Estimated Potential Financial Impact of Pharmacist-Delivered Disease Management Services Across a Network of Pharmacies in Rural Colorado

Details

• Alternative Title:
  J Manag Care Spec Pharm
• Personal Author:
  Nuffer, Wesley ; Trujillo, Tara ; Griend, Joseph Vande
• Description:
  BACKGROUND
  
  This study summarizes the potential financial impact of a 3-year collaboration focused on delivering disease management services through pharmacies in 12 rural Colorado communities.
  
  OBJECTIVES
  
  To (a) identify components within the disease management program that would be billable and generate revenue to each pharmacy and (b) estimate the revenue amount that could be generated based on these services across the 3-year project.
  
  METHODS
  
  Reimbursable services included diabetes self-management education; medication therapy management services, including the comprehensive medication review; and improvements in Medicare star ratings through pharmacy interventions.
  
  RESULTS
  
  An estimated total of $117,800 could have been generated by services provided to patients across the 12 pharmacy sites. After subtracting the estimated cost of labor for a pharmacist to provide these services, an estimated net profit of $60,023 resulted over 3 years. Star rating impacts were discussed but were not able to be included as specific revenue based on the complex contracting between pharmacies and third-party insurers.
  
  CONCLUSIONS
  
  Based on these estimates, delivery of chronic disease management could represent a financially feasible option for community pharmacists. Some credentialing and changes to the mode of delivery would be required to meet billing requirements. Further research is needed to better estimate the cost savings resulting from these services to possibly expand pharmacists’ reimbursement opportunities.
  
  
• Subjects:
  Community Pharmacy Services Cost Savings Disease Management Humans Medicare Medication Adherence Medication Therapy Management Pharmacies Pharmacists
• Source:
  J Manag Care Spec Pharm. 25(9):984-988
• Pubmed ID:
  31456492
• Pubmed Central ID:
  PMC6859940
• Document Type:
  Journal Article
• Funding:
  U58 DP004796/DP/NCCDPHP CDC HHSUnited States/
• Place as Subject:
  Colorado
• Volume:
  25
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2da30e348fd98d339cdfa7cd3f08d0e1998fa25b26dea2cbb23c8872516322ab
• Download URL:
  https://stacks.cdc.gov/view/cdc/83102/cdc_83102_DS1.pdf
• File Type:
  [PDF - 62.46 KB ]