Reimbursement model for pharmacist-directed medication therapy management

Abstract

To describe the development of a practice model with sustainable reimbursement for medication therapy management (MTM) services provided by pharmacists for beneficiaries of self-insured health care plans. The Auburn University Pharmaceutical Care Center (AUPCC) is a free-standing clinic located within the school of pharmacy that provides preventive care and MTM services for a population of 11,600 employees and dependents that subscribe to the university's self-insured health plan. The goal of patient care is to increase use of cost-effective pharmacotherapy and improve the outcomes of medication use among the population. Development and implementation of a practice model and reimbursement method that can be implemented in the employer setting for large self-insured employers and the community pharmacy practice setting. Since opening, AUPCC has developed into a model pharmaceutical care service that can be implemented in the workplace for other self-insured employers. AUPCC is also a model that can easily translate to the community pharmacy setting. In 2010, the model was adapted by Alabama for state employees. Pharmacists can negotiate directly with decision makers within large companies that are self-insured to provide MTM services for the employee population. This is an area of sustainable growth within our profession.