Integrating Pharmacists Into ACOs Could Improve Outcomes, Reduce Costs

A recent paper in the Journal of Managed Care Pharmacy suggested that accountable care organizations (ACO) that integrate pharmacists and primary care could improve outcomes and reduce costs.

“The ACO is an innovative health care delivery model that is defined as a network of physicians and other providers who share responsibility for coordinating high-quality care across a specific patient population,” Tina Joseph, PharmD, of the Department of Pharmacy Practice at the Nova Southeastern University College of Pharmacy, and colleagues wrote. “ACOs consisting of primary care providers have evolved to include a team of providers, often without significant integration of a pharmacist. However, since medication therapy management (MTM) remains costly and problematic in practice, the need to include pharmacists is necessary.”

Dr Joseph and colleagues outlined five integration strategies developed by the Accountable Care Organization Research Network, Services, and Education (ACORN SEED). They also identified a number of barriers to integration of a pharmacist into a primary care ACO.

The five strategies included pharmacist-led medication therapy management (MTM), pharmacist annual wellness visits, chronic disease state management through collaborative practice agreements, collaborative chronic care management, and pharmacist-integrated transitions of care. All of these strategies highlight areas of primary care where a pharmacist can be used in tandem with a physician to lighten the cost and utilization burden.

 The researchers also identified barriers that could make pharmacist-integration difficult. These barriers included poor awareness of how a pharmacist can improve care collaboration, complex laws and regulations, provider status that complicates compensation for pharmacist services, and limited access to medical records.

“ACOs and pharmacists can choose all or some of these strategies based on their unique patient population in order to become better positioned to improve patient experience and reduce the costs of care,” Dr Joseph and colleagues wrote. “As more organizations realize benefits and overcome barriers to the integration of pharmacists into patient care, programs involving pharmacists will become an increasingly common approach to improving outcomes and reducing the total cost of care.”

—David Costill