Advancing The Profession of Pharmacy

The Chronic Care Management Pharmacist

by | Jan 7, 2016 | MTM Entrepreneurship

This series is dedicated to generating ideas for independent pharmacist consulting services within a physician’s office.

In this series, we will identify and elaborate on three ways that a pharmacist can be helpful in generating revenue and reducing costs within a practice.
The first is the Chronic Care Management Pharmacist.

Medicare is rewarding new processes aimed at improving patient care and reducing healthcare expenses.  One new program that became eligible for physician reimbursement is a program intended to monitor certain patients with multiple chronic conditions.

As of January 1, 2015, Medicare is paying for a non-face-to-face care coordination service through use of billing code 99490.  The Chronic Care Management Services may be provided by phone or tele-health by a qualified health care professional under the physician’s general supervision.  

The service is usually offered as a 20 minute contact once every calendar month.  An estimation provided by this CCM calculator shows that just 50 enrolled patients could equate to an additional $25,560 in revenue for the practice each year. ​

This is a relatively new program that an entrepreneurial pharmacist could easily implement for multiple physician groups in their area for a fee.

What do are your thoughts?  Would this be a viable business model in your area?  Leave a comment below.

In Part 2, we will discuss the use of incident-to billing codes for pharmacist-led MTM.

If you found this idea helpful and would like to continue receiving posts from us, we invite you to join the Pharmapreneur Newsletter to receive helpful tips and ideas on how you can build a clinical consulting business in your area!

About the Author

Blair Thielemier, PharmD, is an MTM consultant pharmacist specializing in pharmacy billing models. She consults on and produces e-learning programs for state and national organizations, pharmacy wholesalers, payers, technology start-ups. She has books and online courses available for individuals looking to leverage their pharmacy knowledge into monetized clinical programs at PharmapreneurAcademy.com. She speaks internationally about trends in leveraging pharmacists to improve value-based care.

 

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