Improving Outcomes and Access to Care in Montana

Improving Outcomes and Access to Care in Montana with Pharmacists on the Team Carla Cobb, Pharm. D, BCPP MPPCA Conference November 13, 2020

Welcome Please see the link that you received via email to access meeting information Agenda, participant discussion questions, slides, evaluation form Medicaid billing document Thank you for participating – expect active participation

Meeting Guidelines The host will place all participants on mute Set your Zoom to speaker view Please use the chat box for comments or questions Or if you prefer to speak, please make a request in the chat box and the moderator will ask you to unmute yourself Double check to make sure you are on mute If you are calling in, please use headphones If you are driving, do not use your Bluetooth speaker as it picks up road noise

The Future of Pharmacy

Challenges Mail order Pillpack (Amazon), Divvydose (United), Care. Zone (Walmart) PBMs Workplace Declining conditions, low moral school enrollment Over-production Decreased Jobs losses of graduates wages (despite high debt)

Poll of Private Facebook Group

Opportunities Expensive, Aging Drug population, chronic illnesses, fragmented care therapy problems Suboptimal ED complex new medications medication use visits, hospitalizations, rehospitalizations - $$ PCP, psychiatrist shortages

Solution Redeploy Use pharmacists to patient care roles a consistent, well-defined patient care service (CMM) Payment Clear for services guidance for billing, documentation, audits Prepare pharmacists for patient care roles Elevate pharmacy technician role (and pay)

Payer Panel Mark Eichler, MT Health Co-Op Amy Jenks, State Health Plan Justin Murgel, Pacific Source Shannon Sexauer, Montana Medicaid

Payer Panel Discussion Questions 1. Please provide us with any data that you can share regarding your CPP (or other pharmacy services) program 2. What role do you see for pharmacists to help ensure that high cost, high-risk medications are being used appropriately? 3. What role do you see for pharmacists on the healthcare team in increasing timely access to care? 4. What metrics do you use to assess care for your patient populations? How could pharmacists on the healthcare help improve some of these metrics? 5. What do you think would be the best way to increase patient access to pharmacists’ services and what are the limitations/concerns about expanding access? 6. CPP services are currently paid using MTMS codes. What are the pros and cons of paying CPPs differently than other types of patient care provider using E&M codes?

Directors Panel Mike Bertagnolli, Bozeman Health Jason Nickish, Providence St. Patrick’s, Missoula Jamie Leonard, Benefis Health System, Great Falls Jacki Ulishney, Billings Clinic

Directors Panel Discussion Questions What are some of your recent successes and/or challenges that are important to the profession in Montana, including your status on payment for outpatient pharmacists’ services? 2. What is your vision for the future of pharmacy in Montana and what challenges and opportunities to do you see? 3. What concrete steps can pharmacists take right now to help advance the profession? 4. What other advice do you have for participants and students? 1.

Questions to Run On 1. What challenges and opportunities have you heard that you are most concerned or optimistic about? 2. What have you heard that can be applied to your work? 3. What requests do you have for the group? What could you share with others? 4. Commitment to Action What will you commit to doing when you go back to work? Who will you follow-up with?

2021 Physician Fee Schedule Proposed Rules Similarly, performing required quality assurance activities consistent with § 423. 153(c)(2), such as screening for potential drug therapy problems due to therapeutic duplication, age/gender related contraindications, potential over-utilization and under-utilization, drug-drug interactions, incorrect drug dosage or duration of drug therapy, drugallergy contraindications, and clinical abuse/misuse are considered part of dispensing fees under Part D and are not separately reportable services under Part B. https: //www. govinfo. gov/content/pkg/FR-2020 -08 -17/pdf/2020 -17127. pdf page 50147 Federal Register / Vol. 85, No. 159 / Monday, August 17, 2020

Contact Info Carla Cobb, Pharm. D, BCPP carlacobb 99@gmail. com 406 -670 -3722 Twitter @Pt. Care. Pharm