Scientific Poster Session I - Clinical Pharmacy Forum

Abstract

A multicenter non-profit health system (Ascension) established a centralized pharmacy care management service for its employee health plan with approximately 200,000 covered lives. Ten pharmacists (10 FTEs) and two pharmacy technicians (2 FTEs) provide telephonic medication support for members through medication adherence outreach, medication therapy management (MTM), and chronic medication management (CMM) services.

Proactive outreach targets members with multiple chronic disease states and medications, or a Proportion of Days Covered (PDC) less than 80% however, all plan members are eligible and encouraged to contact the team directly.

Pharmacists and technicians operate in 13 states and are licensed in states they support. The team has access to the local electronic health records as well as population health software. Additionally, the team has access to the local pharmacy dispensing software and case management software.

Justification/Documentation:

3,172 patients received an outreach during the initial pilot July to December 2022. Preliminary total cost of care (TCC) was reduced by 19% for the patients receiving an intervention compared to those not receiving an intervention, producing a preliminary reduction in TCC of $12.7M.

TCC is anticipated to continue to decrease as the team is in place for the full plan year of 2023 and contributing to additional interventions. Additionally, this team focuses on patients with multiple chronic conditions and medications therefore, opportunity to integrate care for further TCC consolidation exists.

Adaptability: This project is applicable to community pharmacies and ambulatory clinics that provide Medication Adherence, MTM, and/or CMM services. Organizations can customize contracts, especially with self-funded employee plans, to provide this type of pharmacy care for members.

Significance: Comprehensive pharmacy services provided demonstrate the value to improved patient outcomes, and also to the reduction in the total cost of care by 10% on average per patient per month.

Presenting Author

Authors