Wellness Visits/Pharmacists: Perfect Together

Patients in North Carolina are very comfortable with clinical pharmacist practitioners (CPPs) who conducted their annual wellness visits (AWVs), according to a study published in the Journal of Managed Care & Specialty Pharmacy.

The Patient Protection and Affordable Care Act mandates that Medicare provide coverage for an AWV that focuses on preventative services to eligible beneficiaries. The visits can be conducted by a physician or another licensed health-care practitioner working under direct supervision of a physician.

In North Carolina, pharmacists licensed as CPPs are authorized to perform and bill for AWVs, but there had been limited data on patient satisfaction with pharmacists in this advanced role.

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The objective of the study, conducted at the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, was to determine patient satisfaction with and perception of an initial Medicare AWV administered by a CPP in an academic internal medicine clinic, and to examine the relationship between patient satisfaction and the number of interventions or referrals made during an AWV.

The study revealed that patients were accepting of and very satisfied with CPPs conducting Medicare AWVs. AWVs offer an opportunity for pharmacists to provide direct patient care focused on preventative health, identify areas for patient interventions and contribute to team-based care. CPPs may serve as a viable option to expand patient access and care with the growing shortage of primary care physicians (PCPs).

Christina Sherrill, PharmD, BCACP, lead author of the study, said that in North Carolina, the credential of CPP allows a pharmacist to perform and bill for AWVs and other services through a collaborative practice agreement the CPP has with a physician. Sherrill, who is Assistant Professor of Ambulatory Care at High Point (NC) University Fred Wilson School of Pharmacy, added that being able to bill for AWVs is important because pharmacists do not yet have “provider status,” so they must find creative ways to bill for services and generate revenue.

Several other states have similar credentials for pharmacists that allow for the reimbursement for AWVs, Sherrill noted.

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“As pharmacists, we are always open to new opportunities to expand our services and practice at the top of our licenses. From the physician’s point of view, partnering with pharmacists to provide this service for the clinic’s patients was an advantageous delegation of responsibility, particularly due to the logistics of conducting AWVs, which can be fairly time consuming,” Sherrill said.

As drug experts, Sherrill said that pharmacists can fulfill all the requirements of an AWV and can answer medication-related questions–which are common–and make referrals as appropriate.

“Our study found that patients were very satisfied with the CPP and AWVs, and felt comfortable with CPPs as the providers of this service,” Sherrill said. Patients stated that they liked the different perspective the CPP could offer, compared to their PCP, particularly the focus on medications. “Patients who preferred seeing their PCP stated this was due to their familiarity with their PCP.”

As the health-care landscape continues to change, Sherrill said that pharmacists will become more involved in direct patient care, providing services similar to AWVs, as well as management of acute and chronic diseases.

“The role of the pharmacist is continuing to expand and evolve as we strive to provide the best possible care for our patients.”