Contextual factors affecting implementation of Medicaid billing for community-based pharmacist services in Virginia: A qualitative study.

Adventures in getting paid

More states address pharmacists’ provider status recognition

Implementation of Statewide Protocols for Community-based Pharmacist Services in Virginia: A Qualitative Study Using the Consolidated Framework for Implementation Research.

Accomplishing provider status: Getting pharmacists paid for their patient care services

Policy topics: Groundwork for patient care, dialogue

The Diabetes Ten City Challenge: interim clinical and humanistic outcomes of a multisite community pharmacy diabetes care program

Capitol Hill Health Fair: Showing Congress what pharmacy has to offer

Evaluation of patient satisfaction and perceptions of a long-acting injectable antipsychotic medication administration service in a community-based pharmacy during the COVID-19 pandemic

Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes

Background: Pharmacists are increasingly fulfilling roles on primary care teams, yet business models for pharmacist services in these settings have not been optimized. This study describes how an ambulatory care pharmacy department implemented various billing methods to generate revenue for pharmacist services. Objectives: (1) Describe pharmacist-delivered billable and non-billable services; and (2) Assess the impact of various billing methods on the return-on-investment (ROI) for billable services. Methods: This study was conducted from September 2016 to August 2017 in Virginia. Pharmacist time spent performing billable encounters using current procedural technology (CPT) codes (e.g., incident-to a physician, annual wellness visits) was calculated. Encounters eligible for the hospital-based facility (G0463) and chronic care management (CCM) codes were considered to be potentially billable services. The ROI was calculated for billable and potentially billable services. Results: A total of 948.3 hours (0.46 full-time equivalents (FTE)), 17% of all clinical services, were billed using CPT codes. This resulted in a total revenue of $173,638.66. Missed revenue from not billing for the G0463 and CCM codes was $68,268.37. The cost of pharmacist services for 0.46 FTE was $78,613.08, resulting in a ROI for billed pharmacist services of 1.2:1. The ROI increased to 1.6:1 when considering potentially billable services. Conclusion: It is feasible to have a positive ROI for billable pharmacist services. To achieve a sustainable business model, there must be a high volume of billable services. G0463 and CCM codes are often underutilized, yet represent significant opportunities in revenue for pharmacist services and should be pursued.

Evaluation of a community-based pharmacy resident-led continuous glucose monitoring program within a family medicine clinic

Recognition of community-based pharmacist practitioners: Essential health care providers

Understanding health care billing basics

As the new communications era aims to provide mobile users with advanced and customised services, it becomes apparent that the requirement for intelligent charging and customised billing of service access emerges bravely. In that scope, the enrichment of mobile services with attributes related to user profiles, context, location, presence and other elements providing customization, affects also the charging process. In particular, the charging and billing for service access have to be more flexible and personalised, so that especial, customised billing for new location-based services and applications is enabled. Hence, charging information related to the user profile and preferences as well as the user location will also have to be encountered at the billing process. This paper presents an integrated architecture, which allows flexible charging and customised billing for the usage of location-based services.

Background: Warfarin has many indications; however, it is the only anticoagulant that is indicated for mechanical mitral value and antiphospholipid syndrome. Management may be conducted by pharmacists in medical clinic settings. Objectives: To evaluate the percentage difference in the international normalized ratio (INR) target range when managed by a community-based pharmacist with a collaborative practice agreement (CPA) versus a physician and to analyze patient satisfaction of an anticoagulation clinic when managed by a community-based pharmacist with a CPA versus a physician. Practice Description: Independent community-based pharmacy. Practice Innovation: Community-based pharmacist managed anticoagulation clinic. Pharmacist provides anticoagulation services under a collaborative practice agreement or conducts INR testing and reporting with physician management of anticoagulation. Methods: Quasi-experiment study design with retrospective and prospective evaluation of warfarin management and patient satisfaction. A retrospective chart review was conducted of patients enrolled in the anticoagulation clinic from January 1st, 2020 to June 30th, 2022. Patients, 18 years or older with an indication for warfarin and attendance of at least 3 anticoagulation appointments were included. The Time in Therapeutic Range (TTR) was determined using the traditional method. TTR differences across the two groups were reported using descriptive, bi-variate, and multivariate statistics. All statistical tests were conducted using SAS 9.0. Patient satisfaction was collected for 6 months using a survey created by the investigators. Survey consisted of 18 questions using a 3-point Likert scale. Survey was assessed using descriptive statistics. Results: Thirty-seven patients met the inclusion criteria, 26 were in the pharmacist management group with 609 appointments, and 11 patients were in the physician management group with 123 appointments. There was no statistical significance for the time in the therapeutic range between the pharmacist-managed group (60.7%) and the physician-managed group (59.4%); p-value of <0.829. Results of the satisfaction survey suggest that patients slightly prefer management by a pharmacist over a physician. Conclusion: Community-based pharmacist warfarin management of time in therapeutic range was equivalent to physician management and with similar patient satisfaction.