Organizers of Troy Medicare have created a Medicare Advantage based on this idea: Maybe local pharmacists are in a great position to make health care work better.
The organizers of the Charlotte, North Carolina-based insurer say they are putting independent pharmacies in the driver’s seat.
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The company is on track to sell community-pharmacy-powered Medicare Advantage plans, and Medicare Advantage plans with prescription drug benefits, for the 2020 contract year.
Flaviu Simihaian, Josh Young, Amina Abubakar and Joe Moose teamed up to start Troy Medicare in 2018. Young, Abubakar and Moose all have doctor of pharmacy degrees.
The four founders recruited about 70 pharmacy owners, physicians and other health care professionals to invest in the new company.
The new company is basing its pharmacy benefits package on use of pharmacy networks organized by community pharmacies, such as the North Carolina-based Community Pharmacy Enhanced Services Network.
“We found that community pharmacies were able to reduce readmissions for complex care patients by 45% and reduce emergency room visits by 15%,” the company says on its website.
Patients who get their prescriptions filled at community pharmacies were 25% more likely to engage their physician and 20% more adherent to their medications, the company says.
Simihaian, the new insurer’s chief executive officer, said in a written answer to questions that surveys show that people ages 65 and older trust their pharmacists more than they trust any other health care providers, including their doctors.