APhA2018: The journey toward value-based payment models

Pharmacists share how they’ve participated in these models and strategies for attendees

Most organizations are going through the shift from traditional fee-for-service to value-based payment models. “Quality is here to stay,” said Amanda Brummel, PharmD, BCPS. Pharmacists “need to understand the culture change happening.”

Brummel, of Fairview Health Services, based in Minneapolis, presented a whirlwind overview of value-based programs as part of The New Frontier: Value-Based Payment Models. A panel discussion among four pharmacists that was moderated by APhA, the standing-room-only education session took place on Sunday, March 18, at the 2018 APhA Annual Meeting & Exposition in Nashville.

Value-based payment “should be the puck you’re skating toward,” said Joe Moose, PharmD, Moose Pharmacy vice president and CPESN USA director of strategy and luminary development.

“If community pharmacy is truly going to be different, we’ve got to deliver services differently,” Moose said. “We’re in the business of keeping people healthy.” His top recommendation to change the culture in a pharmacy is to ask your pharmacy team at every weekly meeting, “What did you do to keep somebody out of the hospital this week?” That, he said, gets everyone thinking in that mindset.

“Start small—where you are,” said Hae Mi Choe, PharmD. Find out if your organization is participating in a value-based program. Figure out who is who in the organization, understand their priorities, and align your proposal with that. Find something trackable and able to be documented. “If you can’t show it, it hasn’t been done,” she said.

She is chief quality officer and director of pharmacy innovations at the University of Michigan Medical Group and associate dean and clinical associate professor at the University of Michigan College of Pharmacy.

Kelli D. Barnes, PharmD, BCACP, of The Ohio State University Wexner Medical Center in Columbus, said that her practice in an internal medicine clinic is growing in large part due to multiple value-based payment models.

“If you’re starting small, think about what is costing the team the most money and the most time. What keeps them up at night? That’s how to get your foot in the door,” she said. “Be there when providers need you. Later, spend time on efficiency.”

Fairview has fee-for-service, PMPM (per member, per month), and everything in between. “Don’t be overwhelmed” by value-based programs, Brummel said. The key is “leveraging the opportunities in value-based payment that allow [pharmacists] to integrate in that way.”