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Journal of Pharmacy Practice Dec 2022Pharmacists are increasingly fulfilling roles on primary care teams, yet business models for pharmacist services in these settings have not been optimized. This study...
BACKGROUND
Pharmacists are increasingly fulfilling roles on primary care teams, yet business models for pharmacist services in these settings have not been optimized. This study describes how an ambulatory care pharmacy department implemented various billing methods to generate revenue for pharmacist services.
OBJECTIVES
(1) Describe pharmacist-delivered billable and non-billable services; and (2) Assess the impact of various billing methods on the return-on-investment (ROI) for billable services.
METHODS
This study was conducted from September 2016 to August 2017 in Virginia. Pharmacist time spent performing billable encounters using current procedural technology (CPT) codes (e.g., incident-to a physician, annual wellness visits) was calculated. Encounters eligible for the hospital-based facility (G0463) and chronic care management (CCM) codes were considered to be potentially billable services. The ROI was calculated for billable and potentially billable services.
RESULTS
A total of 948.3 hours (0.46 full-time equivalents (FTE)), 17% of all clinical services, were billed using CPT codes. This resulted in a total revenue of $173,638.66. Missed revenue from not billing for the G0463 and CCM codes was $68,268.37. The cost of pharmacist services for 0.46 FTE was $78,613.08, resulting in a ROI for billed pharmacist services of 1.2:1. The ROI increased to 1.6:1 when considering potentially billable services.
CONCLUSION
It is feasible to have a positive ROI for billable pharmacist services. To achieve a sustainable business model, there must be a high volume of billable services. G0463 and CCM codes are often underutilized, yet represent significant opportunities in revenue for pharmacist services and should be pursued.
Topics: Humans; Pharmacists; Pharmaceutical Services; Pharmacies; Ambulatory Care; Primary Health Care
PubMed: 34036819
DOI: 10.1177/08971900211013194 -
BMC Health Services Research Sep 2021Slums or informal settlements characterize most large cities in LMIC. Previous evidence suggests pharmacies may be the most frequently used source of primary care in...
BACKGROUND
Slums or informal settlements characterize most large cities in LMIC. Previous evidence suggests pharmacies may be the most frequently used source of primary care in LMICs but that pharmacy services are of variable quality. However, evidence on pharmacy use and availability is very limited for slum populations.
METHODS
We conducted household, individual, and healthcare provider surveys and qualitative observations on pharmacies and pharmacy use in seven slum sites in four countries (Nigeria, Kenya, Pakistan, and Bangladesh). All pharmacies and up to 1200 households in each site were sampled. Adults and children were surveyed about their use of healthcare services and pharmacies were observed and their services, equipment, and stock documented.
RESULTS
We completed 7692 household and 7451 individual adults, 2633 individual child surveys, and 157 surveys of pharmacies located within the seven sites. Visit rates to pharmacies and drug sellers varied from 0.1 (Nigeria) to 3.0 (Bangladesh) visits per person-year, almost all of which were for new conditions. We found highly variable conditions in what constituted a "pharmacy" across the sites and most pharmacies did not employ a qualified pharmacist. Analgesics and antibiotics were widely available but other categories of medications, particularly those for chronic illness were often not available anywhere. The majority of pharmacies lacked basic equipment such as a thermometer and weighing scales.
CONCLUSIONS
Pharmacies are locally and widely available to residents of slums. However, the conditions of the facilities and availability of medicines were poor and prices relatively high. Pharmacies may represent a large untapped resource to improving access to primary care for the urban poor.
Topics: Adult; Child; Cross-Sectional Studies; Health Facilities; Humans; Pharmaceutical Services; Pharmacies; Retrospective Studies
PubMed: 34503501
DOI: 10.1186/s12913-021-06937-9 -
The International Journal of Pharmacy... Sep 2023
Topics: Humans; Artificial Intelligence; Pharmacies; Technology
PubMed: 37738634
DOI: 10.1093/ijpp/riad065 -
Einstein (Sao Paulo, Brazil) 2016To describe indicators and processes developed and implemented for pharmaceutical assistance at the Einstein Program at Paraisópolis Community pharmacy.
OBJECTIVES:
To describe indicators and processes developed and implemented for pharmaceutical assistance at the Einstein Program at Paraisópolis Community pharmacy.
METHODS:
This was a descriptive study of retrospective data from January 2012 to December 2015. Data were obtained from spreadsheets developed for monitoring the productivity and care quality provided at the pharmacy. The evaluated variables were pharmaceutical assistance to prescription, pharmaceutical intervention, orientation (standard and pharmaceutical) and pharmaceutical orientation rate.
RESULTS:
The pharmacy assisted, on average, 2,308 prescriptions monthly, dispensing 4,871 items, including medications, materials and food supplements. Since March 2015, virtually, the pharmacist analyzed all prescriptions, prior to dispensing. In the analyzed period, there was an increase in monthly pharmaceutical interventions from 7 to 32 on average, and, although there was a decrease in the number of standard orientation, the pharmaceutical orientation had an increase, causing a rise of pharmaceutical orientation rate from 4 to 11%.
CONCLUSION:
The processes developed and implemented at the program pharmacy sought to follow the good pharmacy practice, and help patients to make the best use of their medications.
OBJETIVO:
Descrever os indicadores e os processos desenvolvidos e implantados para assistência farmacêutica na farmácia do Programa Einstein na Comunidade de Paraisópolis.
MÉTODOS:
Tratase de um estudo descritivo de dados retrospectivos de janeiro de 2012 a dezembro de 2015. Os dados foram obtidos de planilhas desenvolvidas para acompanhamento da produtividade e da qualidade de assistência prestada na farmácia. As variáveis avaliadas foram: atenção farmacêutica à prescrição, intervenção farmacêutica, orientação (padrão e farmacêutica) e taxa de orientação farmacêutica.
RESULTADOS:
A farmácia atendeu, em média, 2.308 prescrições ao mês, dispensando 4.871 itens, incluindo medicamentos, materiais e suplementos alimentares. Desde março de 2015, praticamente todas as prescrições foram analisadas pelo farmacêutico antes da dispensação. Houve incremento nas intervenções farmacêuticas mensais, de 7 para 32 em média e, apesar de ter havido diminuição no número de orientações padrão, a orientação farmacêutica aumentou, fazendo com que a taxa de orientação subisse de 4 para 11%.
CONCLUSÃO:
Os indicadores e os processos desenvolvidos e implantados na farmácia do programa procuraram seguir as boas práticas de farmácia e ajudar os pacientes a fazerem melhor uso de seus medicamentos.
Topics: Brazil; Cross-Sectional Studies; Humans; Pharmaceutical Services; Pharmacies; Quality of Health Care; Retrospective Studies
PubMed: 27759833
DOI: 10.1590/S1679-45082016GS3751 -
Contraception Apr 2019This study describes hormonal contraception services provided by pharmacists and characterizes patient populations utilizing the service at one supermarket-based...
OBJECTIVES
This study describes hormonal contraception services provided by pharmacists and characterizes patient populations utilizing the service at one supermarket-based pharmacy chain in California and Oregon.
STUDY DESIGN
This is a descriptive study of 391 pharmacies in California and Oregon within a supermarket-based pharmacy chain providing hormonal contraception services and the patients who utilized those services in a 6.5-month period between August 2016 and February 2017. Data were extracted from pharmacy prescription records and available visit documentation forms to describe services provided and patient characteristics.
RESULTS
During the study period, 381 trained pharmacists from the pharmacy chain provided hormonal contraception services in 391 pharmacy locations in Oregon and California. A total of 2117 visits were completed and 1970 hormonal contraception prescriptions were issued and dispensed during the study period. Researchers were able to access documentation for 676 visits (32%). Patients from various age groups (range 13-55 years old) and geographical locations (22 states total) utilized the service. Most had health insurance (74%), had seen a primary care provider in the past year (89%) and were previous hormonal contraception users (91%). Contraceptive methods prescribed include pill (n=1886, 95.7%), patch (n=31, 1.6%), vaginal ring (n=51, 2.6%) and injectable (n=2, 0.1%).
CONCLUSION
Following scope of practice expansion, pharmacists in a community-based pharmacy setting are serving as an access point for women to obtain hormonal contraception services and supplies.
IMPLICATIONS
This study provides an initial look at California's and Oregon's expansion of hormonal contraception prescribing authority to pharmacists. The service was available across all pharmacy locations of a supermarket-based chain in California and select locations in Oregon and utilized by diverse populations of patients. Pharmacists effectively provided hormonal contraception services and supplies to most patients seeking hormonal contraception.
Topics: Adolescent; Adult; California; Drug Prescriptions; Female; Hormonal Contraception; Humans; Middle Aged; Oregon; Pharmacies; Young Adult
PubMed: 30562478
DOI: 10.1016/j.contraception.2018.12.002 -
Journal of Community Health Nursing 2019Access to medications is a critical determinant of health which often mediates the effects of diseases and leads to healthier lifestyles. With limited access to...
Access to medications is a critical determinant of health which often mediates the effects of diseases and leads to healthier lifestyles. With limited access to pharmacies, neighborhoods become pharmacy deserts. The purpose of this study was to explore the medication needs and perceptions of low-income community residents. A purposive sample of 40 low-income community residents participated in focus groups. Content analysis revealed four themes: transitioning to the present, stereotyping, feelings of disconnectedness, and ideal pharmacy. These findings reiterate the difficulties of living in pharmacy deserts, and decrease the gaps of limited qualitative research in this area.
Topics: Aged; Female; Focus Groups; Health Services Accessibility; Health Services Needs and Demand; Humans; Male; Medically Underserved Area; Middle Aged; Minority Groups; Pharmacies; Poverty; Prescription Drugs; Residence Characteristics; Tennessee; Urban Population
PubMed: 30990746
DOI: 10.1080/07370016.2019.1583852 -
Journal of the American Pharmacists... 2024In 2018, the Centers for Disease Control and Prevention (CDC)'s Division of Diabetes Translation (DDT) initiated a 5-year cooperative agreement funding opportunity with...
BACKGROUND
In 2018, the Centers for Disease Control and Prevention (CDC)'s Division of Diabetes Translation (DDT) initiated a 5-year cooperative agreement funding opportunity with departments of health in every state and the District of Columbia. The funded recipients pursued activities that strengthened diabetes management and type 2 diabetes prevention interventions within their jurisdictions. An option to involve the pharmacy sector in their diabetes-related interventions was available.
OBJECTIVES
This research aims to understand who public health departments partnered with in the pharmacy sector and identify the types of activities pursued together to expand access to diabetes-related interventions.
METHODS
A review of annual work plans and progress reports submitted to CDC by recipients during the first 4 years of the funding cycle was conducted. Descriptions of work conducted in partnership with pharmacies, pharmacists, or pharmacy organizations were flagged for review, coding, and analysis.
RESULTS
Of the 51 public health department recipients, 48 collaborated with pharmacy partners within their jurisdictions. Activities were developed and carried out in ways that utilized the pharmacy workforce to support public health diabetes initiatives, such as the development and delivery of diabetes self-management education and support and type 2 diabetes prevention programs in pharmacies (68.8%), delivery of diabetes-related training for the pharmacy workforce (91.7%), and support of billing and sustainability efforts for pharmacy-based diabetes services (52.1%).
CONCLUSION
State public health department diabetes program personnel cultivated productive relationships with a variety of members of the pharmacy workforce. Through these partnerships, they leveraged one another's resources, expertise, and mutual determination to prepare and carry out diabetes-related interventions within their states. This document provides pharmacists and pharmacy decision-makers with foundational knowledge that can lead to increased engagement with public health partners to expand diabetes management and prevention services in pharmacy settings.
Topics: Humans; Diabetes Mellitus, Type 2; Pharmacists; United States; Public Health; Centers for Disease Control and Prevention, U.S.; Professional Role; Pharmacies; State Government; Cooperative Behavior
PubMed: 38417741
DOI: 10.1016/j.japh.2024.102057 -
International Journal of Pharmaceutical... 2018The terms certification, accreditation, and credentialing are often used interchangeably when they apply to compounding-pharmacy qualifications, but they are not...
The terms certification, accreditation, and credentialing are often used interchangeably when they apply to compounding-pharmacy qualifications, but they are not synonymous. The reasons for obtaining each, the requirements for each, and the benefits of each differ. Achieving such distinctions can negatively or positively affect the status of a pharmacy among peers and prescribers as well as a pharmacy's relationships with third-party payors. Changes in the third-party payor industry evolve constantly and, we suggest, will continue to do so. Compounding pharmacists must be aware of those changes to help ensure success in a highly competitive marketplace. To our knowledge at the time of this writing, there is no certification program for compounding pharmacists, although pharmacy technicians can achieve certification and may be required to do so by the state in which they practice (a topic beyond the scope of this article). For that reason, we primarily address accreditation and credentialing for 503A compounding pharmacies. In this article, the evolution of the third-party payment system for compounds is reviewed; the definitions of certification, accreditation, and credentialing are examined; and the benefits and recognition of obtaining accredited or credentialed status are discussed. Suggestions for selecting an appropriate agency that offers accreditation or credentialing, preparing for and undergoing an onsite survey, responding to findings, and maintaining a pharmacy practice that enables a successful survey outcome are presented. The personal experience of author CK during accreditation and credentialing is discussed, as is the role of a consultant (author BJ) in helping compounders prepare for the survey process. A list of agencies that offer accreditation and credentialing for compounding pharmacies is included for easy reference.
Topics: Accreditation; Certification; Credentialing; Drug Compounding; Insurance, Health, Reimbursement; Pharmaceutical Services; Pharmacies; Pharmacists
PubMed: 29385381
DOI: No ID Found -
BMJ Sexual & Reproductive Health Jan 2021
Topics: Adolescent; Contraception Behavior; Contraceptive Agents; Developing Countries; Family Planning Services; Female; Humans; Male; Pharmacies; Quality of Health Care; Self Care; Young Adult
PubMed: 32788181
DOI: 10.1136/bmjsrh-2020-200641 -
Journal of the American Pharmacists... 2024According to a standing order in North Carolina (NC), naloxone can be purchased without a provider prescription.
BACKGROUND
According to a standing order in North Carolina (NC), naloxone can be purchased without a provider prescription.
OBJECTIVE
The objective of this study is to examine whether same-day naloxone accessibility and cost vary by pharmacy type and rurality in NC.
METHODS
A cross-sectional telephone audit of 202 NC community pharmacies stratified by pharmacy type and county of origin was conducted in March and April 2023. Trained "secret shoppers" enacted a standardized script and recorded whether naloxone was available and its cost. We examined the relationship between out-of-pocket naloxone cost, pharmacy type, and rurality.
RESULTS
Naloxone could be purchased in 53% of the pharmacies contacted; 26% incorrectly noting that naloxone could be filled only with a provider prescription and 21% did not sell naloxone. Naloxone availability by standing order was statistically different by pharmacy type (chain/independent) (χ = 20.58, df = 4, P value < 0.001), with a higher frequency of willingness to dispense according to the standing order by chain pharmacies in comparison to independent pharmacies. The average quoted cost for naloxone nasal spray at chain pharmacies was $84.69; the cost was significantly more ($113.54; P < 0.001) at independent pharmacies. Naloxone cost did not significantly differ by pharmacy rurality (F, = 2.38, P = 0.10).
CONCLUSION
Approximately half of NC community pharmacies audited dispense naloxone according to the statewide standing order, limiting same-day access to this life-saving medication. Costs were higher at independent pharmacies, which could be due to store-level policies. Future studies should further investigate these cost differences, especially as intranasal naloxone transitions from a prescription only to over-the-counter product.
Topics: Naloxone; North Carolina; Humans; Cross-Sectional Studies; Narcotic Antagonists; Health Services Accessibility; Community Pharmacy Services; Standing Orders; Pharmacies
PubMed: 38307248
DOI: 10.1016/j.japh.2024.01.017