MDHIN Corporation
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Pharmacy Revenue Assessment

See Where Your
Pharmacy Stands

Discover your pharmacy's clinical revenue readiness, reimbursement opportunities and recommended next steps.

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Free assessment Immediate results No obligation
Clinical Revenue Growth Model MDHIN + RxDirectCare

More knowledge about your pharmacy creates more precise reimbursement and consumer-growth opportunities.

Revenue Opportunity
Business profile
Payer intelligence
Clinical readiness
Revenue activation
Operational Intelligence
Reimbursement Consumer engagement Service growth
Sample Assessment Results

Revenue Opportunity Report

74 /100
Opportunity High
Potential Range $40K–$90K
Clinical Readiness74%
Billing Opportunity82%
Service Expansion68%

Strengths

Patient relationships
Existing workflow

Opportunities

POCT and labs
Clinical billing

Recommended Next Step Build a prioritized clinical revenue plan.
State & Payer Intelligence

Reimbursement differs by state, payer and clinical service.

Understand your business and let MDHIN and RxDirectCare work for you. More information about your operations, payer relationships and clinical capabilities allows MDHIN to identify stronger reimbursement pathways, increase consumer interactions and develop practical revenue opportunities.

State-specificAuthority and reimbursement environment
Payer-awareMedicaid, MCO and commercial pathways
Action-orientedBilling routes and next steps
1
Well-established reimbursement pathways More mature Medicaid and/or commercial billing environments
Idaho Direct pharmacist enrollment and medical-claim billing; strong Medicaid and commercial pathways.
Oregon Medicaid and commercial reimbursement continue expanding for eligible pharmacist clinical services.
New Mexico Long-standing pharmacist provider model with broad clinical authority and payer opportunities.
Colorado Provider recognition with expanding Medicaid reimbursement and credentialing pathways.
Virginia Selected services reimbursed through statewide protocols and collaborative practice arrangements.
Pennsylvania Pharmacist enrollment available for selected Medicaid and commercial clinical services.
North Dakota Recognized Comprehensive Medication Management and related clinical reimbursement opportunities.
Washington Strong provider recognition and commercial reimbursement with payer-specific Medicaid routes.
2
Expanding reimbursement pathways Coverage is generally service-, contract- or credentialing-specific
Alaska Developing clinical reimbursement; payer contracts and credentialing remain important.
Connecticut Expanding authority through protocols, POCT and payer-specific arrangements.
Delaware Broad clinical authority with payer-dependent reimbursement opportunities.
Hawaii Emerging pathways commonly connected to collaborative practice and payer programs.
Illinois Expanded test-and-treat authority and selected commercial reimbursement.
Indiana Growing opportunities that remain contract- and collaborative-practice dependent.
Kansas Protocol and collaborative pathways support selected test-and-treat services.
Kentucky Selected provider-recognition and reimbursement pathways vary by service and payer.
Louisiana Developing reimbursement through credentialing, payer contracts and collaborative practice.
Maine Emerging payer-specific clinical and point-of-care testing opportunities.
Michigan Clinical reimbursement is expanding, but direct payment remains payer specific.
Minnesota Broad clinical activity with selected Medicaid, commercial and CMM pathways.
North Carolina Expanding standing-order, test-and-treat, Medicaid and payer initiatives.
Utah Independent and collaborative services with payer- and program-specific reimbursement.
3
Statewide pharmacy growth opportunities Leverage MDHIN, RxDirectCare and collaborating-provider pathways
Alabama Use collaborative clinical programs, consumer services and MDHIN-supported reimbursement workflows.
Arizona Expand clinical services through payer contracting, protocols and collaborating-provider relationships.
Arkansas Develop reimbursable and consumer-facing services through collaboration and community engagement.
California Leverage broad pharmacist authority, payer programs and collaborative care models.
Florida Build test-and-treat, wellness, chronic care and consumer engagement pathways with provider support.
Georgia Use collaborative practice, payer-specific programs and MDHIN clinical workflows to expand revenue.
Iowa Develop medication management, preventive care and employer or membership-based pharmacy services.
Maryland Combine payer opportunities, collaborative services and community health engagement programs.
Massachusetts Pursue payer-specific clinical programs, health-system partnerships and consumer services.
Mississippi Expand access through collaborating providers, clinical programs and community-based services.
Missouri Build reimbursable pharmacy services through protocols, payer relationships and MDHIN support.
Montana Use telehealth, collaborative care and consumer programs to extend pharmacy reach.
Nebraska Develop clinical billing, employer programs and preventive-care engagement through partnerships.
Nevada Expand clinical and consumer services through credentialing, collaboration and payer-specific programs.
New Hampshire Use pharmacist services, provider collaboration and membership programs to create new revenue.
New Jersey Pursue payer contracting, collaborative clinical care and high-value consumer health programs.
New York Leverage collaborative practice, immunization, testing and MDHIN-supported consumer programs.
Ohio Build chronic care, test-and-treat and payer-specific clinical reimbursement pathways.
Oklahoma Use provider collaboration, community programs and payer intelligence to expand services.
Rhode Island Develop payer-specific pharmacy services and collaborative community care programs.
South Carolina Expand testing, chronic care and consumer engagement through collaborating-provider models.
South Dakota Use medication management, preventive care and telehealth-supported pharmacy services.
Tennessee Build payer-specific and collaborative clinical services around community pharmacy access.
Texas Leverage collaborating providers, employer programs, memberships and broad consumer engagement.
Vermont Develop integrated medication management, preventive services and payer partnerships.
West Virginia Use community pharmacy access to expand chronic care, testing and consumer health programs.
Wisconsin Pursue payer-specific clinical reimbursement, employer services and collaborative care.
Wyoming Extend pharmacy services through telehealth, provider collaboration and community programs.
Every state presents pharmacy growth opportunities. Where direct pharmacist reimbursement is limited or still developing, MDHIN and RxDirectCare can help structure collaborating-provider, membership, employer, consumer-engagement and payer-specific clinical pathways. Coverage and billing requirements must still be confirmed for each service and payer.
Built for pharmacy growth

Identify the opportunities already inside your pharmacy.

Independent Pharmacies

Expand clinical services and reimbursement opportunities. Evaluate your pharmacy's clinical readiness, billing opportunities and growth potential.

Pharmacy Groups

Benchmark locations and identify new revenue opportunities. Compare operational readiness, payer participation and reimbursement opportunities across your organization.

Partnership Opportunities

Consultants, PSAOs & Industry Partners

Help your pharmacy clients grow with MDHIN. Schedule a call to learn how MDHIN and RxDirectCare can help your clients increase reimbursement, expand clinical services and improve community engagement.

Schedule a Partnership Call Contact MDHIN
Start with a clear picture

Discover your pharmacy's clinical revenue potential.

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