HMOs and PPOs: Strategy for success through pharmacy networks

New structures for organization and delivery of health care, such as health maintenance organizations (HMOs) and preferred provider organizations (PPOs), are being formed all across the country. Pharmacists often hear about a new HMO or PPO from a patient who comes into the pharmacy to inform the pharmacist that he or she will no longer be able to get prescriptions filled at that pharmacy because of the new health plan offered by their employer. Pharmacies who serve a large base of patients from a single major employer in their area are being most severely affected by these new structures. Some pharmacies may suddenly lose as much as 20 to 50% of their patient base to one of these organized health plans.