When a patient picks up a script and swipes their card at the counter, it should be a routine transaction that puts payment in your pocket. But as independent pharmacists know all too well, it’s never that simple.
In the dizzying world of PBM oversight, unpredictable reimbursements, ever-shifting fees, and the skyrocketing cost of credit card transactions, you’re often the last to know what you’ll actually earn on a prescription—and sometimes, you don’t earn anything at all.
To better understand how pharmacies can protect themselves, we sat down with Presley Kelleher, RedSail’s VP of Product and Payments, to talk about what it really takes to build a sustainable payment strategy.
As Presley shows, pharmacies that not only survive but thrive all have one thing in common: a clear, concise approach to how prescriptions are priced, how payments are processed, and how revenue is protected at every step.
With a well-defined payment strategy in place, you can keep more of your hard-earned dollars rather than putting them in the pockets of PBMs, processors, or other third parties.
Any good plan starts with a little bit of behind-the-scenes research. Before you can fix your payment strategy, you need to know how you’re getting paid (and where you’re the one doing the paying).
“Without an understanding of how payments impact your pharmacy, hard-earned revenue can go right out the door,” says Presley.
In other words, if you don’t know where money is going down the drain, you can’t stop the leaks.
That visibility starts with taking a hard look at:
Your RedSail pharmacy management system can help with some of this legwork, particularly running reports on least profitable prescriptions and identifying workflow bottlenecks. You can also review your credit card processor’s fee structure and compare it against other options on the market.
When you do your research, you may find—like many pharmacies—that the biggest leaks aren’t dramatic costs but small, repeated losses.
Rome wasn’t built in a day, and neither should your payment strategy.
The pharmacies that make real progress on payments don’t try to overhaul everything at once. They start small. They choose one area to improve, commit to it for a quarter, and build momentum from there.
“Trying to fix everything at once can be overwhelming,” says Presley. “But choosing one focus area and doing it well is how you start seeing real impact.”
That focus area might be:
The key here is to make your focus a team effort. Talk to your staff about where they spend the most time, what slows them down, and what they’d be excited to help improve. When your team has ownership in the process, the strategy sticks that much easier.
And after you’ve successfully implemented one payment strategy, you can expand from there. After all, a payment strategy grows step by step, not all at once, and with each win in tow, you’ll start to see real improvements.
Once you see the leaks, you can start plugging them.
“Pharmacies don’t realize how much power they actually have,” says Presley. “When you find out what’s draining your margins and make the decision to cut it out, you immediately start putting money back into your business.”
That might mean:
Often, this is where many pharmacists regain their first sense of control. No longer stuck in the realm of reactivity, they can finally be proactive.
Once you’ve identified the leaks and tightened the processes around them, the next step is bringing in tools that actually support your strategy.
Pharmacies that thrive use tools and tactics to get ahead. That might mean steering to NDCs with better reimbursement, using MAC appeals strategically, estimating reimbursement before filling, or adopting new pieces of technology.
“Tools should make your strategy easier to execute,” Presley advises. “When you have the right systems in place, you can finally see what you’re earning and keep more of it.”
RedSail is proud to support you in your pricing strategy with two tools designed to keep your profits predictable and protected.
As pharmacies look to diversify their revenue sources, cash-pay is an increasingly attractive option—for patients as well as profits.
More patients are seeking predictable pricing, and many are discovering that cash pay often offers a better deal than their insurance. For pharmacies, offering a cash-pay alternative creates a competitive edge and builds trust with patients who want clarity at the counter.
“Cash-pay is a great way to give patients more choice,” says Presley. “When you offer a fair, consistent price, everyone wins.”
The challenge, of course, is knowing what “fair” actually looks like. Outdated pricing models make it difficult to set rates that are competitive for patients and sustainable for your pharmacy.
That’s where RxCash+ comes in. RxCash+ It’s RedSail’s data-driven pricing solution that takes the guesswork out of cash-pay. It supports the front end of your strategy by helping you:
Another area eating pharmacies’ bottom lines is merchant services—with hidden fees, rate increases, and unexpected payments on your end.
“Choosing the right partner to process payments ensures that you have controlled pricing, no gimmicky fees, and you aren’t getting nickel-and-dimed with multiple rate increases a year,” Presley notes.
RedSail Pay is built to give pharmacies what they’ve been missing:
“When it comes to the credit card portion of the business, having a trusted merchant services partner—and an agreement that guarantees your rates won’t increase—keeps your focus on your bottom line instead of losing revenue to third parties,” Presley adds.
To learn more about RedSail Pay and RxCash+, click here.
Like any good strategy, a payment strategy isn’t “set it and forget it.” It’s an active part of your business that requires regular attention and adjustments.
Pharmacies that thrive revisit their approach often, ask questions, gather data, and check in on what’s working and what’s not.
“Payments change fast, so the pharmacies that stay profitable are the ones that stay proactive,” says Presley.
A monthly check-in can go a long way. Set aside an afternoon to review your numbers, your vendors, and your workflow. Ask yourself:
Track your progress, document what you find, and adjust your strategy accordingly. Over time, these small check-ins can make a big difference.
Profits have always been important, but in a world where pharmacies’ margins shrink by the day, they need to pay particular attention to what’s filling—and draining—those profits.
The pharmacies that stay financially strong despite the chaos of the industry don’t leave revenue up to chance.
They build, implement, and execute a payment strategy that puts them back in control—whether it be navigating PBM reimbursements, managing credit card costs, optimizing cash pricing, or tightening operations up. It’s the best way to protect profitability in an environment that’s designed to erode it.
RedSail is committed to helping pharmacies do exactly that. We’re continuing to innovate around pharmacy payments, with new capabilities and integrations always in the works.
But no matter which tools you choose, establishing an intentional payment strategy is one of the most impactful steps you can take to strengthen your business—and safeguard the future of your pharmacy.
