Sorry for the late response, Saturday was just a busy day and we are trying to enjoy whats left of summer in Chicago.
Any and every pharmacy has a risk when dispensing medications. Patients may not be truthful in illicit drug use or other therapies. I have had patients overdose on xanax, pain med, etc. ER will call and ask me what meds they were prescribed.
Legal risk is minimized as long as the pharmacy dispenses the medication correctly! There is some risk with Drug Interactions but minimal. Manufacturers always say this "may" happen if you take these together.
I remember years ago RPHs would try to limit how many prescriptions they could verify in a shift, but that talk has disappeared or those RPHs were let go?
You know the math in this game, the deeper the reimbursements cuts the more volume and more bare bone staff will be present in any pharmacy. Therefore, risk will increase. Independents have the benefit of adding additional staff to ensure better customer service. JD Powers ranked independent pharmacists as number 1 in customer service, while retail CVS/WAG were near the bottom.
Managing risk and IT(phone) are connected but not integrated yet, Next time you visit the ER staff ( you are visiting them?) see what they are doing to linkin to the medical records of a patient that has not been treated at their hospital.
It might be a investment opportunity that you would be interested in..
Its sad that drugsters have access to pill mills and Fraudulent professionals who run them. The management of risk I was thinking about was more on the lines of risk in communications and achieving desired goals from your staffs input. Like the asthma patient who has a dietary problem and 2 martini lunches with a family history of Heart disease..going to the ER.. Expensive event for for a GI issue wouldn't you think.. Lots of tests...
I had looked at the JD Powers score card, and Like I always said a well run independent pharmacy could walk all over the CDS today. As for the PBM's thats a issue I suggest you focus on. I am positive they would have room for someone who understands the professionalism and cost issues facing independent Pharmacies.
Its sounds like you are starting to Audit your risk exposure to payer groups that is good start by looking at the Medicaid proposal and you ability to provide a service. Have you spoken with your Wholesaler they may some in-site on this issue, not the sales rep but one of the exec's?
I believe you are smart enough not to drive your business off a cliff and don't mind doing the hard work yourself, so stay positive ..