Maryland P3 pilot expands to state employees

P3 pharmacists advise employees about proper use of medications and help with diagnostic testing, counseling, overall disease management

Five thousand Maryland state employees will receive medication therapy management (MTM) services provided by specially trained pharmacists through a new 14-month pilot project of the Maryland P(Patients, Pharmacists, Partnerships) Program. Until now, the program has been available primarily to patients at private self-insured companies.

The expansion of the Maryland P3 Program to state employees has important national implications for pharmacy because it symbolizes the power of collaboration among many stakeholders: a school of pharmacy, a pharmacy organization, a department of health, a government agency, and business groups, said Maryland P3 Program Director Magaly Rodriguez de Bittner, PharmD, BCPS, CDE, Professor and Chair of the Department of Pharmacy Practice and Science at the University of Maryland School of Pharmacy.

“We are very proud that we will have the opportunity to demonstrate the impact of MTM at the worksite in a way that is very visible to public officials and policy makers,” Rodriguez de Bittner told Pharmacy Today.

The national picture

Maryland joins at least six other states that have launched MTM pilot projects or have provided MTM services to state employees in recent years, according to Rebecca Snead, BSPharm, Executive Vice President and CEO, National Alliance of State Pharmacy Associations.

As of June 1, Minnesota began offering an MTM diabetes program to state employees through a contract negotiated between Minnesota’s State Employee Group Insurance Plan and a statewide MTM provider network run by the University of Minnesota College of Pharmacy. In October 2013, Virginia will begin to offer a state employee MTM pilot program to eligible beneficiaries statewide. In 2010, Iowa offered a pilot for state employees, although a bill to codify the provisions was vetoed by the governor in both 2011 and 2012.

State employee retirees in Kentucky receive MTM services, and in North Dakota, employees and retirees of the North Dakota Retiree System are eligible for MTM diabetes services. The Washington State Health Care Authority offered MTM services to eligible public employee enrollees, but the program was discontinued several years ago due to a change in insurance carrier.

Overview of P3 Program

Established in August 2006, the Maryland P3 Program is a partnership between the University of Maryland School of Pharmacy, Maryland Department of Health and Mental Hygiene Center for Chronic Disease Prevention, and Maryland Pharmacists Association, according to a May 13 University of Maryland news release. The P3 Program was an APhA Foundation Pinnacle Award winner in 2010.

In collaboration with primary care providers, P3 pharmacists advise employees about proper use of medications and help with diagnostic testing, counseling, and overall disease management. Since its inception, the program has enrolled more than 700 patients at seven different companies in the mid-Atlantic region.

Self-insured private employers have improved their employees’ health care outcomes and reduced direct health care costs between $495 and $3,281 per year for each participant. These savings were due largely to significant reductions in employees’ hospital and emergency department visits; one employer saw a 33% reduction in the program.

Pilot project details

State employees at the State Center office complex in Baltimore will meet face to face with a pharmacist at the worksite for a one-time review of their current prescription and OTC medications to assess safety, appropriateness, and effectiveness of the drug therapy based on information provided by the employees and their health care providers, according to the news release.

Employees and their primary care providers will receive medication lists and individualized medication action plans. Patients who have or who are at risk of developing cardiovascular disease (hyperlipidemia, hypertension, diabetes, and metabolic syndrome), as well as patients who are obese or tobacco dependent, will be eligible to participate in a more in-depth, comprehensive program in which they will meet with a pharmacist between four and seven times a year.

Pharmacists will review employees’ diet, smoking status, and exercise regimen and assess their medical and medication histories as well as their knowledge of and adherence to their current medication therapy. They will also identify potential and current drug-related problems such as adverse effects and dangerous medication interactions. In addition, they will work collaboratively with employees and health care providers to set patients’ self-management goals.

Pharmacists will document sessions with employees using ThinkEHRx, a pharmacist-focused case management system, and send written notes to employees’ health care providers following each session to ensure collaboration and continuity of care.