Value-based care models can help pharmacies improve their operations

Value-based care is a health care model that focuses on the patient experience, quality of care, and provider performance with the goal of managing a patient’s overall health while considering their individual health goals.¹ The model makes it easier for patients to navigate the healthcare system and offers them more options when it comes to accessing their care.

At the Spring 2024 Total Pharmacy Solutions Summit, held virtually on April 13, Sandra C. Canally, RN, founder and CEO of The Compliance Team, discussed the goals, benefits and opportunities of value-based care in pharmacy, as well as opportunities to improve operations and clinical services.

“What is value-based care?” Canally asked during the session. “There are many different definitions for it, but a simple one is that it is an evolving health care model that is moving pharmacies from transaction-based care to clinically oriented services designed to improve patient satisfaction and outcomes. In other words, quality is prioritized over quantity. That is far more beneficial to the patient and hopefully more cost-effective for the pharmacist.”

READ MORE: Data and collaboration can help realize the full potential of value-based care

Read on to learn some key takeaways from Canally’s session:

• The Centers for Medicare and Medicaid Services (CMS) expects that all Medicare payments will be made through value-based models by 2030. The agency’s vision for improving health care can be summed up in three words: better, smarterAnd healthier.
• CMS’s value-based care model focuses on using incentives to improve care, linking payment to value through new payment models, and transforming health care through better teamwork, better coordination among health care organizations, greater attention to population health, and harnessing the power of health information.
• Pharmacists face many clinical challenges on a daily basis, such as ineffective medication management, medication errors, and poor medication adherence. A value-based model can help alleviate some, if not all, of these challenges.
• Value-based care models can provide a number of positive outcomes for patients, including improved medication adherence, fewer hospital stays, lower healthcare costs, and increased satisfaction.
• For pharmacies, the goal of value-based care is to transform the pharmacist from a medication distributor into an indispensable partner for patients and a central member of the clinical care team.
• A pharmacy’s value-based care standards include providing patients with expanded access to services such as counseling and medication management sessions, providing assessments for patients with complex medication management, providing a process to improve medication adherence in high-risk patients, and implementing care coordination among other health care providers for high-risk patients.
• While it may be difficult to meet all of these standards, Canally says pharmacies that are ready for these new models will be the first to benefit.
• Pharmacies should obtain value-based care accreditation because of their ability to improve and streamline clinical services, optimize overall operations, and help identify areas for improvement.
• By implementing value-based care, a pharmacy can help increase the number of prescribers by better monitoring and treating complex patients.

“Pharmacists who embrace value-based care will be well positioned to meet the needs of their patients and the health care system in the future,” Canally said. “Value-based care models can lead to a number of positive outcomes, including … not only improved medication adherence, but also fewer hospital readmissions (and) lower health care costs because (patients) are not coming back for … readmissions; they are not going to the (emergency department) because you are saving them from having to go through your counseling.”

Visit drugtopics.com/Spring24TPSS to view all Total Pharmacy Solutions Summit sessions on demand.

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