Four ways clinical pharmacists can improve managed care

July 27, 2015
Marc O'Connor
Marc O'Connor

Here are four reasons a clinical pharmacist should be part of care teams for chronically-ill, elderly, and at-risk patient populations.

O'ConnorPharmacists are at last becoming recognized as frontline healthcare defenders for the chronically-ill, elderly, and high-risk patient populations. Clinical pharmacists provide critical health information and wellness practices needed to move both sides of the healthcare value equation in the right direction: improving outcomes and reducing costs. With 75% of healthcare spending in the United States dedicated to the treatment of chronic diseases, the economic implications of noncompliance among patients cause a severe strain to healthcare systems and payers. An IMS Health study indicated that $105 billion of $213 billion in avoidable U.S. medical expenses annually is attributed to medication nonadherence.

Related: The new patient-centered pharmacy

The expanding role of the pharmacist has a major impact on increasing patient adherence, maximizing the value of high-cost medication therapies, reducing readmissions and more. Here are four reasons a clinical pharmacist should be part of care teams for chronically-ill, elderly, and at-risk patient populations:

They increase time per patient interaction

According to a study published in The Journal of General Internal Medicine, physician interaction with a patient lasts only eight minutes. The physician time crunch will get worse, as the Affordable Care Act is increasing coverage access to millions of Americans.

Clinical pharmacists’ expertise and accessibility can make a huge difference in patient outcomes. While conducting medication therapy management, clinical pharmacists can spend time discussing medication issues and protocols with patients. As physicians are forced to squeeze more patient visits into the day, clinical pharmacists can step in and serve as additional educators and counselors for patients. This allows for additional quality interactions, including discovery and patient education that contribute to improvements in medication adherence and improved outcomes.

 

NEXT: They improve patient education

 

They improve patient education

Pharmacists are trained to educate patients and have pharmacological expertise that most prescribers do not. Clinical pharmacists trained as experts in medication therapy management devote patient-focused time to address medication-related issues and optimize medication therapy. Pharmacists can play an influential role in ensuring patient access to quality healthcare by increasing patient knowledge of their disease states and medication therapies.

They expand the care team reach

Screening tests, wellness programs, vaccinations and educational events are not only a convenience to patients, but also expand clinical reach beyond the traditional definition of “provider resources.” More and more pharmacists are trained to take on specialized roles, as seen by the number trained to deliver vaccinations, up from 40,000 to 150,000 between 2007 and 2011. These services allow more people to access healthcare professionals, including pharmacists, to ask questions not only about their prescriptions, but also about prior authorization, co-pay assistance critical to mediation therapy access and other health-related issues.

Related: The benefit of integrating pharmacists into patient care teams

National pharmacy organizations are campaigning to ensure pharmacists achieve provider status, cementing pharmacists as an additional healthcare partner for the entire patient care team.

California is currently leading the way by passing legislation recognizing pharmacists as providers in 2013. Pharmacists extend healthcare services and give patients increased access to care. Provider status enables pharmacist-provided services to be covered under Medicare Part B, which would make medically underserved patients or patients in areas with a shortage of healthcare professionals healthier and less costly to treat.

 

NEXT: They reduce readmissions penalties

 

They reduce readmissions penalties

Pharmacists can help improve hospitals’ overall performance and reduce Medicare readmissions penalties. A study conducted by Curant Health and Purdue University and homecare provider Amedisys demonstrated an 86% reduction in readmissions in one quartile of a Medicare population of home care patients. As the U.S. Department of Health and Human Services and other entities in Washington continue to advance the move from fee-for-service to value-based care, decision makers would be wise to expand care team accountability and value by tapping the accessibility and knowledge of clinical pharmacists. Ensuring a smooth transition from the hospital to home for a patient offers an excellent opportunity for pharmacists to work collaboratively with other clinicians improving outcomes and reducing costs by reducing readmission rates.

As the shift from fee-for-service to value-based care continues to accelerate, adding clinical pharmacists capable of reducing overall costs and improving outcomes for chronically ill, high-risk and elderly patients should be high on the list of priorities for managed healthcare executives.

Marc O’Connor is chief operating officer for Curant Health.