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Special Feature
Reimbursement model for pharmacist-directed medication therapy management
Kimberly Braxton Lloyd, PharmD; R. Lee Evans, PharmD, BCPP, FCCP, FASHP
J Am Pharm Assoc (2003) 2012;52:161-169. doi:10.1331/JAPhA.2012.11228

Abstract

Objectives  To describe the development of a practice model with sustainable reimbursement for medication therapy management (MTM) services provided by pharmacists for beneficiaries of self-insured health care plans.

Practice description  The Auburn University Pharmaceutical Care Center (AUPCC) is a free-standing clinic located within the school of pharmacy that provides preventive care and MTM services for a population of 11,600 employees and dependents that subscribe to the university's self-insured health plan. The goal of patient care is to increase use of cost-effective pharmacotherapy and improve the outcomes of medication use among the population.

Main outcome measures  Development and implementation of a practice model and reimbursement method that can be implemented in the employer setting for large self-insured employers and the community pharmacy practice setting.

Results  Since opening, AUPCC has developed into a model pharmaceutical care service that can be implemented in the workplace for other self-insured employers. AUPCC is also a model that can easily translate to the community pharmacy setting. In 2010, the model was adapted by Alabama for state employees.

Conclusion  Pharmacists can negotiate directly with decision makers within large companies that are self-insured to provide MTM services for the employee population. This is an area of sustainable growth within our profession.

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References

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DaVanzo J, Dobson A, Koenig L, Book R.  Medication therapy management services: a critical review. Accessed at www.lewin.com/content/publications/3179.pdf, November 11,  2011.
 
Lloyd KB, Thrower MR, Walters NB, et al. Implementation of a weight management pharmaceutical care service.  Ann Pharmacother. 2007;41:185–92.[PubMed][CrossRef]
 
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Lloyd KB, Krueger KP, Moore RT, et al. Impact of a workplace health and wellness pharmaceutical care service on the weight and obesity classification of employees.  J Am Pharm Assoc. 2002;42:118–20.[CrossRef]
 
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Bell EC, Ravis WR, Lloyd KB, Stokes TJ.  Effects of St. John's wort supplementation on ibuprofen pharmacokinetics.  Ann Pharmacother. 2007;41:229–34.[PubMed][CrossRef]
 
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