Mallouh Mohammad Abu, Briggs Alyse, Hawkins Stefanie, Heffern Cassie
1 St. Charles Healthcare, Prineville, Oregon.
2 Community Health Network, Indianapolis, Indiana.
Sr Care Pharm. 2023 May 1;38(5):185-192. doi: 10.4140/TCP.n.2023.185.
To quantify the financial and clinical implications of pharmacists completing Medicare Annual Wellness Visits (AWV). Retrospective, observational, population-based health economic analysis utilizing electronic medical record data. A single family-practice clinic within a Missouri-based not-for-profit community health system. Medicare patients in their second year of coverage who had not been seen for an AWV within the previous 12 months. Patients attended a subsequent AWV conducted by a licensed ambulatory care pharmacist between July 1 and December 31, 2021. The pharmacist completed all necessary visit requirements and helped facilitate completion of preventive screenings. Primary outcomes measured were financial implications of pharmacists completing AWVs. The primary objective was to quantify the direct and indirect financial benefits for a health system incorporating pharmacist-led AWVs. Direct revenue was calculated based on the number of visits completed multiplied by the reimbursement rate paid to the health care system by the Centers for Medicare & Medicaid Services (CMS). Indirect revenue was estimated based on the number and type of interventions completed by the patient. The secondary outcome measured was the clinical impact of pharmacist-led AWVs through quantifying preventive care service needs and completion of these services. Alongside these measures, the number of medication discrepancies and drug interactions were also measured and cost avoidance estimated. Annual cost in salary of a pharmacist was considered, but additional cost of overhead was beyond the scope of the study. Thirty-nine AWVs were completed. Two hundred six recommended screenings, labs, and immunizations were identified, of which 24% were completed. The pharmacists were also able to identify 205 medication issues. These visits generated $4,593.42 in direct revenue. Recommended preventive care generated $2,161.71 in indirect revenue. Pharmacist-led AWVs are financially beneficial to the health care system and increases the number of completed AWVs while avoiding demand for additional physician time.
量化药剂师完成医疗保险年度健康检查(AWV)的财务和临床影响。利用电子病历数据进行回顾性、观察性、基于人群的健康经济分析。密苏里州一家非营利性社区卫生系统内的单一家庭医疗诊所。处于医保覆盖第二年且在过去12个月内未进行过AWV的医疗保险患者。患者于2021年7月1日至12月31日期间参加了由持牌门诊护理药剂师进行的后续AWV。药剂师完成了所有必要的就诊要求,并协助完成预防性筛查。测量的主要结果是药剂师完成AWV的财务影响。主要目标是量化纳入药剂师主导的AWV对卫生系统的直接和间接财务效益。直接收入根据完成的就诊次数乘以医疗保险和医疗补助服务中心(CMS)支付给医疗系统的报销率来计算。间接收入根据患者完成的干预措施的数量和类型进行估算。测量的次要结果是通过量化预防性护理服务需求和这些服务的完成情况来评估药剂师主导的AWV的临床影响。除了这些措施外,还测量了用药差异和药物相互作用的数量,并估算了成本节约情况。考虑了药剂师的年度薪资成本,但额外的间接费用超出了研究范围。共完成了39次AWV。确定了206项推荐的筛查、实验室检查和免疫接种,其中24%已完成。药剂师还能够识别205个用药问题。这些就诊产生了4593.42美元的直接收入。推荐的预防性护理产生了2161.71美元的间接收入。药剂师主导的AWV对医疗系统在财务上有益,增加了完成的AWV数量,同时避免了对额外医生时间的需求。