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J Am Pharm Assoc (2003). 2019 Jun 12. pii: S1544-3191(19)30137-2. doi: 10.1016/j.japh.2019.03.013. [Epub ahead of print]

Impact of a pharmacist in improving quality measures that affect payments to physicians.

Abstract

OBJECTIVES:

The objective was to assess the impact of a pharmacist embedded within a primary care practice on quality measures of the Merit-Based Incentive Payment System (MIPS) and patient-centered medical home (PCMH) by characterizing (1) measure achievement after pharmacist involvement in care and (2) measure achievement separately for patients seen by the pharmacist and patients not seen by the pharmacist.

SETTING:

Multidisciplinary primary care practice in Charlotte, North Carolina.

PRACTICE DESCRIPTION:

Pharmacists from an independent community pharmacy are highly integrated into the clinic. Pharmacists work alongside providers to furnish comprehensive care with a team-based approach. The initial focus for the pharmacist was on the Medicare annual wellness visits (AWV) and chronic care management (CCM).

PRACTICE INNOVATION:

Quality measure achievement during face-to-face AWV, telephone-call CCM, or both.

EVALUATION:

From January 1, 2017, to February 2, 2018, 193 patients had an AWV, CCM, or both from the pharmacist. Measure achievement was characterized with the use of descriptive statistics.

RESULTS:

When characterizing quality measures before, during, and after pharmacist intervention for the clinic population, achievement of some measures improved and others worsened. However, for every measure evaluated, the cohort of patients seen by the pharmacist had a greater proportion of patients achieving the quality measure than the cohort of patients not seen by the pharmacist. The greatest differences were observed for influenza vaccination (41% of pharmacist cohort vs. 10% of nonpharmacist cohort), hemoglobin A1C control less than 9% (94% of pharmacist cohort vs. 67% of nonpharmacist cohort), and colorectal cancer screening (55% of pharmacist cohort vs. 28% of nonpharmacist cohort).

CONCLUSION:

Pharmacist provision of clinical services may increase the likelihood of quality measure achievement. The pharmacist integration model addressed gaps in care that appeared to positively affect MIPS and PCMH quality measures. This has the potential to increase reimbursement through value-based payment models.

PMID:
31203017
DOI:
10.1016/j.japh.2019.03.013

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