PMID- 36860179
OWN - NLM
STAT- MEDLINE
DCOM- 20231127
LR  - 20231128
IS  - 1535-2900 (Electronic)
IS  - 1079-2082 (Linking)
VI  - 80
IP  - Suppl 4
DP  - 2023 Nov 23
TI  - Impact of pharmacist-provided Medicare annual wellness visits and chronic care 
      management on reimbursement and quality measures in a privately owned family 
      medicine clinic.
PG  - S143-S150
LID - 10.1093/ajhp/zxad046 [doi]
AB  - PURPOSE: Improvement in patient outcomes from collaboration between pharmacists 
      and physicians in ambulatory clinics has been well documented. Barriers to 
      payment have made widespread growth of these collaborations slow. Medicare annual 
      wellness visits (AWVs) and chronic care management (CCM) provide an opportunity 
      for pharmacist-physician collaborations that are directly revenue generating. The 
      objective of this study was to evaluate the impact of pharmacist-led AWVs and CCM 
      on reimbursement and quality measures in a private family medicine clinic. 
      METHODS: This was a retrospective observational study in which the rate of 
      reimbursement for AWVs and CCM was compared before and after implementation of 
      pharmacist-provided services. Claims data were reviewed for Current Procedural 
      Terminology codes and reimbursement applicable to AWVs and CCM. Secondary 
      outcomes included the total number of AWV and CCM appointments, Healthcare 
      Effectiveness Data and Information Set (HEDIS) measure completion rates, and 
      average change in quality ratings. Outcomes were analyzed utilizing descriptive 
      statistics. RESULTS: Reimbursement from AWVs increased by $25,807.21 in 2018 and 
      $26,410.01 in 2019 compared to 2017. Reimbursement from CCM increased by 
      $16,664.29 in 2018 and $5,698.85 in 2019. In 2017, 228 AWVs and 5 CCM encounters 
      were completed. After implementation of pharmacist services, the number of CCM 
      encounters increased to 362 in 2018 and 152 in 2019 and the number of AWVs 
      totaled 236 and 267, respectively. Completed HEDIS measures and star ratings 
      increased during the study. CONCLUSION: Pharmacist provision of AWVs and CCM 
      addressed a gap in care by increasing the number of patients who received these 
      services while also increasing reimbursement in a privately owned family medicine 
      clinic.
CI  - (c) American Society of Health-System Pharmacists 2023. All rights reserved. For 
      permissions, please e-mail: journals.permissions@oup.com.
FAU - Mack, Keri
AU  - Mack K
AD  - Department of Pharmacy Practice, Palm Beach Atlantic University, West Palm Beach, 
      FL, USA.
FAU - Henneman, Amy
AU  - Henneman A
AD  - Department of Pharmacy Practice, Belmont University, Nashville, TN, USA.
FAU - Snyder, Tara
AU  - Snyder T
AD  - Novo Nordisk, Plainsboro, NJ, USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Am J Health Syst Pharm
JT  - American journal of health-system pharmacy : AJHP : official journal of the 
      American Society of Health-System Pharmacists
JID - 9503023
SB  - IM
MH  - Humans
MH  - United States
MH  - Aged
MH  - *Pharmacists
MH  - *Medicare
MH  - Family Practice
MH  - Quality Indicators, Health Care
MH  - Professional Role
OTO - NOTNLM
OT  - Medicare annual wellness visit
OT  - ambulatory care
OT  - chronic care management
OT  - primary care
EDAT- 2023/03/03 06:00
MHDA- 2023/11/27 12:41
CRDT- 2023/03/02 01:53
PHST- 2023/11/27 12:41 [medline]
PHST- 2023/03/03 06:00 [pubmed]
PHST- 2023/03/02 01:53 [entrez]
AID - 7067063 [pii]
AID - 10.1093/ajhp/zxad046 [doi]
PST - ppublish
SO  - Am J Health Syst Pharm. 2023 Nov 23;80(Suppl 4):S143-S150. doi: 
      10.1093/ajhp/zxad046.