Literature DB >> 30611660

A sustainable business model for comprehensive medication management in a patient-centered medical home.

Patricia H Fabel, Tyler Wagner, Bryan Ziegler, Paul A Fleming, Robert E Davis.   

Abstract

OBJECTIVES: To develop a sustainable business model for pharmacist-provided comprehensive medication management services in a patient-centered medical home. Secondarily, to evaluate the impact that the pharmacist had on clinical (glycosylated hemoglobin [A1C], low-density lipoprotein [LDL], and blood pressure) and economic (physician productivity and cost avoidance) outcomes. PRACTICE DESCRIPTION: This pilot project took place at the Palmetto Primary Care Physicians Trident office in North Charleston, South Carolina, from October 2013 to September 2014. At the time, the practice employed 5 physicians and 2 nurse practitioners and served more than 20,000 patients. PRACTICE INNOVATION: The pharmacist targeted patients with diabetes, lipid disorders, hypertension, congestive heart failure, obesity, polypharmacy, and treatment regimen nonadherence for his comprehensive medication management services. The pharmacist was available for immediate consultation or referrals by appointment 5 days per week. Services provided by the pharmacist were billed as medication therapy management or "incident to" physician evaluation and management services codes. EVALUATION: Number of patients seen per day, revenue collected from services rendered by the pharmacist, physician productivity and payment, cost avoidance, and health quality metrics (A1C, LDL, and blood pressure) were measured to determine the financial sustainability and clinical impact of the project. RESULTS AND IMPLICATIONS: The pharmacist was able to see an average of 11 patients per day, which was 72% of his capacity. The practice collected about $7400 per month for services rendered by the pharmacist. The average daily payment for services rendered by the physicians in the practice increased by 20.6%. More than 70% of uncontrolled patients had an improvement in clinical outcomes, such as A1C, LDL, and blood pressure.
CONCLUSION: This project demonstrates the sustainable business model for embedding a pharmacist into a patient-centered medical home. Published by Elsevier Inc.

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Year:  2019        PMID: 30611660     DOI: 10.1016/j.japh.2018.11.001

Source DB:  PubMed          Journal:  J Am Pharm Assoc (2003)        ISSN: 1086-5802


  4 in total

1.  Capsule Commentary on Zullig et al., Primary Care Providers' Acceptance of Pharmacists' Recommendations to Support Optimal Medication Management for Patients with Diabetic Kidney Disease.

Authors:  Tony Kuo
Journal:  J Gen Intern Med       Date:  2020-01       Impact factor: 5.128

Review 2.  Pharmacist Interventions for Medication Adherence: Community Guide Economic Reviews for Cardiovascular Disease.

Authors:  Verughese Jacob; Jeffrey A Reynolds; Sajal K Chattopadhyay; David P Hopkins; Nicole L Therrien; Christopher D Jones; Jeffrey M Durthaler; Kimberly J Rask; Alison E Cuellar; John M Clymer; Thomas E Kottke
Journal:  Am J Prev Med       Date:  2021-12-04       Impact factor: 5.043

3.  Alternative payment approaches for advancing comprehensive medication management in primary care.

Authors:  Katherine Pham
Journal:  Pharm Pract (Granada)       Date:  2020-12-08

4.  The evaluation of comprehensive medication management for chronic diseases in primary care clinics, a Texas delivery system reform incentive payment program.

Authors:  Tong Han Chung; Ricardo J Hernandez; Anaelle Libaud-Moal; Linh K Nguyen; Lincy S Lal; J Michael Swint; Pio Juan Lansangan; Yen-Chi L Le
Journal:  BMC Health Serv Res       Date:  2020-07-20       Impact factor: 2.655

  4 in total

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