Collaborative drug therapy management services and reimbursement in a family medicine clinic

Abstract

Purpose. The legislative and regulatory issues surrounding the reimbursement of pharmacists for cognitive services are reviewed and billing practices for a pharmacist-physician collaborative drug therapy management service (DTMS) in a family medicine clinic are examined. A case study is offered to illustrate the real-world application of these practices. Summary. As regimens of prescription medications have become more complex and the potential for adverse drug reactions and interactions has increased, the need for individualized optimal drug therapy and drug-therapy experts has grown. Pharmacists, who are professionally trained to be an integral part of the medical team, are well prepared to ensure optimal drug therapy and medication safety for patients. Consequently, collaboration between physicians and pharmacists can lead to improved patient care and reduced medication errors. The following 10 steps are recommended for establishing a successful collaborative DTMS: (1) establish a working relationship with physician colleagues, (2) assess the needs of your patients, (3) draft collaborative DTMS protocols and agreements, (4) apply for credentialing status within your health organization, (5) consult the billing office staff at the clinic, (6) design a clinic-encounter form, (7) identify and train support personnel, (8) allocate resources, (9) advertise the DTMS, and (10) evaluate and improve your service. Conclusion. Establishing a DTMS presents many challenges and obstacles, but they should not lead to discouragement. Rather, pharmacists should be diligent and continue to explore ways in which they could provide optimal medication therapy to patients through appropriate channels that also facilitate reimbursement.