Buying a pharmacy in Orlando and Central 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 Orange, Seminole, Osceola, Lake, Sumter and Marion counties: Orlando, Winter Park, Kissimmee, St. Cloud, Sanford, Clermont, Leesburg, Ocala and the large retirement communities of Sumter and Lake counties. Tourism is what the area is best known for, built on the theme parks, the hotels, the vacation rental homes around Kissimmee and the Orange County Convention Center. It's far from the only business. The University of Central Florida and the military simulation and training offices near it support a technology base, and health care is a major employer.

Marion County is horse country, with thoroughbred farms around Ocala, and it has added warehouses and distribution centers along Interstate 75. Retirees in Sumter and Lake create steady demand for medical practices, home care, home maintenance and auto services. The building trades, restaurants, and companies that serve hotels and rental homes do well across the region.

Central Florida is inland, so storm surge isn't the worry it is on the coasts. Hurricanes still bring wind damage and flooding, though: Hurricane Ian flooded neighborhoods in Orange, Seminole and Osceola counties in 2022. Ask whether the business or its customers were affected.

Tourism keeps demand steadier through the year than in markets that depend on winter residents, with busy stretches around school holidays. Hotels, parks and restaurants compete hard for workers, which pushes up wages for any company that hires hourly staff. New homes have spread fast in Osceola, south Lake and southeast Orange counties and around Ocala, so check whether a company's customers are in growing areas or older ones. Traffic on Interstate 4 limits how much ground a service company can cover in a day.