Blue Cross & Blue Shield of Rhode Island Patient-Centered Pharmacy Program Awarded First Best Practices Prize by FAST Network®

(11.21.2017)
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PROVIDENCE, RI  – FAST Network, a Blue Cross Blue Shield Association initiative focused on government healthcare programs, has awarded Blue Cross & Blue Shield of Rhode Island (BCBSRI) with the first Best Practices Prize for BCBSRI’s Patient-Centered Pharmacy Program, which promotes improved medication practices by better integrating pharmacists into the healthcare delivery system. Since its launch in 2014, the program has created $15.9 million in total health care cost savings.

The FAST Network® Best Practices Prize recognizes Blue Plan innovations that improve quality and value for the members they serve in government business – Medicare Advantage and Medicaid.

“A pharmacist’s role today goes far beyond filling and dispensing medication and prescriptions,” said Beth Hebert-Silvia, BCBSRI’s managing director of pharmacy. “Pharmacists are a core part of the healthcare delivery team, collaborating with patients and providers around treatment plans that are often complex and require strict adherence. The Patient-Centered Pharmacy Program empowers pharmacists to identify and close gaps in care, improving patient health while creating a more streamlined care process.”

Rhode Island has a higher than average senior population, making pharmaceutical management an area of opportunity to increase patient engagement, lower costs, and improve transitions of care and health outcomes. BCBSRI developed the Patient-Centered Pharmacy Program as an interdisciplinary team approach – utilizing community pharmacists, telephonic pharmacists and pharmacists embedded in primary care offices, chiefly patient-centered medical homes (PCMHs). The program’s goal has been to optimize medication by addressing medication underuse, medication overuse, drug safety issues and cost effective alternative therapies. 

BCBSRI’s $15.9 million savings estimates are based on direct costs of reduced or avoided drug costs annualized and on indirect costs supported by an actuarial model estimating the cost of a medical intervention (i.e. hospitalization). PCMH pharmacists account for $11.7 million of the total.

Following the success of BCBSRI’s program, several Blue plans around the country have implemented similar programs, including BlueCross BlueShield of Western New York, Hawaii Medical Service Association and Regence BlueCross BlueShield. BCBSRI has also presented the Patient-Centered Pharmacy Program nationally at the Blue Cross Blue Shield National Summit, Prime Therapeutics Government Programs Symposium, Take Your Doc to the Hill, the Pharmacy Benefit Management Institute and the Academy of Managed Care Pharmacy Annual Meeting.

For more information about BCBSRI’s Medication Management Therapy Program, please visit https://www.bcbsri.com/medicare/medication-therapy-management-program-2018

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