Community pharmacist and family medicine clinic provision of chronic care management services for Medicare beneficiaries with uncontrolled hypertension

Abstract

Introduction: Pharmacist-physician collaboration has shown positive results in improving patient outcomes. Chronic care management (CCM) is a reimbursable service for Medicare beneficiaries in the community setting which includes comprehensive care management and other activities. The pharmacist contribution to CCM services and their associated impact on patient health outcomes has not been fully explored. Objectives: The objectives of this study were to: (a) implement a collaborative CCM service between a community pharmacy and family medicine clinic for their common hypertensive patients; (b) measure blood pressure change for patients receiving the CCM intervention; and (c) report financial viability for the community pharmacy and family practice clinic partnership. Methods: Single group prospective pilot intervention in an independent community pharmacy and family medicine clinic in a small city in the Midwest United States. Forty-five patients with uncontrolled hypertension who are patients to both community pharmacy and clinic were recruited, and 26 received CCM interventions in person or over the telephone from the community pharmacists to manage medications for hypertension. Our main outcomes were blood pressure values and financial viability. Results: Twenty-six patients received at least one community pharmacist encounter. These patients had an average 7.3 mm Hg decline (P =.006) in systolic blood pressure (SBP) and a 2.4 mm Hg decline (P =.079) in diastolic blood pressure (DBP) at 9 months. The total revenue over the study period was $5842. Total revenue for the community pharmacy and clinic was $2785 and $3057, respectively. Conclusion: The community pharmacy/clinic collaboration resulted in improved blood pressure control, a new source of revenue for the community pharmacy, and increased revenue for the clinic. Further research is needed on CCM revenue sharing between physicians and pharmacists to generalize the results.