Faculty Disclosure. Learning ObjecKves. Probing QuesKons. Pharmacists Services HEALTHCARE MARKET 02/26/10

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1 Faculty Disclosure The Current Healthcare Environment: Where Does MTM Fit In? Daniel Buffington, PharmD, MBA Clinical Pharmacology services, Inc Tampa, Florida Dr Buffington has no actual or potenkal conflict of interest associated with this presentakon. Learning ObjecKves Probing QuesKons At the Conclusion of this presentakon, parkcipants will be able to: Describe the current state of the Healthcare Market Discuss PracKce Model Development for pharmacist cognikve services Explain the role of the Electronic Health Records (EHR) in the advancement of pharmacist cognikve services Discuss how Healthcare Reform can advance pharmacy prackce Can you describe your role in the healthcare team? Can you confidently and effeckvely communicate your clinical recommendakons to other healthcare prackkoners? Are you willing to be accountable for your decisions and recommendakons? Can you demonstrate the value and uklity of medicakon therapy management (MTM) services? Pharmacists Services Medication Therapy Management Drug Regimen Review PaEent Care Patient Education HEALTHCARE MARKET Prescriptions Product 1

2 Progression of Intensity and Responsibility MTM Core Elements (APhA) 1. Comprehensive MedicaKon Therapy Review (CMR) 2. Personal MedicaKon Records (PMR) 3. PaKent MedicaKon- related AcKon Plan (PMAP) 4. Consult/IntervenKon Patient Education Drug Regimen Review Problem Intervention Physical Assessment Adherence Persistence Disease Management Medication Management 5. Clinical DocumentaKon Minimal focus Triage-minded Short term nature Instantaneous Multi-focused Multi-relationship Chronic in nature Accountability Drug/Patient/Disease Model American Pharmacists AssociaKon and the NaKonal AssociaKon of Chain Drug Stores FoundaKon. MedicaKon therapy management in pharmacy prackce: core elements of an MTM service model (version 2.0). J Am Pharm Assoc. 2008; 48: Pharmacists Services MedicaKon Therapy Management (MTM) Reimbursement Fee- for- Service Insurance Medicare Part- D CPT Codes new pakent, inikal 15 minutes established pakent, inikal 15 minutes addikonal 15 minutes, either or Current Procedural Terminology (CPT) Codes MedicaEon Therapy Management (MTM) MedicaKon therapy management service(s) (MTMS) describe face to face pakent assessment and intervenkon as appropriate, by a pharmacist, upon request. MTMS is provided to opkmize the response to medicakons or to manage treatment related medicakon interackons or complicakons. MTMS includes the following documented elements: review of the perknent pakent history, medicakon profile (prescripkon and nonprescripkon), and recommendakons for improving health outcomes and treatment compliance. These codes are not to be used to describe the provision of product specific informakon at the point of dispensing or any other roukne dispensing related ackvikes MedicaKon therapy management service(s) provided by a pharmacist, individual, face to face with pakent, with assessment and intervenkon if provided; inikal 15 minutes, new pakent inikal 15 minutes, established pakent each addikonal 15 minutes (List separately in addikon to code for primary service Key CharacterisKcs of CPT MTM Codes APhA MTM Digest Broad definikon All ackvikes that a pharmacist performs related to the evaluakon, recommendakon, or alterakon of a pakent s medicakon therapy in the effort to meet the MTM service descripkon. ProspecKve in nature Involves pre, intra, and post service elements Assumes responsibility and accountability for service Face- to- Face or Non- Face- to- Face (payer dependent) Annual updates NaKonwide surveys Payer insights Referral trends Barrier pajerns 2

3 MTM Resources Missing Business Skill Sets APhA ASHP ACCP Business Model Design PracKce Management Project Management MarkeKng Advanced Project ApplicaKons CLINICAL PRACTICE MODELS Project planning Project management Mind mapping sokware Development eskmakon sokware CollaboraKon tools How will you structure the delivery of your services? PracKce Models Factors PracKce Models OpKons Patient Population Payers Practice Setting Employment Ambulatory Clinic (Hospital- based) Ambulatory Clinic (Community Pharmacy) Physician PracKce Academic Clinic Private PracKce Reimbursement Staffing 3

4 PracKce Models Pharmacy Ambulatory Care Store- based prackce Product & Service Tracking Expanding payer acceptance is improving profitability - Private pay - Insurance - Managed Care - Medicaid - Medicare Part D / PrescripKon Drug Plans (PDP) Challenges balancing dispensing & clinical services - Environment (space) - Work flow - Staffing - DocumentaKon - Corporate Support PracKce Models Facility Barriers Hospital Pharmacists are typically an Employee Model No Facility Billing Codes for Medical Services Not able to capture payment for CPT MTM codes Payers not paying for pharmacist clinical services (MTM) Physicians receive payment simultaneous with insktukonal payment via CPT codes and direct payment - InsKtuKonal prototypes include; Radiology, ED, CriKcal Care, etc. Pharmacists can emulate the medical prackce model to pursue payment for MTM services direct from payers PracKce Models Facility OpKons PracKce Models OpKons Contract Management Radiology Department Service Billing Pharmacy Department Service Billing Contract Management Which model would work for you? Labs X- Rays MedicaEons Radiology Group Practice Pharmacists Group Practice NaKonal Health InformaKon Repository Medical Pharmacy ELECTRONIC HEALTH RECORDS (EHR) Where Does MTM Fit In? MTM? 4

5 02/26/10 Personal Health Record edocumentakon Plaporms MICROSOFT GOGGLE Electronic Health Record (EHR) Electronic Medical Record (EMR) January 1, 2012 Personal Health Record (PHR) MTM DocumentaKon Systems Sokware SelecKon Criteria PaKent care tracking PillHelp MedicaKon Management Clinical Support Services csshealth.com/index.php MedicaKonPathfinder Peer- to- Peer communicakons PracKce management Billing & reimbursement tracking HIPAA & regulatory compliance MirixaPro & Mirixa Edge Outcomes PharmaceuKcal hjp:// NexDose.com hjp:// Electronic Health Records Current MTM IntervenEon PlaVorms Are Not Electronic Medical Records HEALTH CARE REFORM Where do pharmacists stand in the Health Care Reform plans? Copyright(R) Daniel E. Buffington, PharmD, MBA 5

6 Conclusions QuesKons & Answers ConKnue to manage prescripkon process PrioriKze delivering MTM services Emulate medical specialty prackce model Don t look for a job, manage your prackce sesng Constantly demonstrate your value and uklity Be accountable for your pakent s outcomes Document pakent interackons/intervenkons Communicate with other healthcare prackkoners Bill for your services Daniel E. Buffington, PharmD, MBA Clinical Pharmacology Services 6285 E. Fowler Ave Tampa, FL Office Fax Cell 6

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