How the pharmacist fits into the value-based care model

As many as half of patients don’t take medications correctly, and more than a quarter of prescriptions are never filled at all. That’s a big deal given that adverse drug events are the leading cause of hospital readmissions.

But physicians have almost no visibility into what happens after they write a prescription making it nearly impossible for them to improve these dismal drug adherence numbers.

Enter pharmacists. When integrated into value-based care teams, pharmacists can provide on-the-ground patient counseling, identify root causes of non-adherence, and communicate upstream to providers about changes likely to improve outcomes.

The result: better health, fewer hospitalizations, increased adherence, and cost savings for everyone involved. Here’s a closer look at three ways pharmacists can make it easier for physicians to practice value-based care.

1. Pharmacists stay connected to patients to minimize hospitalizations

Adverse drug events cause over 1 million emergency room visits each year – and more than a quarter of these patients require hospitalization for treatment. By proactively reviewing patients’ care plans and reaching out to at-risk patients to discuss medication adherence, pharmacists can help patients avoid these adverse reactions and thus prevent hospitalizations.

Those conversations lead to other long-term health benefits, too, in a sort of virtuous circle.

By having regular contact with patients, pharmacists can consider the context of patients’ lives when developing protocols or coordinating medication profiles and recommend solutions that reflect a patient’s unique circumstances.

With their medication regimen optimized, the patient doesn’t have to worry about missing a dose and risking hospitalization because of medication mismanagement or the health declines that can come from it.

2. Pharmacists provide continuity during care transitions

Transitioning patient care – especially following hospitalization – is a complex process. Pharmacists can act as an advocate for patients by reconciling the differences between care plans and offering their expertise to help patients understand their medications.

And, helping patients understand their healthcare is key to keeping them healthy and out of the hospital.

It’s a matter of advocacy. While hospitalized, patients may forget – or not have the chance – to mention a prescription or over-the-counter medication they regularly take. And, if it’s an emergency visit, they’re unlikely to see a doctor familiar with their personal and medical history.

Pharmacists have the knowledge and tools necessary to recognize and prevent potential interactions between a patient’s old and new medications. Part of this prevention: direct conversations with patients that empower them to understand how to incorporate new prescriptions into their existing regimen and lifestyle to prevent future hospitalization.

Pain medication, for example, may be a temporary addition to a patient’s regimen. But, opioids can have side effects that impair memory – possibly causing issues with managing other prescriptions – and patients may worry about the possibility of addiction.

With a pharmacist’s guidance, patients can rest assured that their medications are administered on a schedule that helps them stay well during and after their prescribed treatment.

3. Pharmacists use their knowledge to lower costs

In a value-based healthcare setting, physicians get compensated for positive health outcomes. So, how can practitioners consistently offer better outcomes?

Again, pharmacists hold the answer.

Better health outcomes are more likely when patients take medications as prescribed. And, patients are more likely to take medications as prescribed when they can afford their prescriptions.

Pharmacists can also recognize a missed opportunity to prescribe generic medications. They also know which biologics are about to become generics, helping patients find cheaper options for the most specialized medications.

These recommendations can save patients money every time they fill a prescription. And importantly, they help everyone in the healthcare system – from patient to provider to insurer – save money by decreasing how often patients discontinue their medication.

That leads to better outcomes, including fewer adverse reactions and hospitalizations, which also helps keep costs down.

Pharmacists help manage the mental and financial costs of ongoing care

Drug costs are rising at a rate outpacing inflation. With inflation at 40-year highs, that’s scary. Patients struggling to afford healthcare may be tempted to skip doses of their medications or even forgo them altogether.

Pharmacists integrated in value-based care teams can help patients ease the financial and mental stresses that come from managing prescriptions. And, they can help physicians practicing value-based care trust that their patient-centered plans result in the best outcomes possible.

Contact us to learn how a value-based pharmacist can help you.

The content in this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment provided by a qualified physician. Always seek the advice of your physician or other qualified health provider before making any changes to your healthcare plan.

Kristen Engelen, PharmD
Kristen Engelen, PharmD, is the chief pharmacy officer of RxLive and a certified consultant pharmacist; she has over a decade of experience in retail pharmacy settings. Kristen became an RxLive co-founder because of her passion for geriatric pharmacy, with a focus on the intersection of pharmacy and aging.