Pharmacist-led chronic care management in the US: modest positive ROI
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Pharmacist-led chronic care management in the US: modest positive ROI Chronic care management (CCM) provided by clinical pharmacists in a primary-care setting can result in a modest positive return on investment ROI), according to a study from the US. The study evaluated the financial performance and reimbursement of CCM provided by clinical pharmacists in a primary-care setting using new Current Procedural Terminology codes for CCM that provide higher reimbursement for delivery of complex CCM. The study was conducted at a large academic medical practice (including 42 physicians and 6 clinical pharmacists) from May 2018 through April 2019 following implementation of pharmacist-led CCM. Over the 12-month study period, pharmacists provided 236 CCM-related encounters among the 65 patients involved in the study, including 31 initiating visits and 205 time-on-task encounters. The time spent by pharmacists delivering CCM was approximately 102 hours. Gross revenue for CCM during the 12-month period was $US7433.91. The cost of pharmacist time spent providing CCM was calculated to be $6430.36. Therefore, the net income from the service was $1003.55, resulting in a 15.6% positive ROI. Out of 158 CCM claims submitted for reimbursement, 131 (83%) were paid and 27 (17%) were unpaid or remained in adjudication after the conclusion of the study period. The ROI for CCM was "modest" compared to that for other reimbursable services pharmacists provide, note the researchers. They suggest that "there are several opportunities to further improve financial performance of CCM." Martin R, et al. Financial performance and reimbursement of pharmacist-led chronic care management. American Journal of Health-System Pharmacy : 30 Sep 2020. Available from: URL: http://doi.org/10.1093/ajhp/zxaa300
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PharmacoEconomics & Outcomes News 17 Oct 2020 No. 864
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