In April, the Alliance for Addiction Payment Reform (the Alliance) released an issue brief, written by ACCP members, on coordinated and comprehensive medication management (CMM) for substance use disorder. The purpose of the brief is to advance the adoption and implementation of CMM in the Addiction Recovery Medical Home, an alternative payment model for the treatment of addiction and substance use disorder. The Alliance has previously highlighted clinical pharmacists as members of the care team in this coordinated model as described in its white paper.
The issue brief discusses addiction treatment and recovery as a chronic condition that can benefit from CMM provided by clinical pharmacists on integrated care teams. The brief features innovative and emerging team-based practice models across the continuum of care and in diverse settings, including acute care, primary care, and coordinated health systems. The brief focuses on the integration of clinical pharmacists into the value-based alternative payment model of the Addiction Recovery Medical Home and the alignment of CMM with the holistic patient-centered approach of this coordinated care model.
Key highlights from the issue brief are as follows:
- “Clinical pharmacists are responsible for CMM in team-based patient care environments.
- Individuals with complex chronic conditions benefit most from CMM and individuals with substance use disorder (SUD) have a high incidence of complex comorbidities.
- CMM services for SUD have demonstrated a positive impact on access to care, quality of care, patient engagement, patient satisfaction, and treatment retention.
- Medication plans for CMM that are led by a clinical pharmacist, as part of an interdisciplinary team, include clear and measurable goals of therapy with specific follow-up timeframes to ensure optimal medication use and outcomes.
- Delegated authority through collaborative practice agreements or collaborative drug therapy management, together with the applicable state pharmacy practice act, confer specific privileges, responsibilities, and accountabilities to the clinical pharmacist that propel efficient team-based care.”
The College would like to acknowledge the following ACCP members for contributing their time, effort, and expertise to this publication.
Veldana Alliu, Pharm.D., BCPS
Dr. Veldana Alliu is a national pharmacy program manager for clinical practice integration and model advancement with the Veterans Affairs (VA) Pharmacy Benefits Management Clinical Pharmacy Practice Office. She earned her Pharm.D. degree from the University of Florida College of Pharmacy and completed a PGY1 pharmacy practice residency and PGY2 health-system pharmacy administration residency at VA Medical Centers. Alliu’s role includes standardizing, integrating, and optimizing the expertise of clinical pharmacist practitioners (CPPs) to improve direct patient care access and quality of care for veterans. She serves as a national clinical pharmacy subject matter expert supporting substance use disorder (SUD) practice expansion in all clinical pharmacy areas through provision of the enterprise-wide Office of Rural Health–funded CPP Rural Veterans Access initiative in SUD.
Lucas G. Hill, Pharm.D., BCACP
Dr. Lucas G. Hill graduated from the University of Missouri-Kansas City School of Pharmacy and completed a combined family medicine residency and faculty development fellowship at the University of Pittsburgh Medical Center. He is now a clinical associate professor at The University of Texas at Austin College of Pharmacy, where he serves as director of the Pharmacy Addictions Research & Medicine (PhARM) Program. Hill is the principal investigator for a 5-year, $25 million Texas Targeted Opioid Response grant, which seeks to address the opioid crisis in Texas by educating health professionals and the public while conducting pragmatic research. He is an editorial board member for the Journal of the American College of Clinical Pharmacy and past chair of the American Association of Colleges of Pharmacy Substance Use Disorder Special Interest Group. Hill has been recognized with several prestigious national awards, including the American College of Clinical Pharmacy New Educator Award and the American Pharmacists Association Generation Rx Award of Excellence.
Tran H. Tran, Pharm.D., BCPS
Dr. Tran H. Tran earned her Pharm.D. degree from the University of North Carolina at Chapel Hill and completed a pharmacy practice residency at the University of Illinois Chicago. She is an associate professor in pharmacy practice at Midwestern University Chicago College of Pharmacy and serves as the Substance Use Intervention Team (SUIT) clinical pharmacist in the Department of Psychiatry & Behavioral Sciences at Rush University Medical Center. Tran previously chaired the American College of Clinical Pharmacy Pain and Palliative Care Practice and Research Network and the American Association of Colleges of Pharmacy Substance Use Disorder Special Interest Group. She is a contributing author for Pharmacotherapy Casebook: A Patient-Focused Approach, has given lectures regionally and nationally, and has written various book chapters and peer-reviewed manuscripts. Tran has received state and national recognition for her clinical practice, professional service, and research from organizations such as the Illinois Council of Health-System Pharmacists, the New York State Council of Health-System Pharmacists, and the New York City Society of Health-System Pharmacists. She currently serves as the health director for the Midwestern University Drug Overdose Prevention Program and oversees the SUIT Drug Overdose Prevention Program, which has collectively trained over 2000 opioid overdose responders in Illinois. She is the principal investigator for the Illinois Strategic Prevention Framework for Prescription Drugs (SPF-Rx) grant funded by SAMHSA.
About the Alliance for Addiction Payment Reform
The Alliance for Addiction Payment Reform (the Alliance) is a national multisector alliance of health care industry leaders – including payers, health systems, and subject matter experts – dedicated to aligning incentives and establishing a structure that promotes the type of integration and patient care needed to improve outcomes for patients, payers, and health systems.
Since 2017, the Alliance has convened clinical, addiction, information technology, primary care, social, regulatory, and policy experts to develop and implement the Addiction Recovery Medical Home Alternative Payment Model (ARMH-APM) – a multifaceted payment model that structures financial resources for addiction treatment and recovery services into value-based and outcomes-driven mechanisms. The Alliance is managed by Third Horizon Strategies, a boutique advisory firm focused on shaping a future system that actualizes a sustainable culture of health nationwide.