Blue Cross & Blue Shield of Rhode Island Launches Innovative On-Site Pharmacist Program

(10.29.2014)
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Blue Cross & Blue Shield of Rhode Island (BCBSRI) today announced the expansion of a new program that brings pharmacists into primary care offices to provide one-on-one medication consultation and support to physicians and patients. The program’s pilot improved healthcare outcomes for patients with access to these specialized pharmacy consultations, and also led to lower overall healthcare costs. 
 
The expanded program builds on a successful pilot at Coastal Medical of Rhode Island. The expanded program will reach more than 71,000 patients at six Patient Centered Medical Home (PCMH) practices across the state, including Medicare Advantage members and select members aged 60 and over. The practices participating are Medical Associates of Rhode Island, University Medicine, Anchor Medical, Rhode Island Primary Care Physicians Corporation (RIPCPC), Coastal Medical, and South County Health System. A PCMH practice takes a team-based approach to primary care, providing a more holistic experience for patients by improving communication between the physicians, nurse practitioners and specialists who interact with each patient.  
 
“We are very excited about this program and believe it can have a very real impact for our patients,” said Tara Higgins, Clinical Pharmacy Director, RIPCPC. “The presence of a dedicated pharmacist in this role will enhance the strong practices we have in place to manage and monitor our patients’ medication. In addition, it will give patients confidence and increase our focus on effective use and periodic review of all of their pharmaceutical therapies.”
 
BCBSRI will assist with funding for either a full- or part-time on-site pharmacist, dependent upon the size of the practice and its number of Medicare Advantage patients. The pharmacist collaborates with the practice’s physician leadership to conduct comprehensive and targeted patient medication reviews. Patients with complex medication management needs may also meet with the pharmacist to review their entire medication profile. 
 
“Our primary goal is to improve the health and well-being of our members,” said Mark Waggoner, Senior Vice President, Care Integration & Management, BCBSRI. “Prescription drugs play a very significant role in many Medicare Advantage patients’ lives, and BCBSRI recognized an opportunity to enable pharmacists and primary care physicians to work more closely together.  Our research indicates that this program will improve outcomes for patients, and we remain committed to innovating – through programs like this one – to improve healthcare.”
 
Together, the pharmacist and patients discuss how to correctly administer medications, which ones are most appropriate for their needs, and which medications can be switched to generics. The pharmacist also focuses on safe transitions in care, such as when a patient receives a prescription from a non-primary care physician as part of a hospital stay or outpatient visit, which helps limit the risk of unnecessary, duplicative or conflicting medication therapies. 
 
Pharmacists participating in the program also collaborate with providers to increase the use of generic drugs by educating physicians about generic alternatives or more cost-effective therapeutic substitutions. In the pilot, these efforts, combined with efforts to improve medication management and transitions in care, accounted for a substantial decrease in pharmaceutical drug spending.
 
While the initial program focuses on Medicare Advantage patients and select members aged 60 and over, BCBSRI will continue to evaluate and expand the effort to include other high-risk patient populations with multiple medication needs.
 
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