Abstract Category: Practice Innovation / Performance Improvement (PI)
Purpose: It is well established in the literature that pharmacists providing medication therapy management services (MTM) post-hospital discharge can improve medication adherence and safety, as well as decrease Emergency Department visits and readmissions. Although the evidence supports these programs, the number of patients receiving such services is very limited, mainly due to cost. The purpose of this study is to determine if enough revenue can be generated to sustain a post-discharge pharmacist driven medication therapy management program.
Methods: A prospective review of patients discharged from medical/surgical units for an 11 months period is being conducted. Two hundred fifty patients will be randomly selected. Demographics and financial information will be recorded. Patients with insurance that provides MTM services, with 8 or more prescription medications, and 3 or more chronic conditions will be considered qualifying patients. Cost of operating the program will be based on the average pharmacist salary and benefits. A fee of $75 for conducting a Complete Medication Review (CMR) will be used to calculate reimbursement.
Findings: Using a randomization formula, 55 patients have been selected to determine if they would qualify for MTM services. Eleven patients (20%) of the 55 evaluated would qualify. Based on this finding and the average daily discharges, 6 patients per day are eligible for MTM services. Using a cost of $65.00 per hour to operate the program and an average reimbursement fee of $75.00 per (CMR), the number needed to cover the daily cost of operating the program on a full-time basis was calculated to be 7 patients CMR’s per day.
Discussion: The findings of this study suggest that the reimbursement produced can help offset the cost of operating the service on an hour per hour basis. It was estimated that a minimum of seven patient CMR’s must be performed per day to cover the cost of operating the MTM program with a dedicated full-time pharmacist. The study data suggests an average of six patients per day may be eligible but this does not include willingness of patients to participate or if they are receiving MTM services elsewhere. Modifications to decrease the cost of operating the program include: decreasing the number of hours per day used for this program, decreasing the number of days the services are rendered, and incorporating pharmacy students and residents under the supervision of a pharmacist to provide the service.
Implications for Practice: The implementation of a medication therapy management program at West Kendall Baptist Hospital, can help resolve medication related problems post discharge, improve patient’s adherence to treatment, potentially decrease readmissions and generate sufficient pharmacy revenue to support the program on a part-time basis.
2018 West Kendall Baptist Hospital Scholarly Showcase
Gonzalez-Abreu, Patricia; Perez Arias, Maria; and Lopez-Samblas, Ana, "Projection of Potential Reimbursement of a Post-Hospital Discharge Pharmacist Operated Medication Management Service" (2018). All Publications. 2749.
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