Progressive Care Profile
Progressive Care Inc., through its subsidiaries, operates as a personalized healthcare services and technology company that provides prescription pharmaceuticals and risk and data management services to healthcare organizations and providers.
The company’s subsidiaries include Pharmco, LLC, doing business as Pharmcorx (Pharmco 901) and Pharmcorx LTC; Touchpoint RX, LLC, doing business as PharmcoRx 1002, LLC (Pharmco 1002); Family Physicians RX, Inc., doing business as PharmcoRx 1103 and PharmcoRx 1204 (pharmacy subsidiaries collectively referred to as Pharmco); and ClearMetrX Inc (ClearMetrX).
Pharmco provides prescription pharmaceuticals, compounded medications, tele-pharmacy services, anti-retroviral medications, medication therapy management, the supply of prescription medications to long-term care facilities, contracted pharmacy services for 340B covered entities under the 340B Drug Discount Pricing Program, and health practice risk management. Pharmco also offers certain disease testing and vaccinations. The company offers services in a variety of languages, including English, Spanish, French, Creole, Portuguese, Ukrainian and Russian.
The company’s services are designed to provide satisfaction across all medication stakeholders and enhance loyalty and key performance metrics. It offers value-added services at no additional charge, including prior authorization assistance, same-day home-medication delivery, on site provider consultation services, primary care reporting and analytics, and customized packaging solutions. The pharmacies accept most major insurance plans and provide access to co-pay assistance programs to income qualified patients, discount and manufacturer coupons, and competitive cash payment options.
Products and Services
The company enhances patient adherence to complex drug regimens, collect and report data, and ensure effective dispensing of medications to support the needs of patients, providers, and payors. The company’s patient and provider support services ensure appropriate drug initiation, facilitate patient compliance and adherence, and capture important information regarding safety and effectiveness of the medications that it dispenses.
Pharmco is rated by pharmacy benefit managers (PBMs) based on its ability to adequately supply chronic care medications to patients during a measurement period. This score is then compared to the scores of other pharmacies in the network at which point a relative rating is issued. For the year ended December 31, 2022, per EQuIPP, a performance information management tool that provides standardized, benchmarked data to help shape strategies and guide medication-related performance improvement, the company’s performance score was Five Stars, ranking its pharmacy among the top pharmacies in the U.S. Primary care physicians may refer patients to pharmacies that have high performance scores, though patients retain the right to have their prescriptions dispensed by a network of pharmacies of their choice.
Through its wholly owned subsidiary, ClearMetrX, the company offers data management and reporting services to support health care organizations. There are substantial restrictions in federal and state laws on the use and sharing of patient data and ClearMetrX is in compliance with such laws. The ClearMetrX offerings include data management and Third-Party Administration (TPA) services for 340B covered entities, pharmacy data analytics, and programs to manage HEDIS Quality Measures, including Medication Adherence. These offerings cater to the glaring need for frontline providers to understand best practices, patient behaviors, care management processes, and the financial mechanisms behind these decisions. The company provides data access and actionable insights that providers and support organizations can use to improve their practice and patient care.
Pharmco also provides contracted pharmacy services for 340B covered entities under the 340B Drug Discount Pricing Program. Under the terms of these agreements, the company acts as a pass through for third-party payor reimbursements on prescription claims adjudicated on behalf of each 340B covered entity and receive a dispensing fee per prescription. These dispensing fees vary by the 340B covered entity and the level of service provided by the company.
For the company’s long-term care (LTC) customers, Pharmco provides purchasing, repackaging and dispensing of both prescription and non-prescription pharmaceutical products. Pharmco utilizes a unit-of-dose packaging system as opposed to the traditional vials as this method of distribution is the industry best practice standard. Pharmco is equipped for various types of unit-of-dose packaging options to meet the needs of LTC patients and retail customers. Pharmco uses the same robotic packaging systems used by chain, mail order, and large-scale pharmacies. Pharmco also provides computerized maintenance of patient prescription histories, third-party billing and consultant pharmacist services. Pharmco’s consultant pharmacist services consist primarily of evaluation of monthly patient drug therapy and monitoring the LTC institution’s drug distribution system.
Medication therapy management (MTM) involves review and adjustment of prescribed drug therapies to improve patient health outcomes for patients with multiple prescriptions. This process includes several activities, such as performing patient assessments, creating medication treatment plans, monitoring the effectiveness of and adherence to prescribed therapies, and delivering documentation of these services to the patient’s physician to coordinate comprehensive care.
Distribution Methods
The company delivers prescriptions throughout Florida and ship medications to residents in those states where it holds non-resident pharmacy licenses. The company holds Florida Community Pharmacy Permits at all Florida pharmacy locations and its Pharmco 901 location is licensed as a non-resident pharmacy in the following states: Arizona, Colorado, Connecticut, Georgia, Illinois, Minnesota, Nevada, New Jersey, New York, Pennsylvania, Texas, and Utah. The company can dispense to patients in the state of Massachusetts without a non-resident pharmacy license because Massachusetts does not require such a license for these activities. Pharmco subsidiaries are full-service retail specialty services pharmacies that offer same-day free delivery within Florida.
Growth Strategy
The key elements of the company’s strategy include increasing importance as health systems evolve to become virtual and digitized; investing in sales and marketing; selectively pursuing growth through strategic acquisitions.
Suppliers
The company’s primary supplier for the year ended December 31, 2022, was McKesson.
Customers
The company sells to numerous customers, including various managed care organizations within both the private and public sectors. Certain healthcare payors, including Medicare Part D and the state of Florida, account for more than ten percent or more of the company’s consolidated net revenue in fiscal 2022. Medicare Part D and the state of Florida Medicaid public assistance program are major customers of the company.
Governmental Regulation
The company conducts ongoing educational programs to inform employees regarding compliance with relevant laws and regulations and maintain a formal reporting procedure to disclose possible violations of these laws and regulations to the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services.
Federal and state-controlled substance laws require the company to register its pharmacies with the U.S. Drug Enforcement Administration (DEA) and to comply with security, record keeping, inventory control, labeling standards and other requirements to dispense controlled substances.
Competition
In the Specialty Pharmacy Services segment, the company competes with several national and regional specialty pharmacy companies that have substantial financial resources and which also provide products and services to the chronically ill, such as CVS Caremark, Express Scripts, Humana, Optum and Walgreens. The company also competes with Omnicare.
