Medicare payment reform offers added incentives for making pharmacists part of a patient’s care delivery team.
For North Carolina-based pharmacist Amina Abubakar, PharmD, phone conversations with physicians were often seen by the doctors as intrusions, and produced defensive attitudes over prescription selections.
Then something changed: Physicians and their staff got to meet her face-to-face.
Abubakar, owner of Rx Clinic Pharmacy in Charlotte, used her pharmacy management system to find the physicians for whom she was filling the most prescriptions. Then she set up in-person visits to get to know one another.
“We spoke as people and not as physician and pharmacist,” she says. “And then, there was a friendship. I wanted a smoother interaction for physicians I was working with each day.”
Abubakar got to explain that when she calls to check on a prescription request, it isn’t to second-guess the physician’s guidance, but to be sure she has all the necessary information. Pharmacists try to put together a puzzle, she says, to be sure the patient has the best treatment tools and so they can receive the right guidance.
“There are prescriptions that come in incomplete. And calls to the physicians have resulted in change,” she says. “Pharmacists are very safe people. They would rather make that one phone call and make sure this is what [the physician] meant versus assuming what is meant.”
Pharmacists have long been receiving star ratings tied to Medicare Advantage plans and payer-based programs. However, Medicare payment reform offers added incentives for making pharmacists part of a patient’s care delivery team.
Abubakar’s clinical pharmacists are working to help physicians, especially with diabetes education. In addition to medication synchronization -providing refills at the same time each month-the pharmacy contacts patients to discuss diet and other behaviors busy physicians can’t always address.
There’s an additional benefit of having pharmacists come to the practice to conduct diabetes education and coaching, increasing the chances of boosting revenue by billing chronic care management codes.
“It’s about total care now-doing everything in our power to get the patients well,” Abubakar says.
Lisa Umfleet, RPh, owner of Parkland Health Mart in Desloge, Missouri, is also working to ensure both her pharmacy and local physicians do their best under Medicare’s new payment program. She has created slides and handouts for those quality metrics where both doctors and pharmacists can collaborate.
“[Medicare payment reform] is a disrupter in healthcare, meaning we all have to rethink how we practice and communicate and be collaborative using all available channels,” she says. “I’ve heard it called ‘no outcomes, no income,’ so we all have to be patient-centered and part of the same healthcare team.”