridiculously low as long as certain conditions are met.

I know a Target store that does 1/4 volume of a core store, but makes half as much in net profit..

Profitability and volume don't always correlate

The thing is a lot of Target CVSs are way in the RED. They are not making profit. They are losing money due to inventory costs and pharmacist salaries.

 

[lane one]

The thing is a lot of Target CVSs are way in the RED. They are not making profit. They are losing money due to inventory costs and pharmacist salaries.

I honestly don't know where you get the crap you spew on this forum, but none of this is factually correct. As Mr. Corporate Pharmacist already pointed out, the rent being charged on these "Target CVS stores" is dramatically less than the corner stores. Most of them are actually quite profitable, despite their lower volume. Again, they previously were loss leaders and they WERE hemorrhaging money, but CVS forced them to lean out.

 

[Modest_anteater]

I honestly don't know where you get the crap you spew on this forum, but none of this is factually correct. As Mr. Corporate Pharmacist already pointed out, the rent being charged on these "Target CVS stores" is dramatically less than the corner stores. Most of them are actually quite profitable, despite their lower volume. Again, they previously were loss leaders and they WERE hemorrhaging money, but CVS forced them to lean out.

As far as the limited knowledge I have the matter, CVS has attempted to right the ship and certainly many stores are profitable now but many are not. I personally know CVSs at Target doing 80 scripts a day. 80 scripts a day. Think about that a second. Justifying 2 FE and 2 part-time pharmacists + more technicians on 80 scripts a day. Admittedly my knowledge comes from only a few CVS/Target employees.

 

[Mr. Corporate Pharmacist]

The thing is a lot of Target CVSs are way in the RED. They are not making profit. They are losing money due to inventory costs and pharmacist salaries.

Many are, but these are still young businesses.

With the advertising and marketing spent plus good leadership, a few years will correct those stores.

Having accessibility and a larger footprint to uphold brand image is well worth a few thousand dollars lost in a few outlier stores IMO

Especially with the direction the company is taking with expanding health services.

Wouldn't be smart for CVS to give up their partnership with Target just yet. And Target is seeing much more foot traffic than it ever had before the acquisition.

It's a win-win for now.

 

[RxPreceptor]

What is the theory behind the numeric waiting bins?

In one of the print outs on numeric waiting bin from the HUB, the article mentions cutting down # steps by using numeric waiting bin (any excuse to cut more hours). Would be nice if the register prompts would actually include qty to avoid techs constantly being pissed off looking for scripts that are obviously in the brown bag section. I am not looking forward to it...seems like it will take up more space (can't combine bags) along with taking longer to find scripts

Rx # is no longer in clear view (use to be in right upper corner) or have any TALLMAN character features to draw the eyes to

 

[mentos]

I honestly don't know where you get the crap you spew on this forum, but none of this is factually correct. As Mr. Corporate Pharmacist already pointed out, the rent being charged on these "Target CVS stores" is dramatically less than the corner stores. Most of them are actually quite profitable, despite their lower volume. Again, they previously were loss leaders and they WERE hemorrhaging money, but CVS forced them to lean out.

As far as the limited knowledge I have the matter, CVS has attempted to right the ship and certainly many stores are profitable now but many are not. I personally know CVSs at Target doing 80 scripts a day. 80 scripts a day. Think about that a second. Justifying 2 FE and 2 part-time pharmacists + more technicians on 80 scripts a day. Admittedly my knowledge comes from only a few CVS/Target employees.

I used to work for Target and this sounds about right. The pharmacists would post photos on FB about how bored they were. One Rph organized the stupid bottles so that they would be perfectly stacked in the drawers, take a photo with a caption "this just happened" and Target Rphs from nearby stores would respond "filled 27 rxs so far today", "58 here", "40 here" etc. This would be mid afternoon on a Monday. The store I worked in would fill 170 on a busy day (with two Rphs, two techs and two interns at once) and we were considered one of the busiest in the area, we had the most flu shots in the district. I can't imagine these stores being profitable even if CVS doubled their volume.

 

[Modest_anteater]

I used to work for Target and this sounds about right. The pharmacists would post photos on FB about how bored they were. One Rph organized the stupid bottles so that they would be perfectly stacked in the drawers, take a photo with a caption "this just happened" and Target Rphs from nearby stores would respond "filled 27 rxs so far today", "58 here", "40 here" etc. This would be mid afternoon on a Monday. The store I worked in would fill 170 on a busy day (with two Rphs, two techs and two interns at once) and we were considered one of the busiest in the area, we had the most flu shots in the district. I can't imagine these stores being profitable even if CVS doubled their volume.

Exactly. This is why I strongly disagree with Lane One's opinion that CVS is doing great at Target.

 

[Mr. Corporate Pharmacist]

Regardless of our speculations, QV sharing will ensure job security for lower volume stores.

CVS is not going to close any stores when there's a way to utilize all the human resources we have.

 

[lane one]

I used to work for Target and this sounds about right. The pharmacists would post photos on FB about how bored they were. One Rph organized the stupid bottles so that they would be perfectly stacked in the drawers, take a photo with a caption "this just happened" and Target Rphs from nearby stores would respond "filled 27 rxs so far today", "58 here", "40 here" etc. This would be mid afternoon on a Monday. The store I worked in would fill 170 on a busy day (with two Rphs, two techs and two interns at once) and we were considered one of the busiest in the area, we had the most flu shots in the district. I can't imagine these stores being profitable even if CVS doubled their volume.

Doubled their volume, cut their RPh hours, cut their operating hours and cut their tech hours in half. Yeah, they used to be a joke compared to CVS. They became profitable...

Exactly. This is why I strongly disagree with Lane One's opinion that CVS is doing great at Target.

Lol. It's not an opinion, I've seen the P&Ls. Perhaps its the only profitable district in existence. Do you really think Larry would take the deal if they weren't going to be profitable?

 

[mentos]

Do you really think Larry would take the deal if they weren't going to be profitable?

In case you haven't noticed, their stock tanked in the past week due to the Omnicare deal.

"CVS Health Corp on Wed forecast 2019 profit well below Wall Street estimates due to weakness in its pharmacy business that serves long-term care facilities..."

 

[Sine Cura]

If you ever worked for CVS why would you ever spend a dime in a CVS, much less buy CVS stock (not part of a mutual fund or whatever).

 

[Thoughtfulsinner]

If you ever worked for CVS why would you ever spend a dime in a CVS, much less buy CVS stock (not part of a mutual fund or whatever).

It's comical to me that people complain so much about CVS but don't get out. Nobody is forcing you to work for them.

 

[Sine Cura]

"It's funny to me that people comment on people bitching and moaning on Internet forums. Internet forums and complaining go together like middle America and obesity. Nobody is forcing anyone to read Internet forums"

 

[Thoughtfulsinner]

"It's funny to me that people comment on people bitching and moaning on Internet forums. Internet forums and complaining go together like middle America and obesity. Nobody is forcing anyone to read Internet forums"

My recommendation would be to walk out of CVS and go to medical school.

 

[Litha]

Will they close Omnicare too? That was an even bigger fail.

Actually Omni used to be profitable. When CVS purchased them and starting "fixing things", that is when the business started to fail. They raised our facility contract prices, mandated we get preferred products (often pricier), decreased our staff causing the deliveries to go out later and pissing the facility nurses off, and made us change procedures that cause a lot of processes to become slower. Facilities are not renewing contracts because they aren't happy, causing a lot of lost revenue.

CVS made Omni fail, not the other way around.

 

[mentos]

Actually Omni used to be profitable. When CVS purchased them and starting "fixing things", that is when the business started to fail. They raised our facility contract prices, mandated we get preferred products (often pricier), decreased our staff causing the deliveries to go out later and pissing the facility nurses off, and made us change procedures that cause a lot of processes to become slower. Facilities are not renewing contracts because they aren't happy, causing a lot of lost revenue.

CVS made Omni fail, not the other way around.

That's terrible. You guys must have been happy as clams before they ruined it.

 

[M0df]

Back to the original topic presented by OP.

I wont put a positive spin on verification sharing. You'll do a good job of it yourself. This implementation seem to be implemented about the same time CVS holds its annual district meetings.

The 'slow' stores in the district should ask how many scripts they will be asked to check for busier stores. I assume this sharing will be restricted to verifying in your particular state. Since you are in Boston/MA area, this shouldn't be an issue. Busier stores should care about how many overlap and pharmacist hours will be cut. Since you are in MA, shifts are limited to 10 hours? (or maybe 12, I forget). I guarantee that the hours will be cut for pharmacists as with every 'innovation' CVS implements, hours are always lost. I have experience with CVS and with a different chain that uses shared verification but average CVS does a lot more volume. It is great conceptually until CVS puts its own spin on it. Of course, Team Leaders will hold conference calls on who is keeping up with their targets of verifying for other stores. Slow pharmacists at slow stores should worry about their job security. They will have to check 30-50 extra scripts for other stores... maybe more.

Oh ya and if they follow other chains.. the Queue should not or will not be easily accessible. You might be forced to verify x scripts for your own store then y scripts for shared store... unless you are in red, then they might give you a break and let you check your own store till you catch up. You are just checking scripts as they come.

 

[owlegrad]

Actually Omni used to be profitable. When CVS purchased them and starting "fixing things", that is when the business started to fail. They raised our facility contract prices, mandated we get preferred products (often pricier), decreased our staff causing the deliveries to go out later and pissing the facility nurses off, and made us change procedures that cause a lot of processes to become slower. Facilities are not renewing contracts because they aren't happy, causing a lot of lost revenue.

CVS made Omni fail, not the other way around.

Have y’all really lost contracts? Y’all just won the palm gardens account, that is a pretty huge boon.

 

[Mr. Corporate Pharmacist]

Back to the original topic presented by OP.

I wont put a positive spin on verification sharing. You'll do a good job of it yourself. This implementation seem to be implemented about the same time CVS holds its annual district meetings.

The 'slow' stores in the district should ask how many scripts they will be asked to check for busier stores. I assume this sharing will be restricted to verifying in your particular state. Since you are in Boston/MA area, this shouldn't be an issue. Busier stores should care about how many overlap and pharmacist hours will be cut. Since you are in MA, shifts are limited to 10 hours? (or maybe 12, I forget). I guarantee that the hours will be cut for pharmacists as with every 'innovation' CVS implements, hours are always lost. I have experience with CVS and with a different chain that uses shared verification but average CVS does a lot more volume. It is great conceptually until CVS puts its own spin on it. Of course, Team Leaders will hold conference calls on who is keeping up with their targets of verifying for other stores. Slow pharmacists at slow stores should worry about their job security. They will have to check 30-50 extra scripts for other stores... maybe more.

Oh ya and if they follow other chains.. the Queue should not or will not be easily accessible. You might be forced to verify x scripts for your own store then y scripts for shared store... unless you are in red, then they might give you a break and let you check your own store till you catch up. You are just checking scripts as they come.

I agree that the biggest concern pharmacists will have is around hours and increased workload ratio.

I don't even have the details on that yet. I'm presenting the purpose, the mechanics, and trying to field questions.

So definitely not looking for positive responses. I want to find more answers through different perspectives, so thank you for sharing!

 

[Litha]

Have y’all really lost contracts? Y’all just won the palm gardens account, that is a pretty huge boon.

Hmm I haven't of that one, maybe not in my region? We lost a bunch of genesis facilities late last year, as well as some big local assisted livings with huge cycle fills. Everyone is switching to you guys

 

[owlegrad]

Hmm I haven't of that one, maybe not in my region? We lost a bunch of genesis facilities late last year, as well as some big local assisted livings with huge cycle fills. Everyone is switching to you guys

That’s so funny because I haven’t heard of genesis. We must be in totally different regions or something, lol.

My facility hasn’t gained a single contract from Omnicare since I have started here. We did just get a brand new contract from a facility that used to have their own pharmacy though, so that is good.

Ok sorry OP I promise to stop derailing now

 

[PharFromNormal]

Some big long term care facilities have recently filed bankruptcy or are extremely close. (Genesis). If you have that contract when they file you can kiss any AR goodbye. Very risky business right now. Not much financial stability.

 

[txpharmguy]

I've worked for WAG forever. We've had dynamic workload balancing (ie, QV sharing since 2005). We don't have any quotas, but stores are usually grouped in clusters and we will verify for each other (10-15 stores). Some stores do a lot some do next to nothing. Higher volume stores have PhLex (pharmacy labor exchange) and they get dedicated off site help (from work at home pharmacists).

 

[Dreamer716]

I've worked for WAG forever. We've had dynamic workload balancing (ie, QV sharing since 2005). We don't have any quotas, but stores are usually grouped in clusters and we will verify for each other (10-15 stores). Some stores do a lot some do next to nothing. Higher volume stores have PhLex (pharmacy labor exchange) and they get dedicated off site help (from work at home pharmacists).

Did you have a specific number you had to verify for the busier stores per day/week? Also, what would happen with scripts requiring DUR. Would that rx just be sent to original store?

 

[txpharmguy]

Did you have a specific number you had to verify for the busier stores per day/week? Also, what would happen with scripts requiring DUR. Would that rx just be sent to original store?

Up to each pharmacist, you could create a DUR exception and the original store would handle it (eventually). If it was a refill of sertraline and they've had it and tramadol forever, I'd just override it. No quotas at stores. The work at home folks do have to meet a certain "average handle time." However, I'm not privy to that info, although it's a lot. I have a customer who used work in the stores and is now a work from home pharmacist. She says she typically will verify 1000+ on her shift. Seems like an insane amount, but when you have no phones and no interruptions, it's entirely plausible.

 

[Thoughtfulsinner]

Up to each pharmacist, you could create a DUR exception and the original store would handle it (eventually). If it was a refill of sertraline and they've had it and tramadol forever, I'd just override it. No quotas at stores. The work at home folks do have to meet a certain "average handle time." However, I'm not privy to that info, although it's a lot. I have a customer who used work in the stores and is now a work from home pharmacist. She says she typically will verify 1000+ on her shift. Seems like an insane amount, but when you have no phones and no interruptions, it's entirely plausible.

2 scripts a minute is nothing.