APhA and QIOs Release Chronic Care Management Guide for Pharmacists


The American Pharmacists Association (APhA), in collaboration with two federally-designated Quality Improvement Network-Quality Improvement Organizations, Health Quality Innovators (HQI) and Delmarva Foundation (a member of the Atlantic Quality Innovation Network), created and recently released Chronic Care Management (CCM): An Overview for Pharmacists. The guide describes requirements for CCM and complex CCM and how pharmacists can play an important role as a member of the healthcare team delivering these services.

“CCM and complex CCM represent an opportunity for pharmacists to leverage their medication expertise in the ongoing management and coordination of care for people with chronic diseases,” said Anne Burns, APhA’s Vice President of Professional Affairs. “Participation as clinical staff in CCM delivery also allows pharmacists to contribute to key quality metrics of interest to qualified health care providers.”

The Centers for Medicare & Medicaid Services (CMS) covers CCM services for Medicare beneficiaries with two or more chronic health conditions who meet specific requirements. CMS estimates that about two-thirds of Medicare beneficiaries have two or more chronic conditions, and CCM services aim to better coordinate the care beneficiaries receive through five core activities performed on a monthly basis:

  • Recording structured data in the patient’s health record;
  • Maintaining a comprehensive care plan for each patient;
  • Providing 24/7 access to care;
  • Offering comprehensive care management; and
  • Providing transitional care management

"The collaboration between APhA and QIOs allows for broader reach and greater impact as we strengthen team-based approaches to quality improvement and care coordination," said Cindy Warriner, HQI Pharmacist. "We hope to raise awareness of the benefits of CCM and the important role pharmacists play in delivering this valuable service."

Chronic Care Management (CCM): An Overview for Pharmacists details the requirements for CCM delivery and provides guidance and informational links to assist physicians and pharmacists in establishing collaborative partnerships for CCM delivery. CCM services are non-face-to-face care coordination services that include a focus on the patient’s medications. CCM services performed by a pharmacist are delivered under the general supervision of a physician or other qualified practitioner.

“The integrated team approach, which includes the expertise of pharmacists, has and will achieve the value and quality outcomes anticipated under Chronic Care Management and the Quality Payment Program,” said Jennifer Thomas, PharmD, Delmarva Foundation. “QIOs are an available resource for practitioners and are well-positioned to support interdisciplinary teams interested in collaborating to provide CCM services.”

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