J Am Pharm Assoc (2003). 2019 Jul-Aug;59(4S):S85-S90. doi: 10.1016/j.japh.2019.03.013. Epub 2019 Jun 13.
The objective was to assess the impact of a pharmacist embedded within a primary care practice on quality measures of the Merit-Based Incentive Payment System (MIPS) and patient-centered medical home (PCMH) by characterizing (1) measure achievement after pharmacist involvement in care and (2) measure achievement separately for patients seen by the pharmacist and patients not seen by the pharmacist.
Multidisciplinary primary care practice in Charlotte, North Carolina.
Pharmacists from an independent community pharmacy are highly integrated into the clinic. Pharmacists work alongside providers to furnish comprehensive care with a team-based approach. The initial focus for the pharmacist was on the Medicare annual wellness visits (AWV) and chronic care management (CCM).
Quality measure achievement during face-to-face AWV, telephone-call CCM, or both.
From January 1, 2017, to February 2, 2018, 193 patients had an AWV, CCM, or both from the pharmacist. Measure achievement was characterized with the use of descriptive statistics.
When characterizing quality measures before, during, and after pharmacist intervention for the clinic population, achievement of some measures improved and others worsened. However, for every measure evaluated, the cohort of patients seen by the pharmacist had a greater proportion of patients achieving the quality measure than the cohort of patients not seen by the pharmacist. The greatest differences were observed for influenza vaccination (41% of pharmacist cohort vs. 10% of nonpharmacist cohort), hemoglobin A1C control less than 9% (94% of pharmacist cohort vs. 67% of nonpharmacist cohort), and colorectal cancer screening (55% of pharmacist cohort vs. 28% of nonpharmacist cohort).
Pharmacist provision of clinical services may increase the likelihood of quality measure achievement. The pharmacist integration model addressed gaps in care that appeared to positively affect MIPS and PCMH quality measures. This has the potential to increase reimbursement through value-based payment models.
评估初级保健实践中嵌入的药剂师对基于质量的激励支付系统（MIPS）和以患者为中心的医疗之家（PCMH）的质量措施的影响，方法是描述（1）药剂师参与护理后的措施实现情况，以及（2）药剂师就诊患者和未就诊患者的措施实现情况。
北卡罗来纳州夏洛特市的多学科初级保健实践。
来自独立社区药房的药剂师高度融入诊所。药剂师与提供者合作，以团队为基础提供全面的护理。药剂师的最初重点是医疗保险年度健康检查（AWV）和慢性病管理（CCM）。
面对面 AWV、电话 CCM 或两者都有的质量措施实现。
从 2017 年 1 月 1 日至 2018 年 2 月 2 日，193 名患者接受了药剂师的 AWV、CCM 或两者。使用描述性统计数据描述了措施的实现情况。
在描述药剂师干预前后诊所人群的质量措施时，一些措施的实现有所改善，而另一些措施则恶化。然而，对于每一项评估的措施，药剂师就诊的患者群体中达到质量措施的患者比例都高于未就诊的患者群体。观察到的最大差异是流感疫苗接种（药剂师队列的 41%与非药剂师队列的 10%）、血红蛋白 A1C 控制小于 9%（药剂师队列的 94%与非药剂师队列的 67%）和结直肠癌筛查（药剂师队列的 55%与非药剂师队列的 28%）。
药剂师提供临床服务可能会增加质量措施实现的可能性。药剂师的整合模式解决了护理中的差距，这些差距似乎对 MIPS 和 PCMH 的质量措施产生了积极影响。这有可能通过基于价值的支付模式增加报销。
