基于社区的药物管理服务外文文献.pdfVIP

Research in Social and Administrative Pharmacy 13 (2017) 48–62 Original Research Strategies for community-based medication management services in value-based health plans Marie A. Smith, Pharm.D., F.N.A.P.a,*, Susan Spiggle, Ph.D.b, Brody McConnell, Pharm.D. (c)a a University of Connecticut, School of Pharmacy, 69 N. Eagleville Rd, Unit 3092, Storrs, CT 06269-3092, USA b University of Connecticut, School of Business, USA Abstract Background: Health plans are moving away from a volume-driven payment structure toward value-driven and risk-based contracts. There is very limited information on commercial payers’ perspectives on coverage of medication management services (MMS) in value-based alternative payment models. While some health plans have experience with Medicare Part D Medication Therapy Management (MTM) programs, this experience does not promote the integration of pharmacists as health care team members. Objectives: The study objectives were to: (1) understand the evaluation process that health plan executives would use to determine benefit coverage for pharmacist-provided MMS in value-based health plans, (2) identify the facilitators and barriers that affect pharmacist-provided MTM services at the community pharmacy level, and (3) propose strategies for pharmacist-provided MMS in value-based health plans. Methods: This study used qualitative research methods that involved structured key informant interviews with commercial health plan executives and focus groups with community pharmacists who had experience providing MTM services. Results: Health plan executives agreed conceptually that MMS could be a valuable program and recognized its potential. However, the most