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JAPhA: Medicare annual wellness visits spell opportunities for pharmacists

BY Antoinette Alexander

WASHINGTON — Medicare’s Annual Wellness Visits present potential opportunities for pharmacists based in physician offices, concluded two experience articles published in the July/August 2014 edition of the Journal of the American Pharmacists Association.

The two articles and a related editorial explore the financial and logistical challenges associated with a pharmacist-led AWVs developed and delivered within a physician’s office.

AWVs are an underutilized benefit of Medicare, APhA noted. They are cost- and copayment-free services that keep patients healthy and well. AWV providers must assess medical and family history, risk factors, routine measurements and vital signs, as well as provide yearly immunizations, a complete medication review and cognitive impairment and depression screenings.

The viewpoint article “Medicare Annual Wellness Visits: Patient need and pharmacist patient care services intersect” by Pamela Heaton stated. “Our older patients need the preventive care provided through AWVs, pharmacists are uniquely qualified for providing medication management and other health-and-wellness services, a reimbursement mechanism is available, and we have an ample — and growing — supply of pharmacists. We must play an important role in filling this gap and should now step boldly into this currently available space.”

An analysis of the first experience article, “Development and implementation of a pharmacist-delivered Medicare annual wellness visit at a family practice office,” by M. Thomas and J. Goode, stated, “As the pharmacy profession's role in health care continues to evolve, more responsibilities in primary patient care services are being assumed by pharmacists. However, this growth has been inhibited by minimal cognitive service compensation by payers. AWVs present a new opportunity for pharmacists to provide a financially viable patient care service that is covered for Medicare beneficiaries through the Affordable Care Act. Pharmacists can successfully be integrated into the healthcare team to provide AWVs and thereby enhance the health and wellness of Medicare patients.”

An analysis of the second experience article, “Financial implications of pharmacist-led Medicare annual wellness visits,” by I. Park, et al, stated, “Pharmacists are not currently recognized as healthcare providers under the Social Security Act, which limits reimbursement potential and impedes the ability to establish outpatient clinical pharmacy services. The Affordable Care Act of 2010 presents a unique opportunity for higher reimbursement than that traditionally available via AWVs. By conducting wellness visits, pharmacists can be both valuable assets to the primary care team in practices of varying sizes and generators of revenue to support their positions.”

These experiences conclude that the challenge in expanding this type of service will be in providing a reimbursement mechanism that will enable pharmacists in any setting to develop relationships with primary care providers and offer AWVs. To enable this possibility, pharmacists need be recognized as providers by the federal and state governments and by private payers, APhA stated.

The full-text articles are available on the Journal’s website at JAPhA.org.

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Walgreens outlines new operational leadership structure

BY Michael Johnsen

DEERFIELD, Ill. — Following Walgreens' announcement last week about taking the next step in acquiring Alliance Boots, Alex Gourlay, EVP Walgreens Boots Alliance and president of Walgreens, announced a proposed operational organization structure in a letter to Walgreens employees. 
 
Mark Wagner, currently president of community management and store operations, will take on a new role as president of business operations. In this new role, Mark will be responsible for creating a customer-focused organization that supports Walgreens' stores, eliminates waste and simplifies the work flow.
 
Brad Fluegel, currently SVP and chief strategy officer, will become SVP chief strategy and business development officer. He will continue to lead strategy for Walgreens and expand his responsibilities to include developing and implementing Walgreens' healthcare clinic, clinical office and healthcare innovation strategies.
 
And Richard Ashworth will be returning from Alliance Boots in a new role as president of retail and pharmacy operations. He will assume responsibility for the field organization to implement a single customer plan and deliver customer care through Walgreens' community locations.
 
Sona Chawla, president and digital and chief marketing officer, will continue in that role.
 
"I will continue to lead our merchandising team while we search for a new leader for the daily living organization," Gourlay wrote. "All of these proposed new roles and titles are subject to approval by the board of directors and will be effective as of Sept. 1," he said. 
 
"I look forward to bringing together this talented team and continuing to work with Greg [Wasson] and the rest of our business partners across Walgreens," Gourlay added. "Looking to the future, we need to stay focused on our customers and patients because that’s what has made Walgreens the great business and brand that it is today. To continue to move forward, we will need to call on the company’s historic strengths — pharmacy-led, customer-driven, with a commitment to each other and a focus on care and service."
 
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FDA approves Belsomra tabs

BY Ryan Chavis

SILVER SPRING, Md. — The Food and Drug Administration has announced approval for Belsomra (suvorexant) tablets, which are used to treat insomnia. The drug works by altering the signaling of orexin in the brain. Orexins are chemicals involved in regulating the sleep-wake cycle and play a role in keeping people awake, the agency stated.

“To assist healthcare professionals and patients in finding the best dose to treat each individual patient’s sleeplessness, the FDA has approved Belsomra in four different strengths — 5, 10, 15 and 20 mg,” said Ellis Unger, M.D., director of the Office of Drug Evaluation I in the FDA’s Center for Drug Evaluation and Research. “Using the lowest effective dose can reduce the risk of side effects, such as next-morning drowsiness.”

The drug should only be taken no more than once a night, within 30 minutes of going to bed. The total dose shouldn't exceed 20 mg once daily. Belsomra is produced by Merck, Sharpe & Dohme Corp.

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