A recent report released by the Department of Health and Human Services (HHS) entitled “Rural Hospital Participation and Performance in Value-Based Purchasing and Other Delivery System Reform Initiatives” revealed that hospitals participating in value-based payment programs struggle on readmissions metrics defined in the Hospital Readmission Reduction Program (HRRP). In fact, the report found fact 79% of rural and 76% of urban hospitals were penalized based on these measures.
Value-based payment is a set of initiatives of the Centers for Medicare & Medicaid Services (CMS) that links Medicare payments to hospitals to various quality metrics, including hospital readmissions through HRRP. This is an area where independent pharmacists can help hospitals improve through pharmacy-based transitions of care.
According to a 2015 Pharmacy Times article, studies have shown that patients who receive medication therapy management (MTM) services from a pharmacist within a few days of discharge from a hospital are at substantially lower risk for readmission. The article further highlighted results published by the Journal of the American Pharmacists Association which found readmission rates were nearly two-thirds lower for those receiving MTM services from a pharmacist than those who did not (6.9% for those receiving MTM services vs. 20% for those who did not).
Moreover, an article in the June 2016 edition of America’s Pharmacist highlighted additional services pharmacists offer that assist patients in making the transition from a hospital setting to their home while reducing the risk of readmission. These include services such as medication reconciliation, which is a review of a patient’s entire medication regimen to avoid negative interactions with new prescriptions, improving patient education of their medications, and improving access to medications.
Such services are common in independent pharmacies and uniquely positions them to partner with hospitals to offer these services and assist in improving readmission numbers, particularly in rural and urban communities.
There are 1,800 independent pharmacies that are the sole pharmacy for their rural community. In urban communities, patients in underserved neighborhoods often have greater access to independent pharmacies. Moreover, information from the 2016 NCPA Digest, sponsored by Cardinal Health, indicates that 83% of independent pharmacies offer MTM services and adherence programs such as medication synchronization. Such data suggests that independent community pharmacists can be valuable partners as hospitals seek to improve their quality measures.
For independent pharmacies interested in pursuing transition of care partnerships with local hospitals, NCPA has created a toolkit of resources, including financial calculators to determine whether such a partnership is a sound business decision for your pharmacy, resources on how to find the financial penalties your local hospitals are paying, and sample documents pharmacies can revise and personalize if they wish to proceed with such partnerships. Contact Kevin Day, PharmD, NCPA’s Associate Director of Strategic Initiatives at firstname.lastname@example.org for more information on transitions of care.