“What if the [doctor’s] practice you went to was mostly run by volunteers, and every time you went, you saw someone different who you didn’t really know, but they were the ones who showed up that day, so that’s who you get?”
This is the reality faced by nearly half Buncombe County’s uninsured residents, according to David Taylor, who posed the question at a ribbon-cutting ceremony this morning for the Asheville Buncombe Community Pharmacy. It’s a pattern of less-than-perfect care that he and other regional health care officials hope to improve upon. Taylor is the head pharmacist for AB Community Pharmacy, which is located in the C3356 Comprehensive Care Center on Biltmore Avenue.
All profits from the AB Community Pharmacy’s operation will go to the Asheville Buncombe Community Christian Ministry, which operates free health clinics staffed predominantly by volunteers that serve about half the county’s uninsured residents.
The AB Community Pharmacy is the product of an innovative partnership among ABCCM, regional behavioral and mental health care providers, and Buncombe County officials. Its mission is twofold: Provide the general public with an affordable, comprehensive retail pharmacy, while helping support and expand free clinic services in the Asheville area with its proceeds.
Taylor, ABCCM Executive Director Rev. Scott Rogers and other county and health care representatives were on hand for the ribbon-cutting and tours of the new pharmacy. Although the project is still in its infancy, its partners hope that AB Community Pharmacy could be the beginning of a new chapter in ABCCM’s mission to fill the gaps in the health care system for Buncombe residents.
“We are kind of the medication bank for the community,” Rogers said in a short speech prior to the ribbon-cutting, likening AB Community Pharmacy to MANNA FoodBank and other projects his organization has helped get off the ground. He offered thanks to partner organizations like Smoky Mountain LME/MCO and RHA Health Services for the opportunity to be included in C3356’s comprehensive care mission (See “Healthcare agencies, local officials celebrate opening of C3356 Comprehensive Care Center,” April 27, 2016, Xpress). Rogers also acknowledged the generosity of Buncombe County, which made the building available to ABCCM for the C3356 comprehensive care center.
Taylor spoke next, thanking Rogers and ABCCM for the opportunity to head up the retail-pharmacy effort as its sole employee. “It’s not often that a pharmacist gets to practice what he loves and also help the community, and not feel like he’s indebting people. We can give back to the community that we live in already, and that’s a really great thing.”
Hand in hand
The idea behind the AB Community Pharmacy is simple: As with any other commercial pharmacy, customers can come and have their prescriptions filled using their insurance plan. “We can bill most major insurances, including Medicare, Medicaid, Tricare, BCBS, Humana, CVS/Caremark, Express Scripts, Cigna, just to name a few,” Taylor says. “We also provide some of the lowest prices in town for cash-paying patients. I have a fully stocked pharmacy and can order anything I don’t have for next-morning delivery.”
Where AB Community Pharmacy differs from other pharmacy outlets, however, is in where the money goes. While the pharmacy takes a small percentage of its proceeds to cover the costs of supplies and operation, the vast majority of the profits will go directly to ABCCM for the purpose of supplying and funding its Medical Ministry clinic on Livingston Street, which provides medical and dental services to the uninsured, as well as to ABCCM’s free pharmacy, which is located right next door to Taylor’s retail business in C3356.
“The free pharmacy provides care to those who [make less than] 200 percent of the federal poverty level, have no insurance and are referred to them by a participating physician,” Taylor explains. In contrast, AB Community Pharmacy is open to the public and can serve anyone. “We chose this particular location because it allows our two pharmacies together to provide care for 100 percent of the patients seen at this facility,” Taylor says, some of whom struggle to find transportation to and from pharmacies scattered across town.
While the two pharmacies operate side by side, there are several important differences between the free pharmacy and AB Community’s retail facility, besides the obvious difference in cost. “It’s very important to know that our retail pharmacy is not limited to [C3356] and could not survive without customers from outside these walls,” Taylor says. “I expect that within the next couple months our customer base will be mostly people not affiliated with the C3356 facility.”
Behind the counter
So how does a commercial pharmacy make money without raising the price of prescriptions for consumers? The key, says Taylor, is the payments the customer doesn’t see. “People don’t realize that if they pay 10 dollars for a drug, that drug could actually be up to 1,000 dollars, and the insurance is reimbursing us $1,100. That’s only a 10 percent markup, but 100 dollars is still a lot of money for one transaction.”
That money is then put into a bank account overseen by ABCCM, where funds are distributed to help pay for supplies and services at the nonprofit’s free clinic and two pharmacies.
But how can a business afford to remain viable if it’s donating all its profits? For one thing, Taylor says, his pharmacy has minimal overhead. “I’m the only employee and I make a typical pharmacy manager’s salary.” While volunteers assist him with putting together orders, Taylor is primarily responsible for almost every other task involved in the pharmacy’s operations. “I’m the manager, but I’m also the marketing director, the pharmacy technician and everything else.”
ABCCM provided start-up capital to get the pharmacy running in the short-term; in return, all net profits from AB Community Pharmacy sales will go back to ABCCM once the pharmacy begins to turn a profit. “I have the knowledge and skills to operate this business, but I didn’t have the money,” Taylor says. “Together we have created the most altruistic pharmacy in WNC and possibly all of North Carolina.”
For his part, Rogers says that the pharmacy is just the latest example of ABCCM working with its community partners to ensure that those who need their help, get it. “We’ve got to give back and take care of the uninsured,” he says with pride. “They’re the ones out there who are working, feeding us in our restaurants, making the beds in the hotels, clipping grass or out there working with small entrepreneurs. We at ABCCM believe that we’re here to fill the gaps in the community.”
Great expectations
For the moment, Taylor says he’s focused on spreading the word about the new pharmacy and getting the general public behind the idea. “We need more business, first of all, so we have to get the word out.” While the number of prescriptions filled at AB Community Pharmacy has grown exponentially since its soft opening three months ago, Taylor says outreach is key to ensuring continued growth. “We are not able to afford a corner spot on Biltmore Avenue or a huge sign, which is why we need help letting people know we are here.”
Long-term, Taylor and ABCCM would like to use the donated proceeds from the pharmacy to expand and improve the quality of care ABCCM offers at its clinic by hiring full-time medical professionals. “This will provide better hours and more continuity of care [at the clinic],” Taylor says. “We hope to allow those in our community who work their butts off for $7.50 an hour to get the same quality of care as everyone else.”
Taylor hopes the strong sense of community awareness in Asheville and Buncombe County will lead more residents to his doors in the coming year. “If you want the same product that you’re getting anywhere else, but you want the peace of mind that your money’s going somewhere besides a CEO’s pocket, to actually do something good, then why not use us?” he says. “I’m confident that once people understand what we are about and see the quality of care they get here, that won’t be an issue.”
AB Community Pharmacy is fully operational and located on the second floor of the C3356 facility on Biltmore Avenue. For more information, check out abccm.org/community-pharmacy/ or contact pharmacy manager David Taylor at (828) 398-0123 or david.taylor@abccm.org. To learn more about the services and care offered at ABCCM’s Medical Ministry clinic, visit abccm.org/circle-of-gratitude/.
Author’s note: In the original version of the article, Reverend Scott Rogers was quoted as referencing the Blue Ridge Community Health Center as formerly occupying the C3356 facility. The correct name of the former tenant referenced was Blue Ridge Center for Mental Health. The quote has been amended to reflect this, and I apologize for the error.