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What is comprehensive medication management and how does it differ from continuous medication management?
Comprehensive Medication Management is a program created by CMS to be included in the new Comprehensive Primary Care Plus (CPC+) clinic model
The CPC+ model was created by MACRA as part of an advanced APM.
Now remember in MACRA, there’s two different payment tracks that clinics and providers can choose the MIPs route or the advanced APM route.
The CPC+ model is application-only and it’s only available in certain states and regions.
“There are 2,900 primary care practices currently participating in Comprehensive Primary Care Plus (CPC+) in 18 regions: Arkansas, Colorado, Hawaii, Greater Kansas City Region of Kansas and Missouri, Louisiana, Michigan, Montana, Nebraska, North Dakota, Greater Buffalo Region of New York, North Hudson-Capital Region of New York, New Jersey, Ohio and Northern Kentucky Region, Oklahoma, Oregon, Greater Philadelphia Region of Pennsylvania, Rhode Island, and Tennessee.”
There are two different track models a CPC+ clinic can opt in to.
In Track 2, there’s an option mentioned to improve care through comprehensive medication monitoring.
The idea behind comprehensive medication monitoring is to develop a plan after discharge or for those patients receiving longitudinal care management.
There are four primary “change tactics” mentioned in Track 2 of the CPC+ model:
- Conduct comprehensive medication reviews (CMRs) particularly for high risk patients that include Action Plans individual therapy goals and follow up plans.
- Provide medication self-management support for patients to help them stay here to their prescribed therapies.
- Work together with pharmacists and other health care providers to promote clinically sound cost effective medication therapies.
- Integrate a clinical pharmacist into the care team to provide medication management services.
My thoughts for a program that includes a clinical pharmacist like this could include services like:
- In collaboration with the practice creation of a formulary for cost effective drug of choice medications for each of the most common disease states.
- In collaboration with the practice to identify a list of high risk medications or flagged medications that warrant extra attention.
- Conduct CMRs on an annual basis starting with those patients with multiple chronic conditions, recent transitions of care or on high risk or flagged medications.
- In collaboration with the pharmacy get the patient set up on adherence support programs like medication synchronization help them with delivery services or any financial support that the patient may need
- Help to create an action plan with the individual so that they know their specific therapy goals
Providing comprehensive medication management programs and a CPC+ model is an opportunity for consultant pharmacists to help providers and focus on patient care outcomes.
If you are interested in building clinical services like comprehensive medication management…
