Collaborative Practice Agreements (CPAs) create formal practice relationships between pharmacists and prescribers. While CPAs are not a prerequisite for collaborative care delivery, they can improve the effectiveness of care and make business sense for the pharmacist because they can increase patient access, expand available services to patients, and generate new revenue for pharmacists. However, there are also logistical complexities that deter pharmacists from pursuing this type of agreement. So, when considering all the pros and cons, should you get a CPA? Here are four things to consider when making the decision.
Are State Laws Supportive?
It is important to acknowledge that not all state laws treat CPAs the same. According to the National Alliance of State Pharmacy Associations (NASPA), only 33 states allow licensed pharmacists to participate in a CPA. This means there are no state-mandated requirements for extra training for the pharmacist. Therefore, if your pharmacy is in one of those 33 states, it will be easier for you to pursue a CPA.
Can I Find a Prescriber Interested in Collaborating?
The first step to develop a CPA is to find a prescriber to partner with. You will need to invest time and energy in building trust with the prescriber. While some are open to CPAs, many are protective of their scope of practice and could be too busy to take the time to understand the benefits of the arrangement. For the best chance of success, focus on unmet patient needs in the prescriber’s practice and the community. If you cannot find a willing prescriber, Physician 360’s model is a great alternative option. Click here to learn more.
How do I Write the CPA?
There is no universal template for a CPA, but the agreement may specify the types of patients, the disease states, and the treatment protocols (including medications). Some commonly delegated functions include authorizing refills, adjusting doses, initiating new therapy, and ordering laboratory tests. Other details, such as which types of practitioners can participate, the length of time that agreements remain valid, and reporting metrics, may need to be addressed. The CDC has a comprehensive tool kit to guide this part of the process.
Are There Business Benefits?
Numerous factors affect the profitability of direct patient care services for a pharmacy. The most important is whether the service is reimbursable or not. If your pharmacy is already delivering direct patient care, a CPA can increase efficiency, which is good for revenue and customer retention. In certain states, a CPA can also diversify your revenue streams by adding services in acute and preventative care you otherwise could not offer. Sometimes patients will pay cash for these services so some of the insurance reimbursement challenges are mitigated. CPAs for immunizations, naloxone, conditions, and treatment with fairer reimbursement rates lead to more consistent profit. In general, CPAs help pharmacy businesses adapt to evolving payer preferences because they position pharmacists as providers.
For example, having a CPA in place allows pharmacies to provide immediate antibiotic and symptomatic support for patients that test positive on a rapid diagnostic strep test.
Additionally, your pharmacy can acquire additional patients through a CPA. Relationships with prescribers in the community can assist in potential referrals to your pharmacy. This boost in traffic can lead to increased sales for that specific treatment and revenue from incidental purchasing while in the pharmacy, as well as the lifetime value of the patient converting their chronic condition medications to your pharmacy.
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- Expand scope of clinical practice
- Attract new patients
- Diversify revenue
- Questionable reimbursement
- State laws vary (CPAs need maintenance)
- Prescribers often not interested
- Takes time to build relationship