The Value of a Pharmacist

Using pharmacists in accountable care organizations (ACOs) improves medication use by patients. That’s according to a study, “Optimization of Medication Use at Accountable Care Organizations,” which describes how ACOs manage medication use as part of their value-based contracting and care delivery.

The study was conducted between June 2015 and February 2017 by Leavitt Partners and was sponsored by the National Pharmaceutical Council.

Lead author Chrisanne Wilks, PhD, told Drug Topics that the main objective of the study was to measure the ability of ACOs to optimize the pharmaceutical component of care and uncover what-if any-relationships exist between practices to improve medication use and the ACO’s financial and quality performance. The researchers also sought to identify organizational factors that could influence an ACO’s capabilities for optimizing medications.

One ACO reported that part of its information technology team is staffed by pharmacists who are responsible for managing the entire medication profile of the organization and support safe prescribing practices, Wilks says. Another ACO has integrated a pharmacist into one of its larger practices to evaluate and streamline prescribing habits. The ACO reported that over six months the pharmacist saved the practice a quarter million dollars.

“A third ACO has employed a ‘transition of care’ pharmacist who works with patients from admission through the transition to the next level of care,” Wilks says. The ACO reported that this pharmacist used medication reconciliation to prevent duplicates and improve communications around inpatient vs. outpatient drug regimens.

Data from the study revealed that successfully treating many chronic conditions relies on effective medication use. Wilks pointed out that as healthcare reimbursement continues to shift to value-based contracting, the optimization of medication use is essential to achieving improved patient outcomes and experience at lower costs. “Accountable care organizations and other risk-bearing provider entities are integral to transforming the healthcare delivery system in the United States,” Wilks says.

Despite the significant role medications play in managing chronic illnesses, there has been limited investigation into how much ACOs focus on medication use.

Why Not More Pharmacists?

There are several barriers to including pharmacists in optimizing medication use at ACOs, says Wilks. The first is a lack of reimbursement for services. Another is the difficulty in isolating and attributing costs savings due to the integration of pharmacists. A third is the absence of buy-in from clinicians, who may not realize that clinical pharmacists can optimize medication use, Wilks adds.