In 2014, we created a patient-centered pharmacy program that was designed to support adding pharmacists into our largest PCMH groups and practices, as well as systems of care, to help our members safely and effectively manage their prescriptions – especially members who have complex health conditions. Under the terms of the program, BCBSRI has provided funding to several primary care offices during the last five years for them to hire pharmacists who then work in their offices. These pharmacists—there are 30 in all across the four major systems of care in Rhode Island, including 11 who are fully funded by BCBSRI—consult with our members and their care teams as necessary to provide medication management and ensure they’re taking their medications safely and appropriately.

This program is helping to make an impact on members’ lives by working closely with them—and their nursing home, doctors, and family, as necessary—to review medication appropriateness, support adherence, and make necessary changes that positively impact their health. This can include identifying drugs that were incorrectly dosed, restarting necessary drugs that were stopped, and providing critical drug education. The program is also helping to save money by avoiding unnecessary medical costs.

Because not all of our members are part of practices that have embedded pharmacists, our internal pharmacy team fills in the gaps with programs that provide important pharmacy services to a broader population of our members. These include patient outreach and engagement, and medication therapy management (MTM) programs in our network retail pharmacies, as well as at our Your Blue Store℠ locations, where team members hold weekly “office hours” for members to visit and receive one-on-one medication consultations. Our team also provides clinical insight and support for our Medicare Advantage members, in part by having a presence at more than 40 Medicare Annual Enrollment Period (AEP) meetings we hold throughout Rhode Island each fall.

Collectively, our pharmacy programs have achieved extraordinary results in terms of adherence, gaps in care, cost savings, and more. Some highlights from 2018 include:

• Increased medication adherence (diabetes, hypertension, cholesterol, and depression)
• Total cost savings of about $14 million
• More than 6,700 prescription orders modified
• More than 800 hospital admissions avoided

To learn more about the great work of our pharmacy programs team, or to refer a member who you think would benefit from the program, you can contact the team directly at Pharmacy.Programs@bcbsri.org or (401) 459-1750. This is another great example of how we’re partnering with our provider community to improve our members’ health…thank you as always for your support.