The implementation and expansion of primary care (PC) pharmacist medication optimization and management services has been hindered mainly by the lack of a payment mechanism for PC providers to engage pharmacist services. If pharmacists expect to be included in new PC team-based payment models, we need to actively engage in ongoing PC practice transformation discussions with PC organizational leaders. In this commentary, examples of integrated PC pharmacist services and payment models are provided to (1) reinforce the feasibility of pharmacist integration into expanded PC teams and (2) share with PC leaders, payers, and policy makers.
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GattisWAHasselbladVWhellanDJO’ConnorCM.Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team: results of the Pharmacist in Heart Failure Assessment Recommendation and Monitoring (PHARM) Study. Arch Intern Med. 1999;159:1939-1945. doi:10.1001/archinte.159.16.1939
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Alternative Payment Model Framework and Progress Tracking (APM FPT) Work Group. Alternative Payment Model (APM) framework: final white paper. https://hcp-lan.org/workproducts/apm-whitepaper.pdf. Published January 12, 2016. Accessed September 1, 2018.
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LuderHRShannonPKirbyJFredeSM.Community pharmacist collaboration with a patient-centered medical home: establishment of a patient-centered medical neighborhood and payment model. J Am Pharm Assoc (2003). 2018;58:44-50. doi:10.1016/j.japh.2017.10.006
SmithMGiulianoMRStarkowskiMP.In Connecticut: improving patient medication management in primary care. Health Aff (Millwood). 2011;30:646-654. doi:10.1377/hlthaff.2011.0002
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KoenigsfeldCFHorningKKLogemannCDSchmidtGA.Medication therapy management in the primary care setting: a pharmacist-based pay-for-performance project. J Pharm Pract. 2012;25:89-95. doi:10.1177/0897190011416671
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IsettsBJSchondelmeyerSWArtzMBet al. Clinical and economic outcomes of medication therapy management services: the Minnesota experience. J Am Pharm Assoc (2003). 2008;48:203-211. doi:10.1331/JAPhA.2008.07108
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Centers for Disease Control and Prevention. Advancing team-based care through collaborative practice agreements: a resource and implementation guide for adding pharmacists to the care team. https://www.cdc.gov/dhdsp/pubs/docs/CPA-Team-Based-Care.pdf. Accessed March 2, 2018.
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National Alliance of State Pharmacists Associations. Collaborative practice agreements: resources and more. https://naspa.us/resource/cpa. Published June 8, 2017. Accessed August 31, 2018.
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SmithMA.Pharmacists and the primary care workforce. Ann Pharmacother. 2012;46:1568-1571. doi:10.1345/aph.1R438
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SmithMA.Primary care teams and pharmacist staffing ratios: is there a magic number?Ann Pharmacother. 2018;52:290-294. doi:10.1177/1060028017735119
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ChoeHMStandifordCJBrownMT; American Medical Association STEPSforward™. Collaborate with pharmacists to improve patient outcomes: embedding pharmacists into the Practice Patient Care Module. https://www.stepsforward.org/modules/embedded-pharmacistsAccessed September 25, 2018.
