Independent Pharmacy Accounting

NCPA Updates and Upcoming Events

National Community Pharmacists Association (NCPA) protects and promotes the interests of independent pharmacists whose success is vital to their patients and their communities. On this episode of The Bottom Line Pharmacy Podcast, your hosts Bonnie Bond, CPA, Kendell Harris, CPA and Scotty Sykes, CPA, CFP® are excited to sit down with Bri Morris, Senior Director of Program Management and Lead of Long-term Care Division at NCPA.

The team discusses various hot topic updates in the pharmacy community and dives into the exciting events kicking off at the NCPA national tradeshow and convention in Kansas City.

The Bottom Line Pharmacy Podcast is your regular dose of pharmacy CPA advice to fuel your bottom line, featuring pharmacists, key vendors, and other innovators.

Stay tuned for future podcasts airing soon wherever you subscribe to podcasts.

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If you prefer to read this content, the video transcript is below.

Bonnie: All right, well, hello. Welcome to the podcast. Today we are super excited to have Bri Morris, from NCPA, joining us. Bri is our buddy on the road we see all the time within NCPA. She is the Senior Director of Education and Long-Term Care. And so Bri, thank you so much for taking some time to speak with us this afternoon.

Bri: Absolutely, Bonnie. Thank you guys so much for having me.

Scotty: Bri is a travel warrior like we are.

Bri: Oh, yeah.

Scotty: All summer, been hitting the road.

Bri: Yeah.

Bonnie: And we see that we spotted her in airports and all over the place.

Bri: It’s true.

Kendell: I did run into her at an airport. It was funny because I had my mask on, and I am just walking around, and I am like, Bri! She looks at me like, who? I mean, you meet thousands of people so you are probably going through your head, “What pharmacist? What pharmacy owner? Which workshop did I meet him at?”

Bri: I think it’s an important consideration that this is also like eight o’clock in the morning.

Bonnie: Yes.

Kendell: 8:00 a.m.

Bri: At our layovers. So, we both have taken like 6:00 a.m. flights for a trade show number two of the summer so, we are half zombies to begin with.

Bonnie: Well Bri, I don’t know if you have got to this point, but I have got to the point when I travel now, especially in the summer when you have multiple trips, when I am traveling, I am in my like travel clothes. Incognito almost, like I do not have makeup on, I have not done my hair. I am just wearing like, you know, sweat pants and a T-shirt.

Kendell: Bri was done up. She was looking good. She was looking good.

Bonnie: Oh, okay, well, good for her.

Bri: That is very sweet.

Scotty: Bri is always looking fresh, come on.

Bri: Oh, that is very sweet and very untrue, but I appreciate that. I am giving off that appearance, at least, though.

Bonnie: I do not. I travel and then when I get there then I decide to finally, so sometimes I hope people do not notice who I am in the airport.

Bri: Now, do you guys get to a point where you travel so much that you like have your travel, like Bonnie, your travel makeup and your travel toiletries and that sort of thing, so you do not even have to think about packing it anymore?

Bonnie: I have not got to that point, but that is a really smart–

Scotty: I have severe anxiety when it comes to packing. I cannot pack; it is terrible. I will pack for two weeks, for three days. I cannot, I just cannot pack.

Bonnie: I am a pack-like-two-hours-before-I-leave kind of girl.

Scotty: I hate packing.

Bri: That is me, Bonnie.

Kendell: So, you know those like Ziploc sandwich bags, the gallon one?

Bonnie: Yup.

Kendell: That is my toiletry. Go one day to the pharmacy section, get all your little mini things, throw it in there, you are good to go.

Bonnie: My biggest worry in traveling, especially when all these shows are together, and there are a lot of the same people and vendors, is that I am going to wear the same thing over and over and over. So that is my biggest worry. Is that, “Did I wear this at the last show? What did I wear at this show? I spoke at that show so they might have taken pictures of that.” That is the biggest thing.

Scotty: Well, I can speak at these shows in front of 200 people, with no anxiety, but I get packing and I am like, oh my gosh, “What do I do? What do I pack? I have no idea.” So, I think that is just a guy thing maybe, but, Bri, tell us about what your takeaways were, – maybe off the cuff – of your trade show experience this year. I mean you were at all of them, like we were.

Bri: Yeah, absolutely. Well, it was so exciting to see everyone back together again.

Bonnie: Yes.

Bri: I know we saw so many people last year at NCPA 2021 in Charlotte and it was great to be together and just that excitement after being away for so long. But what was really interesting to me at the trade shows, was the excitement to get on the show floor, and to talk to vendors, as well as, kind of this, emergence as people are kind of getting a little bit closer to what the steady state of pharmacy is back, and back to, and kind of we have got past this hump of crazy hours. Everyone is starting to think about services again and what services they are going to pursue, and what is going to give you a good ROI and how you can help your community. So, it was really cool to be able to learn from what folks have done over the last few years, and then also what they are looking to do moving forward.

Scotty: And we are seeing a lot of pharmacies really look into revenue outside of just filling scripts. So, those are kind of the big takeaways we had from the show for sure.

Bonnie: I think we were all talking about that before COVID, but then I think COVID… One of the benefits from COVID, if there was any, would be that people learned how important that was because they saw it right in front of their eyes of you know, bringing in, how to get in new customers and keep them. So, I hear people talking about doing that, people that were not talking about that before, they are talking about that now, for sure.

Scotty: Certainly. And Bri, so after the trade show, you guys jumped right into NCPA that is, jumped right into your legislative push to have pharmacies host members of Congress, et cetera. I have been hearing all about it. It seems like it has been very successful and my thinking here is, if you are a pharmacy owner, you absolutely have to be involved in these political arenas. You just have to be. And I know you guys kind of preached that as well. Has that been pretty successful for you guys so far?

Bri: Yeah, absolutely. So, we kind of came back from the trade shows and launched into August, which would – during the recess that Congress had – we called it a month of action. And so, encouraging everyone to invite their congressmen into their pharmacy to really see day-to-day what it looks like. How you are helping your patients, show them the DIR fees and show them the negative reimbursement. That is really impactful when you can see it firsthand and all the different things that are hard to articulate necessarily in language. But pharmacies tell a story, right?

Like I think about where I am from and I am from a small town in Arkansas. There are just a couple of pharmacies in the entire county. So, the pharmacy that I worked at growing up, we did long-term care. We actually did the hospital pharmacy next door; it is a critical access hospital. So, they went in the morning and did that, they have filled scripts for me on Christmas day, whenever I have been sick before. And that story is hard to tell when you are sitting in Washington, D.C. So, having a congressman come in and really see what you do day-to-day, has been really cool. So, great to do all throughout the year, lots of pharmacies have done it in August, while folks are at home.

Scotty: And you mentioned the dreaded DIR fees. And I actually have a new stat I shared with Patrick there at NCPA. And for the revenue band between $2-$4 million dollars, average 2021 DIR fee was $140,000. And so far through June of ’22, we are at $82,000. So, we are seeing an increase there. And then for the $4-$7 million dollar revenue range, ’21 average was $215,000, and so far through 2022 June, we are at $115,000. So, that just goes to show you that you know, that legislative action with your Congress members is vital. I mean, that is some great data to share right there. And also, what we took away from the trade show is… one of the big things was diversifying that revenue and getting into the clinical services, cash-based services, et cetera. So, just some eye-opening data there for real.

Bonnie: More important than ever for sure.

Scotty: That’s right.

Bri: Absolutely.

Scotty: So, Bri, tell us a little bit about the long-term care division that you head up there. What all goes on there?

Bri: Yeah, absolutely. So, as you guys well know, long-term care is a really great way that pharmacies can differentiate themselves and take care of their communities. And we recognize that about half of our membership is in the long-term care space, whether that is: “I have a group home, or assisted living facility, or, I have 1,000 beds of skilled nursing.” And a lot of the legislative and regulatory priorities of a true closed-door long-term care pharmacy are very similar to that of a community pharmacy.

So, the long-term care division is exactly what it says: it is a separate division within NCPA for those pharmacies that are serving the long-term care community. Whether that is: “I have 10 beds of a group home…” We are going to help you get started and help you grow that segment of your business. And we have a ton of business resources to support that. Or, for those pharmacies that are several thousand-bed facility pharmacies that serve larger facilities, we have got a ton of resources for them, as well as supporting their interest on the hill whenever there is a topic that comes up that relates to them.

Scotty: And certainly, long-term care is going to be gaining more and more and more traction. I mean, you have all these Baby Boomers that are going to be retiring and getting older and they are going to need help. I mean, this area is going to grow, I think, tremendously in the future.

Bri: Yeah, absolutely. Something that we have been really excited about – membership has been really excited about – is this idea of medical at home. So, taking care of those patients who would otherwise be in a long-term care facility by keeping them at home and providing those long-term care services, just as you would to a nursing center, for those patients to stay at home. So, this is not an ambulatory patient that you are just delivering medication to out of convenience. This is a patient that might have a caregiver or someone to take care of them in the home. But it is a really great opportunity for pharmacies.

Something that I think some pharmacies do not know with LTC, there are no DIR fees right now. I mean, that is a big deal on its own. There are usually, especially outside of the home setting, but there are… you are providing a service that goes above and beyond what you do in the community setting and so, there is increased reimbursement. So, it is a really good opportunity for pharmacies that have, you know, especially if you are doing med sync and you have got a packaging solution, you are like halfway there, maybe three quarters of the way there, and can really take advantage of an opportunity in your community.

Bonnie: That is a good point.

Scotty: And that is that “combo-med,” if you will, type arrangement where you can get reimbursed and not have those DIR fees, which is fantastic, but you have to meet those specifications for the medical at home. We are seeing a lot of pharmacies definitely dip their toes into that for sure. That has been picking up.

Kendell: And I do have a question. Some pharmacies, the ones who are just straight traditional. Maybe that is what they have been doing for a long time, but the whole DIR fees and everything else is putting a real big pinch on them. And they say, “You know what, I am ready to take a step and to do something different.” Some have even identified some homes that they would want to try to get involved in. What would be the first step you would recommend for a pharmacy like that? Or is there a way that NCPA could provide any… are there any resources for someone just getting started out, to help them out in their first initial push?

Bri: Yeah, I think a really great first step for someone who is kind of learning about the industry and seeing if it is something that they want to look into, is to attend the Business of Long-term Care Workshop that we have.

Kendell: Oh wow.

Bri: We have one coming up actually right before convention, September 29th through 30th in Kansas City. But it really walks you through: “What is long-term care, what are those opportunities? What does it look like workflow wise? And then how do you actually go out and get that business?” I think one thing to remember, especially if you already have a thriving community pharmacy, and you are looking to grow, I would definitely start small. I would look for a group home, get your process set up, look for opportunities that are similar to what you are already doing. If you are doing med sync, you are doing packaging, a group home in your community is a prime opportunity because you are doing most of what those folks are going to need. So going out, getting a little bit of business, getting comfortable with it, and then growing from there.

Kendell: Great advice.

Bonnie: That makes great sense.

Kendell: That is wonderful. Thanks.

Scotty: Great advice.

Bonnie: So, speaking of workshops, is there another workshop that is going on during that same time period I believe?

Bri: Oh, there might be Bonnie. There might be. So, we do an ownership workshop, pharmacy ownership workshop, and we are so excited to partner with you guys, as some of our faculty for that program. And it is really for those folks out there who are interested in opening or buying a pharmacy. It is kind of a deep dive, A to Z, your first step into that.

Scotty: It’s kind of the cool club. I mean, you got Bonnie on there, you got Jeff Baird, it is the cool club I am telling you. I kind of feel left out here.

Kendell: Let me show, just share. I will speak through it, but I just want to share, I pulled it up: the cool club as you called it.

Bonnie: Oh, my gracious.

Kendell: So, some of the speakers… we got Jeff Baird, the famous Bonnie.

Bonnie: Jeff Baird.

Kendell: Greco from the Live Oak Bank. I am not going to be at this one. It is going to be Ollin Sykes; he is going to be representing. But Tammy, McDonald, Jonathan.

Scotty: McKesson.

Kendell: I had a chance to just sit in. Ollin invited me to just sit in on one and the wealth of information that I gained, even though I work in accounting every day, is just amazing. I just wanted to shout out the website, ncpa.org/pharmacy-ownership-workshop. That is where you go to sign up. You have a lot of information there: the agenda, the registration, everything. FAQs. So, it is really simple. And then, I always got to pick on Scotty as much as I can.

Scotty: Oh my gosh.

Kendell: His little photo. He gets embarrassed every time I show this.

Scotty: Look at that.

Kendell: So, the frame of conventions.

Bonnie: Look at that.

Kendell: Frame that photo, Scotty. It is a good one we got to–

Scotty: Look at that trimmed up beard. I might be

Bonnie: Oh, my gracious.

Kendell: You go to ncpa.org/annual-convention. There is a nice photo of Scotty up there that I always pick on him about but no, I am very excited.

Scotty: And unfortunately, they got me on the board there, but I am not going to be there this year.

Bonnie: Oh man.

Kendell: Oh yes.

Scotty: Had a conflict arise. It is a good conflict. I actually, well, I will brag a little bit, but I qualified for a state golf tournament, so I am going to give that a go and have to skip out, but we have a great team that is going to be there, for sure. So, come check out our booth. And talking about the ownership workshop, if you are looking to start a pharmacy or buy a pharmacy, maybe even sell a pharmacy, step one: you absolutely have to go to the workshop. Anybody that calls me and asks me, “Hey, I am looking to start a pharmacy, “Hey, I want to buy a pharmacy.” Number one, “Did you sign up for the ownership workshop?” Because that is going to be your crash course to get your feet wet and get the ball rolling.

Bonnie: And Bri, I work with a lot of startups and a lot of transitioning pharmacies where they are purchasing stores. I cannot tell you, I would actually like to dig through the data and see, but some of our most, I would say almost all of our most successful clients that we have, if you go back and ask them, they were at a workshop, they did the workshop. It is just, it is really great. And like Kendell mentioned, I have been going for years to these and it is just, even as a person that is presenting, I love to just sit back and listen to all the other people that are talking.

And a lot of it is the same thing, but I just learned so much every time. There are even people – that always amazes me – that are looking at purchasing stores that are not pharmacists. In some states that is allowed and people do that. So, it is great networking as well for pharmacists to… I mean, we have even had in some of those breakout sessions or lunch or whatever, people stand up and say, “I want to buy a pharmacy and I am in Georgia.” And then somebody in there, is like, “I have a pharmacy in Georgia.” And we are like, “You two, you go talk.” So, I mean, it is amazing, and you guys do these, is it three times a year, four times a year?

Bri: Three-to-four times. And I think, I mean, that is such a great point, Bonnie, you know, the other benefit of coming in Kansas City is it is right before our annual meeting.

Bonnie: Yes.

Bri: So, you can go to the workshop as a prospective owner and then stay and talk to so many current owners throughout the meeting. Every time we do one of these workshops, we get the feedback surveys from folks and see what they liked. And I really like to dive into that data because I want to make sure we are meeting everyone’s needs. I do not think I have seen one negative comment about the ownership workshop. That people just love it because it is information that you have to know and it is going to stop you from…

You know, I think a lot of this content… it is you guys, experts in accounting, we have Baird legal advice, we have Scott Weaver who is talking about ownership transitions and the RX ownership team. So, it is really pulling together these resources that quite frankly are going to have a price to folks after the workshop. And you are not going to get it cheaper than you do for that registration. So, it is a really great time to get all those questions answered. And the content after talking to you guys… a lot of it is built on the lessons learned that you have found from working with other clients, right? You are trying to stop people from making mistakes that you have seen others make.

Bonnie: That is the best way to learn. I mean, it is very true. And it is great that it is usually a smaller group, and everyone is kind of in there, and by the end of it, you feel like you are friends with most of the people that are in the class, so you kind of know what their deal is, where they are, what their plan is. It is always amazing to me too, that you kind of ask in the beginning, what their plan is, “You want to do a startup or you want to buy a store?” And just in a matter of 48 hours, after hearing a lot of this information, it can change people’s direction completely. So, that tells you right there that there are some things they are hearing in these workshops, that is making a difference.

Scotty: We like to call it the A team. That is the A team at the workshop so, really great group of people like you said Bri, and a lot of experience at that workshop. But speaking of the A team, I mean, you guys at NCPA, Bri, I mean, you guys have a fantastic team. I hear great things about what you guys do, and how hard you work and the team you guys have worked so well, it seems like, and Doug working his tail off. And the legislative wins you guys have had, and the momentum that is starting to gain some traction, it would appear, with DIR fees and so forth. So, hats off to you guys, because I think you guys are doing a really great job.
But I wanted to kind of wrap us up here Bri, and touch on the disaster relief grants. That is something that is always popping up unfortunately in the world and around us, and some natural disasters here and there, and we do have those or NCPA does have those NCPA disaster relief grants. So, if you just want to plug that, it would be great.

Bri: Yeah, absolutely. So, just as you said, Scotty, it is something that… we understand tragedy hits sometimes and there have been tornadoes or hurricanes or what have you that have come through, and we do have some grants that are available whenever something like that happens to you. So, if you go to our website and just search for “disaster relief,” you can find out more information, and I hope you never need it, but it is there if you do. So, we are here and appreciate everything that our members do.

Scotty: Yeah, I have heard those grants have been very key in some disaster areas in the past hurricanes and such. So, definitely want to plug that and you know, donate to it if you can. But I appreciate your time Bri, it is fantastic having you on. We are going to have to have you on again.

Bonnie: For sure.

Scotty: I believe Bonnie and Kendell; you guys are going to go live at NCPA here.

Kendell: Yeah, we are going to try to do it.

Bonnie: We are going to try.

Kendell: We are going to try it; we are going to bring the mic, bring a little laptop and let’s get some live action here from pharmacies, live, and some vendors, and just report back. So, that will be nice.

Bonnie: We may have to do it from the workshop; that is a fun group.

Kendell: That is a fun group. Maybe we can just get some segments and put them together.

Bonnie: Yeah, well, we will do something.

Scotty: Maybe I can do a call-in. Maybe I can call in or something, I do not know.

Bonnie: Bri, we will have to catch up with you at the show, Kansas City, for some barbecue.

Bri: Absolutely.

Bonnie: I hear they have great barbecue out there.

Bri: Yeah, we will have to go and get some barbecue together while we are here. That sounds great.

Kendell: I hear there is a certified taster on your team. Jessica… That is what I heard, right?

Bri: Yes. Yes. Jessica Satterfield, our resident last year, and new associate director on the policy team is a certified Kansas City barbecue taster. I am sure that I got that wrong, but she is a wizard–

Bonnie: Probably missed a few things there.

Bri: On all things, KC-barbecue-related, as well as KC sports while we are there. So, I think that it is going to be a good meeting. And you know, we have not been to Kansas City before. I think a lot of members may not have been to Kansas City, so it is going to be really fun. And we are super excited, because this year we are inviting all pharmacy teams to come as well.

Bonnie: Nice.

Bri: We have a lot of support staff that is going to be there and going to get to feel it, and you know, we hear a lot about how folks, like the owner goes and I mean, I get this as a pharmacist that has filled in before. The owner goes to the conference, they come back with a whole list of things, and then the staff is like, “Oh my gosh, when are they going to forget this list of items?” So, bringing them, it will be really cool, so there is no FOMO, no “fear of missing out.”

Bonnie: Right, they get it.

Scotty: Get that buy-in too. They buy into the big ideas as well. They might come with their own list.

Kendell: Yeah.

Bonnie: That is right.

Bri: They will be the ones that will say, “Hey, do not forget about this.”

Scotty: That’s right.

Bri: So, it will be accountability. It is going to be a lot of fun. Cannot wait to see you guys there.

Bonnie: You too.

Scotty: We appreciate you being on today and–

Kendell: Let me introduce the ending, Scotty, we have to introduce it.

Scotty: You got it, man, you go with it.

Kendell: So, Bri, this is what we do at the end.

Bri: Okay.

Kendell: The name of it is “The Bottom Line Pharmacy Podcast,” and that is a pun, obviously that is a pun on the financial statements for profit and loss. And what we do is, each of us take a turn, at the end of each podcast to say, “What is the bottom line?” A couple of sentences: “What is your key takeaway?” Since we forgot to fill you in earlier, Bonnie, can you start us off? What is the bottom line from this podcast for you?

Bonnie: I have two, so I need to choose one. I am going to say the ownership workshop. It is important, people. If you are thinking about starting a store from the ground up – purchase of the store – you have to start with the workshop.

Kendell: That is a good one. That is a good one. Scotty, what is the bottom line?

Scotty: I think the bottom line is the workshop, and if you are starting in the trade show, I mean, what better place to really get your mind going than a trade show and speaking with your colleagues and–

Bonnie: And barbecue.

Scotty: Exchanging ideas.

Kendell: And barbecue. Yeah, exactly.

Bonnie: Workshop, trade show, barbecue, come on.

Scotty: I thought it was steaks in Kansas City, but maybe I am wrong.

Kendell: I think they do all barbecue; I hear it is phenomenal.

Scotty: It is barbecue, okay.

Kendell: Yeah, yeah, yeah. That is what I hear. And Bri, hopefully we are not putting you on the spot, but what is the bottom line for you, that you would want all our listeners and viewers to take away?

Bri: I would say, if you are looking to own a pharmacy, come to ownership workshop. If you already own a pharmacy… hope to see you at the trade show and bring your team.

Bonnie: Yes.

Scotty: Boom.

Kendell: And the mic has been dropped. I do not think there is anything else.

Scotty: Well, thank you, Bri.

Bonnie: Thank you, Bri.

Scotty: Appreciate you being on, and keep up the great work over there.

Bri: Thank you, guys.

Bonnie: Thank you.

Bri: Thanks.

Bonnie: Bye.

Scotty: Buh-bye.

Bri: Bye.

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