Improving Diabetes Outcomes in 2025: How Pharmacies Can Drive Change (and Revenue) with EQUIPP
With 38 million Americans living with diabetes and annual costs reaching $413 billion, the importance of proactive, patient-centered care continues to grow. Pharmacists play a key role in supporting diabetes management beyond traditional dispensing, and tools like EQUIPP can help identify care gaps and ensure pharmacies are recognized and reimbursed for the clinical services they already provide.
The Diabetes Crisis: Scope and Prevention
Diabetes is a complex condition, and understanding the distinction between its two primary forms is essential for effective management and prevention.
- Type 1 Diabetes (Insulin-Dependent): An autoimmune disease in which the body destroys pancreatic β-cells, resulting in little to no insulin production.
- Type 2 Diabetes (Insulin-Resistant): A metabolic disorder in which the body continues to produce insulin, but peripheral tissues do not respond to it effectively.
This distinction is clinically significant, as Type 2 Diabetes is often preventable through lifestyle modifications such as diet and exercise, whereas Type 1 Diabetes is not preventable. Nevertheless, both forms can lead to serious long-term complications when blood glucose remains uncontrolled. These complications are largely vascular and neurological in nature, affecting the eyes, brain, kidneys, and extremities.
The Power of Early Detection
Data clearly shows that delays in care can have severe consequences. A delayed diagnosis of diabetes by 3 or 6 years can increase the risk of cardiovascular events by 5% to 10% over a decade.
Early detection is critical to reducing the risk of significant long-term complications associated with diabetes.
Advancing Pharmacy: Point-of-Care A1C Testing
We, as pharmacy professionals, must push to advance our profession beyond the typical dispensing model. One of the most impactful new services some pharmacies are offering is Point-of-Care A1C Testing.
- Convenience for Patients: Having their A1C checked during a routine pharmacy visit saves patients the time and effort of traveling to a lab and waiting in line.
- Closing Gaps in Care: EQUIPP will identify patients overdue for A1c monitoring and highlight reimbursable opportunities for the pharmacy to complete testing.
Getting Started with EQUIPP Enhanced Services
Through EQUIPP’s Enhanced Services, reimbursement is possible for this crucial service (paying $$ per intervention). Our PQS team is developing a playbook to help you implement a Point-of-Care A1C program, covering everything from obtaining a CLIA waiver to staff training and documentation.
Keep an eye on the EQUIPP Knowledge Base and the upcoming EQUIPP Academy for the official launch of the A1C Clinical Program Playbook for pharmacies!
Medication Adherence: The Core of Diabetes Management
Following diagnosis, the best way to improve outcomes is through proper disease management and that starts with medication adherence. As the most accessible healthcare provider, pharmacists are perfectly positioned to lead this effort.
Why Adherence Matters to Your Bottom Line
Medication adherence for diabetes is a highly-weighted Medicare Star Rating measure (weight of three, compared to one for most others). Better adherence rates lead to higher Star Ratings for health plans, which translates into increased funding from CMS and a greater ability for plans to offer competitive services.
The adherence goal, measured by the Proportion of Days Covered (PDC) methodology, is 80% for each member.
Leveraging the EQUIPP Platform for Revenue
EQUIPP provides two primary methods to improve outcomes and get paid for your work:
1. EQUIPP My Programs (Performance Bonuses)
This dashboard lists health plans that offer annual performance bonuses based on your pharmacy's adherence rates. You can log in to see which patients are outliers and require intervention to boost your rates.
2. Longitudinal Adherence Monitoring Program (LAMP) Enhanced Services
The LAMP page identifies routine activities like refills, day-supply conversions, and patient check-ins that are eligible for reimbursement.
- Final Fill Opportunities: The easiest way to earn revenue. Plans are offering extra $$ per fill just for the last refill of the year.
- Action Tip: Document your patient interaction live and in real-time. The refill must happen on the day of or after the conversation to qualify for payment.
Introducing EQUIPP Copilot: AI for Efficiency
We understand that jumping between your dispensing system and a website can be tedious. That's why we're thrilled to introduce the EQUIPP Copilot.
The Copilot is a HIPAA-compliant AI overlay that sits directly on top of your existing pharmacy software.
- It uses AI to identify the patient's name and date of birth.
- It highlights intervention opportunities in real-time.
- It allows you to document interventions without leaving your dispensing screen.
- It can even be installed on Point-of-Sale machines to catch opportunities at pick-up.
This technology is designed to make documentation faster and ensure you don't miss out on revenue. It is currently free through the end of the year.
Find the download link for the Copilot at the top of your Equipp dashboard and start saving time today!
Your Next Step: Free Continuing Education
We've partnered with CE Impact to offer two hours of free continuing education (CE) credits for pharmacists and pharmacy technicians (four 30-minute sessions).
- Access: Access is only available through the links in the dedicated email from EQUIPP. If you can't find the email, please contact our support team.
By utilizing the tools and resources available through EQUIPP, your pharmacy can play a transformative role in managing diabetes, improving patient health, and securing a more financially stable future for your practice in 2025.
Do you have questions about implementing Point-of-Care A1C testing or need a demo of the EQUIPP Copilot? Feel free to contact us at support@pharmacyquality.com.