AccessHealth said Thursday that the program features a comprehensive series of tools, resources and webinars designed to help community pharmacies understand all aspects of the 2016 Medicare Part D plans so they can improve patient health outcomes and optimize reimbursement.
In its suite of managed care services, AccessHealth has developed an extensive guide to assist pharmacies in navigating the upcoming Medicare Part D changes for the 2016 plan year. The AccessHealth 2016 Medicare Part D Reimbursement and Performance Guide outlines the 2016 reimbursement, direct and indirect remuneration (DIR) details, and plan-specific clinical and operational criteria being measured for pharmacies to potentially receive additional pay-for-performance dollars. If a plan has a generic dispense rate (GDR) component, it is also listed, the company said.
According to AccessHealth, pharmacies can use the guide to help identify the Medicare plans in their area and familiarize themselves with the performance criteria for each plan; highlight the plans in which they have a large number of patients and prioritize based on their patient mix; determine specific clinical and operational criteria for the plans most significant to their business; and leverage tools and solutions to become a top-performing pharmacy.
The company noted that pharmacy reimbursement models continue to evolve with greater focus for pharmacies on clinical performance and patient outcomes.
“Community pharmacy’s ability to provide solutions that help improve patients’ health and improve their scores across an increasing number of quality measures is key to their survival. AccessHealth is committed to helping independent pharmacies understand the 2016 reimbursement landscape, gain entry to more narrowly focused preferred pharmacy networks, and take advantage of emerging performance-based incentives,” Kevin Connor, vice president and general manager of AccessHealth, said in a statement. “We saw this shift to preferred networks early on and have been working very hard to give independent pharmacies the tools and resources they need to be ready and set them up for success.”
Throughout the year, AccessHealth is hosting a series of webinars designed to help independent pharmacies ready for the new reimbursement rates plus identify opportunities to leverage the movement toward pay-for-performance incentives. The next installment in the AccessHealth Webinar Series, titled “Optimizing Pharmacy Performance,” is scheduled for Dec. 10 and will feature an in-depth overview of the 2016 operational and clinical performance requirements of preferred networks. Building on the review of the guide, the session will focus on specific strategies required for successfully maneuvering preferred networks, AccessHealth said.
“While the shift to preferred networks and new reimbursement models is unsettling for many independents, there are also opportunities for incentives that we are preparing our members to take advantage of,” stated Eyad Farah, vice president of business development and strategy for AccessHealth. “For example, more Medicare Part D plans are offering pharmacies incentives to interact with their patients and provide care in ways that improve their STAR ratings. It is now more important than ever to take advantage of the performance opportunities available to them to become top clinical performers by making investments in tools and services to increase customer and patient engagement like EQuIPP access, medication synchronization solutions, and utilizing a team of AccessHealth advisors who provide recurring guidance around performance scores.”