Forging a novel provider and payer partnership in Wisconsin to compensate pharmacists for quality-driven pharmacy and medication therapy management services

Journal of the American Pharmacists Association

Volumn 49, Issue 5, 2009, Pages 642-651

  Trapskin, Kari ^a   Johnson, Curtis ^b   Cory, Patrick ^c,d   Sorum, Sarah ^e   Decker, Chris ^a  

^a Pharmacy Society of Wisconsin   (United States)

^b UNIVERSITY OF WISCONSIN MADISON   (United States)

^c Unity Health Insurance   (United States)

^d University of Wisconsin Health   (United States)

^e Professional and Educational Affairs   (United States)

Author keywords

Collaboration; Community pharmacy; Medication therapy management services; Payment systems; Pharmacy organizations; Quality improvement; Wisconsin

Indexed keywords

ARTICLE; COOPERATION; ECONOMICS; EVALUATION; HEALTH CARE PLANNING; HEALTH CARE QUALITY; HUMAN; MEDICATION THERAPY MANAGEMENT; METHODOLOGY; PHARMACY; PILOT STUDY; REIMBURSEMENT; UNITED STATES;

COMMUNITY PHARMACY SERVICES; COOPERATIVE BEHAVIOR; HEALTH PLAN IMPLEMENTATION; HUMANS; MEDICATION THERAPY MANAGEMENT; PILOT PROJECTS; PROGRAM EVALUATION; QUALITY ASSURANCE, HEALTH CARE; REIMBURSEMENT MECHANISMS; WISCONSIN;

EID: 77649230943     PISSN: 15443191     EISSN: 15443450     Source Type: Journal    
DOI: 10.1331/JAPhA.2009.08158     Document Type: Article

References (25)

1. National Academy of Sciences. Rewarding provider performance: aligning incentives in Medicare. 2007. Accessed at www.nap.edu/catalog.php?record-id= 11723#toc, October 28, 2008.
2. Cranor CW, Bunting BA, Christensen DB. The Asheville Project: long-term clinical and economic outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc. 2003;43:173-84.
3. Bunting BA, Cranor CW. The Asheville Project: long-term clinical, humanistic, and economic outcomes of a community-based medication therapy management program for asthma. J Am Pharm Assoc. 2006;46:133-47.
4. Fera T, Bluml BM, Ellis WM, et al. The Diabetes Ten City Challenge: interim clinical and humanistic outcomes of a multisite community pharmacy diabetes care program. J Am Pharm Assoc. 2008;48:181-90.
5. Carter BL, Chrischilles EA, Scholz D, et al. Extent of services provided by pharmacists in the Iowa Medicaid pharmaceutical case management program. J Am Pharm Assoc. 2003;43:24-33.
6. Institute of Medicine. To err is human: building a safer health system. Washington, DC: Institute of Medicine of the National Academies; 2000.
7. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: Institute of Medicine of the National Academies; 2001.
8. PQA. PQA announces official launch of demonstration projects. Accessed at www.pqaalliance.org/files/PQALaunchofDemoProjectsJuly2008.pdf, February 10, 2009.
9. Nau DP, Kliethermes MA, McCabe S. Quality measurement: time to get serious. J Am Pharm Assoc. 2006;46:668-78.
10. Bluml BM. Definition of medication therapy management: development of professionwide consensus. J Am Pharm Assoc. 2005;45:566-72.
11. American Pharmacists Association, National Association of Chain Drug Stores Foundation. Medication therapy management in community pharmacy practice: core elements of an MTM service (version 1.0). J Am Pharm Assoc. 2005;45:573-79.
12. American Pharmacists Association, National Association of Chain Drug Stores Foundation. Medication therapy management in pharmacy practice: core elements of an MTM service model (version 2.0). J Am Pharm Assoc. 2008;48:341-53.
13. Academy of Managed Care Pharmacy. Sound medication therapy management programs: 2006 consensus document. Accessed at www.amcp.org/data/nav-content/ websiteMTMdocument.pdf, May 17, 2006.
14. Academy of Managed Care Pharmacy. Sound medication therapy management programs, version 2.0 with validation study. J Manag Care Pharm. 2008;14(suppl S-b):S2-42.
15. Gnadt N, Mott DA, Trapskin K. Pharmaceutical care claims submissions: an update on participation in Wisconsin. JPSW. 2007;Sep-Oct:13-5.
16. The Lewin Group. Medication therapy management services: a critical review. J Am Pharm Assoc. 2005;45:580-7.
17. Wisconsin Patient Safety Institute. Maximizing patient safety in the medication use process: practice guidelines and best demonstrated practices. Accessed at www.pswi.org/professional/tools/Patient-Safety-Booklet.pdf, February 7, 2009.
18. Worley MM. Optimizing pharmacists' effectiveness as medication therapy managers through a segmentation approach. J Am Pharm Assoc. 2005;45:593-9.
19. Nichol A, Downs GE. The pharmacist as physician extender in family medicine office practice. J Am Pharm Assoc. 2006;46:77-83.
20. Howard M, Trim K, Woodward C, et al. Collaboration between community pharmacists and family physicians: lessons learned from the seniors medication assessment research trial. J Am Pharm Assoc. 2003;43:566-72.
21. Centers for Medicare & Medicaid Services. Medicare Part D medication therapy management (MTM) programs: 2008 fact sheet. Accessed at www.cms.hhs.gov/PrescriptionDrugCovContra/Downloads/MTMFactSheet.pdf, May 13, 2009.
22. Trapskin K. Here we go...update and reflections on WPQC. JPSW. 2008;Nov-Dec:36-8.
23. Karls, A. Improving the quality of care. JPSW. 2008;Nov-Dec:39-40.
24. Cranor CW, Christensen DB. The Asheville Project: factors associated with outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc. 2003;43:160-72.
25. Webber A. Building the business case for quality improvement. J Am Pharm Assoc. 2005;45:437-42.