Specialty pharmacy coaching model tied to lower costs, improved diabetes outcomes in value-based care programs | Asembia AXS26 Summit

A pharmacist-led coaching model that focuses on frequent patient touchpoints and social support is showing measurable gains in both outcomes and costs for high-risk populations, according to data presented today at the Asembia Specialty Pharmacy Summit in Las Vegas.

During a session on value-based care, leaders from UMass Memorial Health and Shields Health Solutions shared how a high-touch care model helped patients with complex conditions such as diabetes.

This program pairs patients with pharmacist coaches who go beyond traditional roles of solely medication support and help address social needs, lifestyle changes and mental health concerns.

Results from the program showed clinical and financial improvements, including those who entered the program revealed an average A1C above 10% and saw reductions of about 1.7% to 1.8%. They also had less emergency room visits, fewer hospitalizations and shorter hospital stays, according to session presenter Samir Malkani, M.D., who is clinical chief of the division of diabetes, endocrinology and metabolism at UMass Memorial Health.

Malkani added that the total medical costs dropped by about $2,600 per patient each year.

“We (researchers) think it's a combination of factors, including better adherence to medication, understanding the disease better and the coaches helping them with these unfavorable social determinants of health, which is the hardest part to quantify,” said Malkani.

Many of the biggest gains came from building stronger relationships with patients rather than short office visits, he added. The regular check-ins with coaches of this program create a space for patients to share challenges such as food insecurity or financial stress, which often affect diabetes outcomes.

From a population health view, the model also allows for more personalized care, Malkani said.

“Every patient is unique, and what’s great about the program is that we give coaches the bandwidth to really tailor care and listen to the patient story,” Bill McElnea, vice president of population health at Shields Health Solutions and co-presenter of the session, said. “At the first step it’s always understanding the provider’s care plan and then adding support with a pharmacist skill set. Nutrition, lifestyle and motivation all play a big role in helping patients stay on track."

Both presenters said the program supports value-based care by combining pharmacy revenue with shared savings, helping make the model more sustainable while improving patient outcomes.