Implementing an integrated care management program in community pharmacies: A focus on medication management services.

OBJECTIVES

To describe the initiation of a community pharmacy medication management service within a statewide integrated care management program.

SETTING

One hundred twenty-three community and community health center pharmacies in 58 counties of North Carolina.

PRACTICE DESCRIPTION

Independent and community health center pharmacies offering medication management as part of an integrated care management program to Medicaid, Medicare, dually eligible Medicare-Medicaid, and NC Health Choice beneficiaries in North Carolina.

PRACTICE INNOVATION

Community pharmacies joined an enhanced service network created by Community Care of North Carolina to provide medication management services as part of an integrated care management program.

EVALUATION

During the first 3 months of the program, 41% of pharmacies consistently documented the medication management services. Interviews were conducted with pharmacists from the inconsistent pharmacies to drive program improvements.

RESULTS

Pharmacists at 73 community and community health center pharmacies were interviewed. The majority of pharmacists reported that challenges in "initiating services" and "documenting" were due to increased intensity of service and documentation compared with Medicare Part D medication therapy management requirements. Program changes to improve participation included revision of documentation requirements, authorization of technicians to transcribe pharmacists' interventions, additional documentation templates, workflow consultations, and feedback on documentation quality.

CONCLUSION

Community pharmacies are capable of providing medication management integrated with care management. Some pharmacies have more difficulty initiating new services in the current workflow landscape. To facilitate implementation, it is important to minimize administrative burden and provide mechanisms for direct feedback. Pharmacy owners, managers, and leaders in pharmacy policy can use these findings to aid implementation of new services in community pharmacies.