Pay-for-performance model of medication therapy management in pharmacy practice

2011 ◽  
Vol 51 (3) ◽  
pp. 425-431 ◽  
Author(s):  
Thomas L. Lenz ◽  
Michael S. Monaghan
Keyword(s):  
Pay For Performance ◽  
Pharmacy Practice ◽  
Medication Therapy Management ◽  
Performance Model ◽  
Therapy Management ◽  
Medication Therapy

Medication Therapy Management in the Primary Care Setting

2011 ◽  
Vol 25 (1) ◽  
pp. 89-95 ◽  
Author(s):  
Carrie Foust Koenigsfeld ◽  
Kristin K. Horning ◽  
Craig D. Logemann ◽  
Ginelle A. Schmidt
Keyword(s):  
Pay For Performance ◽  
Density Lipoprotein ◽  
Cost Savings ◽  
Medication Therapy Management ◽  
Medication Cost ◽  
Therapy Management ◽  
Medication Therapy ◽  
State Management ◽  
Controller Medication ◽  
Generic Prescribing

Objectives: To evaluate the effect of medication therapy management on chronic disease management and generic drug prescribing in the clinic setting. Methods: Private insurer initiates Pay-for-Performance (PFP) project for clinic-based pharmacists in Iowa and South Dakota (n = 9 clinics) in 2009. Each pharmacist was assigned ∽300 patients with at least 1 of 4 disease states (diabetes mellitus, hyperlipidemia, hypertension, and asthma). Pharmacists were expected to complete 2 medication reviews for each patient. The primary outcome was frequency of patients achieving goal levels: diabetes: hemoglobin A1c (A1c) <8%, low-density lipoprotein (LDL) <130 mg/dL, and blood pressure (BP) <140/80 mm Hg; hypertension: BP <140/90 mm Hg; hyperlipidemia: LDL <130 mg/dL; and asthma: percentage of persistent asthmatics on controller medication. Generic prescribing rates were evaluated for antihypertensives, cholesterol-lowering agents, proton pump inhibitors, and antidepressants. Results: A total of 827 patients at 3 clinics were included in the analysis. For diabetes, 77.1% had A1c <8%, 83.2% had LDL <130 mg/dL, and 76.3% had BP <140/80 mm Hg. For hypertension, 86.2% had BP <140/90 mm Hg. For hyperlipidemia, 80.6% had LDL <130 mg/dL. For asthma, 100% were on controller medication. One medication review was completed on 88.8% of patients. Generic prescribing rates ranged from 65.8% to 79.4%. Implications/Adaptability: A high percentage of patients achieved goal levels at clinics with clinical pharmacist services. A multidisciplinary approach to patient care may improve disease state management and medication cost savings.

Retrospective Analysis of Estimated Cost Avoidance Following Pharmacist-Provided Medication Therapy Management Services

2012 ◽  
Vol 26 (4) ◽  
pp. 420-427 ◽  
Author(s):  
Ashley R. Branham ◽  
Aaron J. Katz ◽  
Joseph S. Moose ◽  
Stefanie P. Ferreri ◽  
Joel F. Farley ◽  
...  
Keyword(s):  
North Carolina ◽  
Retrospective Analysis ◽  
Pharmacy Practice ◽  
Medication Therapy Management ◽  
Common Disease ◽  
Therapy Management ◽  
Cost Avoidance ◽  
Medication Therapy ◽  
Medication Reviews ◽  
Reduced Costs

Objective: To compare the estimated cost avoidance (ECA) of pharmacist-provided medication therapy management (MTM) services among common disease states encountered in community pharmacy practice. Design: Retrospective analysis. Setting: Nine community pharmacies in North Carolina. Patients: Three hundred and sixty-four patients who are 65 years of age or older, a Medicare Part D beneficiary and a North Carolina resident. Interventions: An MTM pharmacist-provider conducted medication reviews to eligible patients between July 2009 and October 2009. For each encounter, patient interventions, pharmacist recommendations, and ECA were recorded. Main outcome measure: ECA. Results: In 9 pharmacy locations, 634 MTM interventions were documented during the study period. The ECA in a 4-month period yielded approximately $494 000. Comprehensive medication reviews, new prescription counseling and appropriate medication administration, and technique counseling made up nearly two-thirds of interventions. Overall, the probability that an MTM intervention would result in an ECA greater than $0 was .35. Conclusions: Pharmacist-provided MTM effectively reduced costs associated with patient medication use. Such interventions reduced costs in overall health care specifically in the areas of cardiovascular, gastroesophageal reflux disease, pulmonary, and diabetes groups.

Expanding the role of pharmacy technicians to facilitate a proactive pharmacist practice

2019 ◽  
Vol 76 (6) ◽  
pp. 398-402 ◽  
Author(s):  
Brandi Newby
Keyword(s):  
Patient Care ◽  
Pharmacy Practice ◽  
Medication Therapy Management ◽  
Direct Patient Care ◽  
Order Entry ◽  
Practice Model ◽  
Therapy Management ◽  
Pharmacy Technician ◽  
Medication Therapy ◽  
Pharmacist Role

Abstract Purpose This study describes a change in pharmacy practice to expand pharmacy technician roles to allow dispensing without a pharmacist check, thereby enhancing the pharmacist role in direct patient care. Summary In an effort to optimize patient care with limited resources, we set out to change our pharmacy practice model. We transferred duties that did not require clinical judgment in the dispensary from the pharmacist to the regulated technician. The transferred roles included order entry, order entry verification, and final check of medications and preparations. The changes in roles were well received by the pharmacy staff. The pharmacist practice changed from a reactive process, where the pharmacist waited for orders to be sent to the pharmacy, to a proactive process where the pharmacist collaborated directly with patients and the health care team. The pharmacists were able to provide daily medication therapy management for every inpatient in the new practice model compared with only reactive targeted care in the former practice model. Implementation of the new practice model at our site led to a reduction in time for medications to be delivered to the patient and reduced pharmacy-related medication errors. Conclusion A new pharmacy practice model was successfully implemented whereby the pharmacy technician roles were expanded to the point where they perform all the distribution roles in the dispensary. This, in turn, allowed a change in the pharmacist role, which was focused on daily proactive direct patient care and medication therapy management.

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