CPF FUNDED GRANT DETAILS

This project expands on previous CPF grant 117 where we interviewed primary care physicians, consumers, and a limited number of payers on the use of a shared pharmacists network to provide medication management services MMS.In the past two years, the healthcare payment reform landscape has radically changed: the risk for care quality and cost savings is moving toward provider groups rather than with payers, some payers are recognizing that medical and pharmacy benefits should be more integrated in risk-based contracts with providers, and pharmacists are interested in providing community-based MMS with primary care practices and in community pharmacies as payers design value-based health plans. However, community-based pharmacist MMS are not usually included in new health plan design discussions. We will conduct focus groups with community-based pharmacist leaders, structured interviews with payer leaders from major national health plans, and key informant interviews with primary care clinicians offering community-based MMS. The objectives are to: 1-learn how payers evaluate MMS as a new or expanded benefit in value-based health plans,2-understand the facilitators and barriers to implementing community-based MMS at the primary care practice and community pharmacy level, and 3-develop strategies for incorporating community-based MMS in value-based health plan designs.