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The drive toward coordinated health care is redefining the relationships between providers and creating opportunities for drug chains and other community pharmacy operators to become more tightly woven into the continuum of care. The momentum behind the transition continues to build, with two programs unveiled in recent weeks illustrating the trend.
Aetna, one of the nation’s biggest health care benefits companies, is teaming up with CVS Caremark and Dovetail Health to test an approach designed to assist patients who are taking multiple medications. The Aetna Rx Home Success Program provides members, particularly those who have just been released from a hospital or other medical facility, with individualized support from a pharmacist.
When beneficiaries who have enrolled are about to be discharged, Aetna case managers evaluate their situation and categorize their risk of readmission as either moderate or high. Patients in the first group are contacted by a CVS Caremark pharmacist within two days of leaving the hospital to schedule a medication review over the telephone; high-risk patients are visited at home by a Dovetail pharmacist.
Under either scenario, the pharmacist reviews all pharmaceuticals taken by a given patient, addresses potential drug interactions, provides information about the importance of adherence and other issues, and identifies gaps in care. The pharmacist then works with the patient and physician to develop a health care plan.
“We look forward to piloting this program with Aetna, as high rates of hospital readmission result in increased costs for the patient and the payor, which can negatively impact a patient’s health outcome,” says Dr. Troy Brennan, executive vice president and chief medical officer at CVS Caremark.
Research cited by Aetna executives that appeared in Annals of Internal Medicine in 2003 found that hospital readmissions resulting from the incorrect use of prescription drugs involved 3.5 million patients and cost the health care system some $15.2 billion a year.
“Many patients who are newly discharged from a hospital or rehab facility are taking multiple medications,” Brennan notes. “Trying to navigate multiple treatment guidelines provided by the patient’s primary care physician and the treatment facility discharge team can be overwhelming. Our research shows that the intervention of a clinical pharmacist helps patients better understand their medications and avoid potential setbacks to recovery after returning home.”
Walgreens is involved in another new program intended to improve patient access to care and enhance outcomes.
The drug chain is starting a clinical collaboration with Orlando Health, a nonprofit organization that operates a physicians’ practice network, hospitals and other care centers in central Florida. The partnership is intended to leverage the convenience of Walgreens’ in-store Healthcare Clinics.
“In today’s health care landscape, these types of innovative coordinated care programs are vitally important to help ensure patients have access to the quality care they need,” says Dr. Jeffrey Kang, senior vice president of health and wellness services and solutions at Walgreens. “With our expansive retail footprint, diverse portfolio of health care assets and proven success in collaborating with others in the medical community, Walgreens in uniquely positioned to bridge critical gaps in care and improve patient outcomes, furthering our mission to help patients get, stay and live well.”
Doctors at Orlando Health will communicate directly with nurse practitioners at Walgreens’ clinics to coordinate care. Patients will be able to access a broad range services at the stores, including routine screening, monitoring, immunizations and treatment for many conditions.
The new projects undertaken by CVS Caremark and Walgreens are just two examples of how health care providers are rethinking the way they interact. With payment models evolving toward remuneration based on patient outcomes rather than services rendered, creating and maintaining a seamless delivery system is essential. With its unmatched understanding of pharmaceutical products and extensive infrastructure, community pharmacy is emerging as an important factor in that equation.
