Scientific Poster Session IV - Original Research

Original Research
  Tuesday, November 14, 2023
  08:30 AM–10:00 AM

Abstract

Introduction: The Pharmacy Population Health Center (PPHC) was developed to improve overall health and increase reimbursement for patients with value-based care (VBC) plans. Their ability to increase Medicaid gap closure using the Pharmacy Risk Score (PRS) is unknown.

Research Question or Hypothesis: Does pharmacy involvement increase Medicaid care gap closure?

Study Design: A single-center, retrospective, cohort study of Managed Medicaid-insured patients seen at outpatient facilities within a large academic medical center.

Methods: Adult patients with a PRS of six or greater and were failing both hemoglobin A1c (HbA1c) and blood pressure (BP) care gaps. The intervention included patients who were reviewed by pharmacy, compared to the control of patients who were not. The primary outcome was closure of at least one care gap by the end of 2022. Secondary outcomes included number of each gap closed, frequency of pharmacist recommendations, and frequency of recommendations implemented by providers.

Results: Data was collected for 80 patients from January 2022 – October 2022. The primary outcome occurred in 37 (74%) patients in the intervention and 15 (50%) patients in the control (OR 2.85, p-value 0.032). HbA1c gap was closed in 30 (60%) patients in the intervention and 8 (27%) patients in the control. BP gap was closed in 24 (48%) patients in the intervention and 11 (37%) patients in the control. The number of recommendations made was associated with gap closure (p-value 0.012) while the number of recommendations implemented by providers was not (p-value 0.4).

Conclusion: Pharmacy intervention was associated with a nearly three-times increase in closure of at least one care gap in Medicaid patients, with HbA1c gap closure achieved more frequently than BP gap closure. The number of recommendations made by pharmacy was associated with increased gap closure regardless of the number implemented by providers. The PRS accurately identified patients who would benefit from pharmacy involvement.

Presenting Author

Ellen Montgomery PharmD
Atrium Health Wake Forest Baptist

Authors

Marina Adkins PharmD
Atrium Health Wake Forest Baptist

Molly Hinely PharmD, BCPS
Atrium Health Wake Forest Baptist

Tiffany Sherod-Harris PharmD, CPP
Atrium Health Wake Forest Baptist