Learning Session 1

Working with Pharmacists to Increase Medication Therapy Management

Speaker: Brian J. Isetts, RPh, PhD, BCPS, FAPhA, Department of Pharmaceutical Care & Health Systems at the University of Minnesota College of Pharmacy

Date: June 20, 2014, 9am ET, 8am CT

Dr. Brian Isetts Biography

Presentation Slides

Presentation Transcript

Objectives of the presentation:

  • Describe the current use of pharmacists as physician extenders for MTM.
  • How can physician extender codes be used for pharmacists to conduct MTM?
  • How can the state health department and clinicians work with health plans to establish a consistent reimbursement schedule within health plans for MTM by pharmacists?

Main points to be covered:

  • Building systems of care to support safe and effective use of medication
  • How are pharmacists being equipped to work in team-based care models?
  • How can pharmacists be supported through reimbursement systems and what action steps we can take to engage pharmacists in team-based care?

Main points presented:

  • The need for medication management – Currently, systems work on fee for service with little regard for quality improvement, therefore medications are dispensed freely and without good understanding by patients of their use and intended results. Billions of dollars are spent on medications as well as the poor outcomes of the ineffective and unfortunate consequences of medication use.
  • The solution that has emerged – Systems should move to a value-based, outcomes-based, global population-based reimbursement system which rewards team based management of medication usage, including pharmacists on the team, to achieve a patient’s compliance in their drug therapy treatment goals with zero tolerance for preventable medication harms. This can also result in cost savings to the medical clinic and patient when therapies reach intended goals.
  • The future and what you can do to tap into this exciting development – Understanding, promotion and use of value-based, population-based payments.  Using the framework of CMS colleagues, Doctors Rajkumar, Connelly, and Administrator Marilyn Tavaner published in JAMA Online April 21st presenting the four categories of payments going from fee-for-service, no ties to quality; fee-for-service, ties to quality; and all the way to global population-based payments.  Collaboration between physicians and pharmacists through the use of interconnected EHRs.

Main take-away points:

  • To the Patient – You should not choose to take a medication if you don’t know its intended medical use, how it’s going to be effective, your goals of therapy for you, and what your unique safety concerns are because comprehensive medication management should indeed be a public health right for all Americans.
  • To Public Health Practitioners – Seek out ways to bring physicians, pharmacists, social workers, and public health together to inform, discuss and encourage use of pharmacists in the team-based medication management therapy model and work to identify innovative reimbursement methods.