Pharmacists Get Creative Overcoming Barriers to Care by Going the Extra Virtual Mile

Jill Murphy, Associate Editor

Pharmacists interact with patients more than any other member of the health care team, therefore it is vital they help address barriers and gaps in member care that impact plan performance.

Because pharmacists interact with patients more than any other member of the health care team, it is crucial that they continue to help address barriers and gaps in member care impacting plan performance beyond traditional pharmacy measures, according to a session at the Pharmacy Quality Alliance 2021 Online Annual Meeting.

Panelist Laurin Dixon, director of Medicare Star Ratings at Arkansas Blue Cross and Blue Shield, said the primary concern when the COVID-19 pandemic first began was making sure patients had the proper medication and adhering to them. However, as care resumed in Q3 and Q4, the care teams focused on solving several challenges, such as limited internal resources, lack of screening availability during telehealth engagement, and incomplete evaluations of care gaps holistically due to limited time/appointments available.

Anna Hall, director of Quality Services at Enhanced Medication Services, elaborated on how the goal of 2021 was to incorporate a network of community pharmacists to engage members in quality pharmacy measures and HEDIS, such as breast cancer screenings, colorectal cancer screenings, and comprehensive diabetes care eye exams.

Hall outlined the collaborative intervention model that was created due to the pandemic, which includes the Clinical Service Center + Health Plan Collaboration and the Community Pharmacy Network Engagement. These models include a clinical services team of pharmacists, technicians, engagement specialists with an ABCBS quality team, and an integrated clinical intervention display for community pharmacy network via personal pharmacists.

During these interventions, Hall mentioned how discussing screening options, identifying members with previous screenings, and educating on the importance of regular screenings were done during a live-telephonic outreach for the cancer screenings. These patients were also guided by provider communication to make sure the entire process was done from start to finish.

As for coordination between health plan and clinical intervention vendor teams, it is important that there are 2 teams working as an extension of each other to maximize performance.

“In terms of care coordination and follow-up, making sure that information is available to patients if they are ready to schedule a screening or tracking in-home tests to make sure they are followed up with are just 2 important things,” Dixon said.

As for the future of pharmacies, Hall hopes that the creativity and collaboration that was done for members to receive care will continue in a safe, convenient care model.

“Some of these models will continue and newly established models will go forward even after the pandemic is over,” Hall said.

REFERENCE

Dixon L, Hall A. Pharmacists Get Creative! Overcoming Barriers to Care by Going the Extra Virtual Mile. Presented at: PQA 2021 Online Annual Meeting; May 12, 2021. Accessed May 12, 2021.