Abstract
(1) Background: As the U.S. healthcare system evolves from fee-for-service financing to global population-based payments designed to be accountable for both quality and total cost of care, the effective and safe use of medications is gaining increased importance. The purpose of this project was to determine the feasibility of integrating medication therapy management (MTM) services provided by community pharmacists into the clinical care teams and the health information technology (HIT) infrastructure for Minnesota Medicaid recipients of a 12-county community-based accountable care organization (ACO). (2) Methods: The continuous quality improvement evaluation methodology employed in this project was the context + mechanism = outcome (CMO) model to account for the fact that programs only work insofar as they introduce promising ideas, solutions and opportunities in the appropriate social and cultural contexts. Collaborations between a 12-county ACO and 15 community pharmacies in Southwest Minnesota served as the social context for this feasibility study of MTM referrals to community pharmacists. (3) Results: All 15 community pharmacy sites were integrated into the HIT infrastructure through Direct Secure Messaging, and there were 32 recipients who received MTM services subsequent to referrals from the ACO at 5 of the 15 community pharmacies over a 1-year implementation phase. (4) Conclusion: At the conclusion of this project, an effective electronic communication and MTM referral system was activated, and consideration was given to community pharmacists providing MTM in future ACO shared savings agreements.
Highlights
The aim of this project was to integrate medication therapy management (MTM) services provided by community pharmacists into the clinical care teams and the health information technology (HIT)infrastructure for Medicaid recipients of a 12-county community-based accountable care organization (ACO)
These challenges were related to the Southern Prairie Community Care (SPCC) HIT master integration plan and recurring key personnel transitions
The original plan called for HIT integration of physician practices and clinics, followed by SPCC MTM pharmacists and pharmacies
Summary
The aim of this project was to integrate medication therapy management (MTM) services provided by community pharmacists into the clinical care teams and the health information technology (HIT)infrastructure for Medicaid recipients of a 12-county community-based accountable care organization (ACO). This was a novel opportunity to engage community pharmacists in a feasibility test of change related to value-based care model integration and financing. Funding for this feasibility study was obtained from the Community Pharmacy Foundation. In this feasibility study, there was an existing reimbursement system in place for the provision of MTM services by pharmacists through the Minnesota Medicaid Program. This existing reimbursement mechanism helped to address a common challenge of providing MTM services. Other common challenges to the provision of MTM services include collaborative relationships with prescribers, billing difficulties, inadequate management support for MTM, and technology barriers such as access to patients’ medical records and bi-directional exchange of health information [2]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
