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Use med sync appointments to improve care and boost Star Ratings

In brief:

  • Fewer than 50% of Medicare beneficiaries that are eligible for MTM receive an annual CMR.1
  • Completion of CMRs is now a Star Ratings measure for health plans.
  • Using the appointment-based model for medication synchronization allows pharmacies to integrate CMR into the workflow, adding revenue and improving performance on Star Ratings measures.

In 2016, the Centers for Medicare and Medicaid Services (CMS) included comprehensive medication review (CMR) completion rates in its Star Ratings measures for health plans. Pharmacies that aren’t regularly providing that service could find themselves at a disadvantage. (See “What You Need to Know Now About CMRs.”)

Colorado’s Good Day Pharmacy knows all about this. Their Eaton location is a top performer on completing CMRs. The pharmacy was the top performer at completing CMRs in Colorado for 2015, and by mid-2016 was among the top in the Western United States, with 83% of cases complete.

A key to success

To create time to meet with patients for an annual CMR, which is part of the MTM benefit under Part D plans, Good Day Pharmacy has adopted an appointment-based model for medication synchronization. Using this appointment-based model for med sync has allowed Good Day to integrate MTM into its workflow and engage in more annual CMRs.

Make appointments part of your workflow

“We started this [med sync] in 2013,” said Vicki Einhellig, Good Day’s president and chief operating officer. “We recognized the value of med sync to both the patient and the pharmacies.”

Studies have shown that med sync improves patient adherence and is more efficient. “It frees up time for patients, because they are not coming to the pharmacy three or four times a month, and for pharmacists, because we are being proactive and filling patients’ medications before they would typically call. We have noticed a smoothing out of the workload throughout the week.”

The appointment-based model for med sync creates a specific day each month for pharmacists to meet and interact with patients, counsel them, and provide additional services.

“We use an appointment-based model that includes an outreach call prior to filling the medications to ask about any changes in medication therapy,” she said. “Once the medications are filled, we call the patient to let them know everything is ready for them to pick up. When they come in, we review all chronic prescriptions with the patient and provide other services, including MTM and vaccinations.”

Use technology to streamline med sync

Good Day started with a paper calendar system and then moved to Google Calendar. “Once the pharmacies reached 50 patients, we realized we needed to have software to provide organization and standardization,” Einhellig said.

After testing two platforms for six to eight months, Good Day chose PrescribeWellness to work with their Star Wellness SyncRx program. “[Technology] provided an established method for us to follow,” Einhellig said. “The patient appointment is flexible and related to when they pick up their medications. In the future, I see us moving to a specific appointment time and expanding our discussion with patients. Right now, we incorporate it into our existing workflow and staffing.”

Selling med sync to patients

Pharmacy jargon such as “med sync” can overwhelm patients, and most consumers don’t want to sign up for yet another “program.”

So, Good Day Pharmacy trains its staff to talk with customers about the benefits of receiving all of their prescriptions at the same time each month. Good Day focuses on conveying simple, clear benefits without saying “program.” “We discuss it as a time savings for them,” explained Vicki Einhellig.

Everyone at Good Day takes every opportunity to talk about med sync with patients. “We had to get staff in the habit of having those conversations,” she said. The pharmacy provided training and set goals for the staff. Good Day now has more than 1,800 med sync patients at its eight locations in Colorado.

Identify opportunities

Good Day’s central office notifies each of its eight pharmacies of opportunities to provide additional services for patients, such as CMR. “We identify and send out opportunities to each pharmacy via email every week,” Einhellig said.

During bi-monthly calls with their pharmacies, Good Day’s leaders talk about these opportunities and the importance of making a difference for health plans on Star Ratings measures. Good Day also holds quarterly meetings with pharmacy managers to share metrics and best practices. “We need to show success in these programs, and the tools are there,” Einhellig said, including systems such as PrescribeWellness, Mirixa and Outcomes.

Every week, Good Day employees can see how each location is performing on a variety of measures, including sales as well as the number of med sync patients, number of MTM cases, and scores on EQuIPP™ (the Electronic Quality Improvement Platform for Plans and Pharmacies). “It creates healthy competition,” Einhellig said.

“We can definitely see a correlation between sync enrollment and EQuIPP numbers,” she said. “In the last six month at our Wellington location we’ve quadrupled our med sync enrollment.” Adherence on diabetes medications increased 18.8%, for blood pressure medications adherence is up 6%, and cholesterol medication adherence increased 4%.

With the pharmacists regularly reviewing all of a patient’s prescriptions, the percentage of older patients on high-risk medications fell from 3.7% to 0. “This has put all our pharmacy measures indices in the top 20% most months and decreased unexpected fluctuations,” Einhellig said.

In the PrescribeWellness platform, from May to July the pharmacy moved from around 3 stars to 4.88. That includes moving from a mid-2 stars in diabetes medication adherence to over 4 stars, with 5 stars in the hypertension, cholesterol and HRM measures.

A med sync program with the appointment-based model increases pharmacy revenue through patients being more adherent and receiving more refills. That monthly interaction also offers opportunities for the pharmacy to improve its performance on Star Ratings measures and capture more revenue opportunities.

Discover more ways to expand your clinical role by downloading “Maximizing Clinical Opportunities for Future Advantage,” through the Driving Pharmacy Performance Education Center.

 

 

1 “MTM Services Underused in Part D Drug Plans,” Pharmacy Times, Sept. 8, 2014. LINK