Iowa pays R.Ph.s to manage high-risk patients

May 8, 2006

Iowa pharmacists are being paid to manage the medications ofpatients at high risk of therapy problems in a one-yearcollaborative practice pilot funded by the Community PharmacyFoundation (CPF).

Pharmacists in the CPF Focus 2006 initiative are being paid $75 for an initial consultation with about 250 eligible patients insured through the Iowa Farm Bureau health plan administered by Wellmark Blue Cross/Blue Shield of Iowa. They are paid $25 to $45 for follow-up contacts with patients who must be taking at least four medications for at least one of 13 high-risk chronic conditions, according to Thomas Temple, R.Ph., executive VP-CEO, Iowa Pharmacy Association. About 100 pharmacies are participating in the test.

"Pharmacy has got to move away from trying to put cheaper drugs in a bottle to getting a good return on the investment," said Temple. "We think pharmacists can play a major role in that. Pharmacists in this project will attempt to identify adverse drug events and look for cost savings. The University of Iowa will evaluate the outcomes. The research will focus on pharmacy and medical claims to try to assess cost savings as a result of enhanced medication use by patients."

Created in 2000 after a class action settlement over differential pricing by chains and independent pharmacies, CPF decided last year to expand its scope to begin cultivating grant projects in a strategic fashion to be able to achieve a central focus, said board member Robert Osterhaus, R.Ph. The board identified critical components, including quantifying pharmacist services, documenting their value in a consistent fashion, finding new ways to provide patient services electronically, and working with healthcare plans and other providers, he added.

"We hope this initiative will let pharmacists across America know that we care," said Osterhaus, who also serves in the Iowa legislature. "For the first time, they have a research-based foundation to assist them on their journey through troubled waters."

The timing of the Feb. 1 launch of the Focus 2006 program was "terrible," admitted Cheryl Clarke, IPA senior VP-professional and public affairs. Even though they were still in the midst of the chaos unleashed by Medicare Part D, "the pharmacies stepped up to the plate and saw this as the profession's future," she said. "We got an incredible response given the trauma they were enduring."