Buying a pharmacy in Jacksonville and Northeast Florida

• Patients who refill on schedule, with prescriptions coming from many prescribers rather than one clinic down the hall.
• Income beyond plain retail prescriptions: compounding, facility accounts, vaccinations, medication synchronization (lining up a patient's refills on one day).
• Careful buying. What the store pays for generic drugs has a large effect on its margin.
• A pharmacist who will stay on as prescription department manager, and technicians who know the patients by name.
• A pharmacy system that shows what each plan pays, claim by claim, so you can see which claims lose money.
• A clean audit history with the plans, and inventory that matches the books.
• A drive-through window, easy parking and a location near the doctors' offices that send it patients.

• Payer mix. Ask for a year or more of claims by plan. If a few plans carry most of the volume, a cut in one contract hits hard.
• Contracts after a sale. Florida Medicaid wants notice from the seller and your enrollment application at least 60 days before closing, and it can hold you liable for overpayments it has already identified (section 409.907(6)). Each drug plan network has its own process for a change of ownership. Ask early how long each takes, because a gap sends patients elsewhere.
• Audits and clawbacks. Plans audit prescriptions and can take back payment for paperwork errors. Look for pending recoveries and fees charged after claims were paid.
• Inventory. Count it at closing, leave out stock that has expired or will soon, and make sure the controlled substance records match the count.
• The pharmacist question. If the owner is the main pharmacist, budget for hiring a replacement.
• Competition. Mail order and nearby chains pull away maintenance prescriptions (regular refills for ongoing conditions); facility and compounding work is harder for them to take.

• Which plans make up most of your prescriptions, and are any of them paying below cost on common generics?
• Are you the prescription department manager today, and who would run the counter after you step back?
• What audits have you had from plans or the board in the last few years, and how did they turn out?
• How do you buy your drugs: one main wholesaler, other sources, a buying group? And how often do you compare generic prices?
• Do you serve any assisted living facilities or group homes, and is that work under contract?
• Which services beyond retail prescriptions are growing, and which would you add if you were staying?
• How much of the front-of-store stock is current and still sells?

This region covers Duval, St. Johns, Clay, Nassau, Baker and Putnam counties: Jacksonville, Jacksonville Beach, St. Augustine, Ponte Vedra Beach, Orange Park, Fleming Island, Green Cove Springs, Fernandina Beach, Yulee, Macclenny and Palatka. Jacksonville merged with most of Duval County in 1968, which makes it the largest city by land area in the lower 48 states.

The economy leans on logistics, the Navy and financial services. Logistics runs through JAXPORT, major rail lines and the meeting of Interstates 95 and 10. The Navy has Naval Air Station Jacksonville and Naval Station Mayport. Insurance and health care matter too. St. Augustine, founded by the Spanish in 1565, and Amelia Island draw steady tourism. Trucking and logistics firms, the building trades, medical practices and home services all fit this market.

Northeast Florida is less seasonal than South or Southwest Florida, with fewer winter residents and more year-round employers. Direct hurricane landfalls have been less common here than on other parts of the coast, but storms still bring flooding along the St. Johns River and the beaches, so check insurance costs and flood zones.

Military families bring skilled workers and working spouses into the labor pool, though they also move on when orders change. St. Johns, Clay and Nassau have added the most new homes, and companies serving those suburbs have grown with them. Georgia is close, and some companies here serve customers across the state line. Work in Georgia may need Georgia licenses, so ask how much revenue comes from there and who holds those licenses.