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JEREMY THOMAS, PHARM.D., CDE, is Assistant Professor, Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock; at the time of writing he was Assistant Professor, Department of Clinical Pharmacy, University of Tennessee Health Science Center, Memphis. MICHELLE M. ZINGONE, PHARM.D., BCPS, CDE, is Assistant Professor, Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee (UT), Knoxville. JENNIFER SMITH is Pharm.D. candidate, UT, Memphis. CHRISTA M. GEORGE, PHARM.D., BCPS, CDE, is Assistant Professor, Department of Clinical Pharmacy, College of Pharmacy, UT, Memphis.

Address correspondence to Dr. Zingone at the Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 1924 Alcoa Highway, Box 117, Knoxville, TN 37920 (mzingone{at}utmem.edu).

Purpose. The feasibility of contracting for medication therapy management (MTM) services in a physician’s office was studied. Methods. Patient records from January to June 2007 were reviewed at a university-based family medicine clinic to identify patients eligible for MTM services. Inclusion criteria included a minimum of six long-term medications and three chronic diseases. If eligible for MTM services, the patient’s primary pharmacy was contacted to determine in which Medicare prescription drug plan (MPDP) the patient was enrolled. Each MPDP was then contacted to establish a contract for compensation for face-to-face encounters by a pharmacist. Data were analyzed using descriptive statistics. Results. A total of 832 patients with Medicare Part B coverage were identified, and 404 charts were randomly selected for review. Of the 404 charts reviewed, 208 patients met the inclusion criteria. MPDP information was obtained for 185 patients. Patients were taking a mean ± S.D. of 8.6 ± 2.4 medications. Patients’ most common diseases included hypertension, hyperlipidemia, diabetes, gastroesophageal reflux disease, and arthritis. A total of 185 patients were enrolled in 20 MPDPs. Of those plans, 6 (30%) provided MTM services through internal drug plan staff to 80 (43%) of the patients reviewed. No information regarding MTM services was available from 13 (65%) of the 20 MPDPs. One MPDP (5%) provided MTM through face-to-face encounters; however, this MPDP contracted with only the dispensing pharmacy, not individual pharmacists. Conclusion. Over a six-month time period, pharmacists in a family medicine practice were unable to receive compensation by Medicare for providing MTM services. Index terms: Contract services; Health benefit programs; Pharmaceutical services; Pharmacists; Reimbursement

 

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