Medication Synchronization – The “Power House” of Clinical … · 2019-08-29 · •Enjoyed coffee on Pharmageddon •Extra 2018 fills for donut hole patients •Obtained new

Medication Synchronization –The “Power House” of Clinical

Pharmacy Practice Transformation

Program Speakers:Adrienne Cervone, PharmD

Jeff Covelli, RPhRobert Maher, PharmD

papharmacistsnetwork.com

Speaker Disclosures

• The speakers do not have any relevant financial relationships with any commercial interests


Learning Objectives

• Describe the practice of medication synchronization

• Discuss the benefits of medication synchronization on community pharmacy workflow

• Describe the benefits of medication synchronization on quality metrics

• Evaluate an existing medication synchronization program and discuss areas of opportunity for improvement


Why Med Sync?

Adrienne Cervone, PharmD

President,

Beaver Health Mart Pharmacy

Beaver, PA


The Process

• Why I cannonballed into Med Sync• Original goals:

• EQuiPP: Adherence goal of 20% (biggest challenge)

• Limit daily “on demand” pressure


The Process

• Set goals with employees• Sync 3 patients WEEKLY

• Start with the easy patients

• Mandatory for free delivery

• Partial fill document for physicians

• Opt out


Expected Benefits of Med Sync

• Focus of the day has shifted• Less calls from patients

• Prescriptions are ready

• Fuel costs and mileage have decreased

• Enjoyed coffee on Pharmageddon• Extra 2018 fills for donut hole patients

• Obtained new insurance before patient walked in


Unexpected Benefits of Med Sync

• Patients stayed despite non-preferred contracts

• Patients realized how they were truly taking medications• Opportunity for clinical intervention

• Lower doses of medications needed

• OTC sales did not decrease


Unexpected Benefits of Med Sync

• PPCN• Meeting goals of mission statement

• Beaver Health Mart Pharmacy is • Improving patient outcomes

• Increasing quality measure ratings

• Lowering overall healthcare costs


Questions?

Benefits of Medication

Synchronization On Quality Metrics

Jeff Covelli RPh

Hometown Pharmacy MTM Coordinator

Jeffrey Covelli RPh

1995 BS Pharm University

of Pittsburgh

18 years with Hometown

Pharmacies

5 years serving dedicated

MTM Coordinator role

Hometown Pharmacy Company

Overview

16 Locations PPA/OPA Members

7 retail pharmacies in

Pennsylvania

7 retail pharmacies in Ohio

1 long term care pharmacy in

Ohio

1 Compounding/Specialty

pharmacy licensed in Pa/Ohio

Medication Synchronization Program

Benefits

Reasons Benefits

Workflow Control Time well spent, efficiency

Inventory Control Reduces inventory, shortens receivable

windows to wholesaler, “one-offs”

Payroll Control Maximize payroll dollars to match

heavy script volume days, outbound

calls to patients and doctors

Delivery Services One home delivery per month is goal

Clinical Services MTM, immunizations, patient cost-

analysis

Sample Work Week 1100 Script Per Week

Store

Pharmacy Metrics Part D/DIRMeasure Aetna CVS ESI Humana Optum

Adherence

RASA85% 75% 90% 82%-92%

Adherence

Statins85% 75% 90% 80%-90%

Adherence

Diabetes85% 75% 90% 80%-90%

Generic

Dispense

Rate

$0.11

$6.88

$11.8

8

CMR

Complete

Rate

10% 10%

DIR Brand 3%-5% 3%-5% 8% 10%

DIR

GenericGER 5%-

8.5%

8% 10%

Disclaimer-PSAO Specific

Equipp Pharmacy Platform

Equipp Metrics Explained

RASA Adherence, Cholesterol Adherence, Diabetes

Adherence.

Adherence benchmark goals set by CMS/PQA

Patient has to be 80-100% adherent over 180 day measure

period. Any patient under 79.99% will show up as an

outlier. 144/180 days adherent is threshold

Work outlier reports monthly to get patient above 80%

adherence threshold

Medication synchronization drives all the above, helps

keep patients adherent, simplifies workflow, improves

inventory management, impacts bottom line

Outliers

CVS/Aetna Performance Report #1

79% performance score pays at 4.8% brand rate Aetna

97% performance score pays at 3.0% brand rate Aetna

79% performance score pays at 6.2% brand rate CVS

97% performance score pays at 5.2% brand rate CVS

Aetna generic rate GER


83% score CVS takes 7.7% on generics

92% score CVS takes 6.7% on generics

RAS Adherence 24%-32% weight

Statin Adherence 26%-38% weight

Refer back to Outliers, must meet 80%

adherence rate over rolling retro 180 days

This box represents outliers

RAS Statin

6/7 9/11

11/13 12/16

11/13 12/16

5/5 4/4

16/17 14/16

16/17 14/16


Diabetes Statin

Gap

CMR

Completion

Rate

Formulary

Compliance

Overall

Performance

4/6 603/637 79.33% Aetna

8/9 10/14 1/1 797/844 83.25% CVS

8/9 10/14 1/1 797/844 83.25%CVS

4/4 382/399 97.10%Aetna

6/6 6/7 1/1 803/816 92.72%CVS

6/6 6/7 1/1 803/816 92.72%CVS

Represents

Outliers

MTM Platforms Served YTD

7/30/19

MTM Vendor # Cases

Served Pa

2019 YTD

# Cases

Served Ohio

2019 YTD

$$ Revenue

Generated

2019

Strand Rx 269 0 $18,990

Mirixa 367 116 $8,530

Outcomes

MTM

655 3126 $80,447

Total 1291 3242 $107,967

Wrap Up

-Adherence drives metrics across all PBM’s

-MTM CMR completion rates account for 10% of

total performance scores CVS/Aetna

-Proper allocation of payroll dollars, controlling

inventory, completing clinical tasks drive the

bottom line

-Medication synchronization increases overall

efficiency of operations

-Questions?

Klingensmith’s and Patton Pharmacy

Med Sync

Robert L. Maher Jr., Pharm.D.

Director of Pharmacy ServicesMedication Synchronization use to be the dessert of

our Pharmacies and now it’s our vegetables!!

“Pharmacy Workflow

should revolve around

OUR patient’s pickup

date” -PioneerRx

Why Sync?

• Operational Efficiencies

• Stronger Relationships

• Improved Clinical Performance

• Increased Revenue

Workflow Schedule• Seven (7) days prior to pickup date:

o Patient shows up in Medication Sync Calls. Time to begin our “precheck” process.

• Three (3) days prior to pickup date*:o Run patient’s prescriptions from cycle fills

queue and begin filling in preparation for pickup.

• Two (2) days prior to pickup date:o Utilize Sync QA / Fill calendar to ensure

patient’s sync meds are ready (waiting for pickup)

oNotify patient that sync meds are ready (Call, Text, Automated call)

Monday Tuesday Wednesda

y

Thursday Friday Saturday &

Sunday

Complete

MedSync

Calls for next

Monday

Complete

MedSync

Calls for next

Tuesday

Complete

MedSync

Calls for next

Wednesday

Complete

MedSync

Calls for next

Thursday

Complete

MedSync

Calls for next

Friday

Complete

MedSync

Calls for next

Saturday &

Sunday

Run cycle fill

queue & fill

for Thursday

pickup

Run cycle fill

queue & fill

for Friday

pickup

Run cycle fill

queue & fill

for Saturday

& Sunday

pickup

Run cycle fill

queue & fill

for Monday

& Tuesday

pickup

Run cycle fill

queue & fill

for

Wednesday

pickup

Run cycle fill

queue & fill

for Thursday

pickup

Final check &

call for

Wednesday

pickup

Final check &

call for

Thursday

pickup

Final check &

call for

Friday

pickup

Final check &

call for

Saturday &

Sunday

pickup

Final check &

call for

Monday &

Tuesday

pickup

Final check &

call for

Tuesday &

Wednesday

pickup

Target Market

• High Risk Patientso Determined by Pharmac

Software algorithm

• Hospitalization risk

• Types of prescriptions

• Disease state

• Filling pattern

• Quantity of Prescriptions

Daily MedSync Tasks

Sync Comments

Medication Sync Call

• 7 Days prior to pickup

• Why?o Med changes / HOLD meds

o PRN meds this month?

o Vaccinations? New programs?

o Building trust

o Low stress work now to prevent higher stress situations later

Medication Sync Call

• Are all cycle: “Yes” due this month?

• Renewals sent?

• Discontinued old RXs?

• Double check sync comments?

• Add any new sync comments?

• Why?o Low stress work now to prevent higher stress work later.

Maximize your efficiency

Final Check (Quality Assurance)

• Goal is to get all patients to

100% ready (green)

• Why?o Patient only wants to make one trip

o Building trust (correct & on time)

How the Patient Benefits

• Simple

• Efficient

• Saves Time

• Keeps Patient Adherent

• Full Overview of Prescriptions

• Pharmacy – Patient Relationship

• Improved Clinical Services

“Include the patient in the conversation when

determining a sync date. Great way to educate the

patient on the MedSync process and let them know that

it may take some time to get all their meds aligned.”

Targeting The Prescribers

• Share the programo Medication Synchronization

• Share our missiono Adherence and Compliance

• Highlight Prescriber Benefitso Our pharmacy workflow aids the

prescribers office and our program

ensures the proper use of their patients

prescriber therapy.

Chronic Care Management in

the Community Pharmacy

Chronic Care Management

in the Community

Pharmacy• General Supervision (Billing of

Incident to)

• CCM is reimbursed from the

“Medical/Non-Pharmacy Spend”

not the 10%

“Medication/Pharmacy Spend”

• CCM services consist of least

20 minutes of clinical staff time

directed by a physician or other

QHP per calendars month with

meeting certain criteria

CCM in the Community Pharmacy

Do you have a Synchronization Program/Med Adherence ProgramAre you doing MTM?

Develop a Collaborative Practice Agreement with a PCP. Establishing billing and shared revenue agreement.

CCM Documentation• Adherence• Med

Approp/Safety• Effectiveness • Care Plan

(Outcome)


Questions?



Time to Breakout!

Documents

Medication Synchronization – The “Power House” of Clinical … · 2019-08-29 · •Enjoyed coffee on Pharmageddon •Extra 2018 fills for donut hole patients •Obtained new