The Use of Clinical Pharmacists in Primary Care Practices

PROJECT SUMMARY

CMS's MIPS/MACRA programs continue to force healthcare providers to document and prove their focus on performance improvement, cost effectiveness, and clinical and quality outcomes. While worthwhile and noble; the operations, data collection, and implementation of these programs can negatively affect already overburdened physicians and practices. Furthermore, non-compliance can significantly decrease revenues. To address these requirements, practices need a solution that not only satisfies CMS's requirements but also contributes to the bottom line and advances care.

There is a growing body of literature stating that clinical pharmacists may help address the needs of practices and physicians to document clinical quality, perform medication reconciliations and drug utilization reviews, and promote evidence based medical therapy. This ultimately decreases adverse events and achieves goals of therapy. As members of the care team, clinical pharmacists can support the level of care that physicians provide to patients. The largest barrier for pharmacists to consistently provide direct patient care in outpatient settings is the lack of being recognized as a “healthcare provider”, like Nurse Practitioners or Physician Assistants, by CMS. However, given that they are CMS recognized them as “healthcare professionals,” pharmacists can independently provide Annual Wellness Visits, provided that they are practicing under direct supervision, are licensed in their state, and working within their scope of practice. As part of the care team providing direct patient care, pharmacists are able to close care gaps and pay for themselves, therefore expanding the practice's overall capacity. This business plan will explore the use of clinical pharmacists in practices to meet both clinical quality and financial goals while reducing physician burden.