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Top 10 Strategies to Mitigate DIR Fees in Your Pharmacy

Updated: Apr 29, 2023

As a pharmacy professional, I understand that Direct and Indirect Remuneration (DIR) fees can significantly impact a pharmacy's profitability. In this blog post, I will discuss the top 10 strategies to help mitigate DIR fees and ensure a healthier bottom line for your pharmacy.

  1. Optimize medication adherence: Improved patient adherence to medications can lead to better performance metrics, which can positively impact your DIR fees. Develop strategies to encourage adherence, such as medication synchronization, patient education, and reminder programs [1].

  2. Focus on Star Ratings: CMS Star Ratings measure pharmacy performance on various quality measures, including adherence, patient safety, and patient experience. Higher Star Ratings can result in lower DIR fees, so prioritize improving your pharmacy's performance on these metrics [2].

  3. Provide comprehensive Medication Therapy Management (MTM): Offering MTM services to patients can improve medication use, enhance patient outcomes, and contribute to better performance on quality measures, ultimately reducing DIR fees [3].

  4. Educate patients about medication use: Ensuring that patients understand how to properly use and administer their medications can result in better adherence and outcomes. Utilize instructional videos, patient counseling, and educational materials to help patients make the most of their medications [4].

  5. Regularly review and optimize formularies: Keep up-to-date with formulary changes and ensure that your pharmacy stocks the most cost-effective and clinically appropriate medications. This can help improve performance on cost and utilization measures, which can reduce DIR fees [5].

  6. Leverage technology: Utilize pharmacy management software and data analytics tools to track your performance on quality measures and identify areas for improvement. These insights can help you develop targeted strategies to mitigate DIR fees [6].

  7. Build relationships with local prescribers: Collaborate with local healthcare providers to optimize medication therapy and address potential drug-related issues. This partnership can improve patient outcomes and reduce DIR fees by enhancing performance on quality measures [7].

  8. Improve patient communication: Effectively communicate with patients about their medications, health conditions, and the importance of adherence. Utilize various communication channels, such as phone calls, text messages, and in-person consultations, to keep patients informed and engaged [8].

  9. Monitor and analyze claims data: Regularly review your pharmacy's claims data to identify trends and potential areas for improvement. This information can help you develop targeted strategies to address performance gaps and mitigate DIR fees [9].

  10. Stay informed about DIR fee policies and legislation: Keep up-to-date with changes in DIR fee policies and advocate for fair reimbursement practices. Join industry organizations and collaborate with peers to stay informed and influence policymaking [10].


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