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Optimizing use of medications vital for ACOs

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WASHINGTON — Pharmacists can perform a pivotal role in ensuring the optimal use of pharmaceuticals and improving patient outcomes in accountable care organizations (ACOs), concludes a case study published in the December issue of the Journal of Managed Care & Specialty Pharmacy.

The report, “Best Practices: Improving Patient Outcomes and Costs in an ACO Through Comprehensive Medication Therapy Management,” describes Fairview Pharmacy Services’ success in utilizing pharmacists’ skills and leveraging their full clinical expertise in comprehensive patient care.

“The lessons learned through our medication therapy management program can assist other organizations in improving patient outcomes while reducing costs,” said Amanda Brummel, director of clinical ambulatory pharmacy services at Fairview and a study author. “Every ACO is unique, but this case study suggests key components that can be modified and adapted for MTM programs, depending on the needs of an ACO.”

Written in partnership with the National Pharmaceutical Council (NPC), the study identified several factors for consideration in the development of an MTM program within an ACO, including start-up costs and ongoing financial considerations, which the report characterizes as critical issues that will likely depend on the characteristics of each organization.

According to the study, an ACO may want to target high-risk patients, such as those who are not meeting health goals, those missing key drug therapies, or those who are utilizing the emergency services or inpatient setting frequently. The Fairview MTM program uses both physician referrals and data analysis to identify patients who might benefit from MTM services.

“There are various delivery methods to provide direct patient care. Although Fairview MTM pharmacists are embedded in primary care sites, they also utilize telephone appointments or Internet-based options to interact with patients,” says the study.

“The approach to collaborative practice may vary and some are dependent on whether a state has legislation that allows this practice. Fairview MTM pharmacists can initiate, modify and discontinue prescriptions based upon approved protocols, and the referring physician is subsequently informed of the changes in therapy.”

The study also explores the issue of communication from pharmacist to physician. For example, once changes are made to a prescription, “it is critical that those changes be communicated quickly and efficiently to providers involved in that patient’s care.”

At Fairview, the company uses electronic medical records to communicate with physicians when medication regimens have changed and to discuss the patient’s care plan.

Also of importance is what the study describes as a visionary leader: Organizations need to identify individuals who can carry out the vision and promise of an MTM program.

“This study reinforces previous findings that optimizing the use of pharmaceuticals in an ACO is critical to its effectiveness in reducing costs and improving the patient’s experience,” said NPC executive vice president and chief science officer Robert Dubois, who is a study coauthor.


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