Clinical Pharmacy Services

Specific to clinical pharmacy services, the law provides for:

MTM Grant Programs. The new law establishes a stand-alone grant program to ensure pharmacist-provided MTM services as defined by the pharmacy profession’s consensus definition on the Core Elements of an MTM program. The program ensures the testing of practice and care delivery models, such as patient-centered self-management programs, that improve patient outcomes through team-based collaborations between prescribers and pharmacists.

Integrated Care Models. The law also includes provisions to ensure that providers with expertise in pharmacotherapy, including pharmacists, are fully engaged in integrated, collaborative, team-based approaches to delivering care, including medical homes, accountable care organizations, community health teams, and home-based chronic care programs.

Transitional Care Activities. The law recognizes the gaps in care coordination and communication that often occur when patients are transferred from one care setting to another. Problems arising from inappropriate medication use are a primary reason for hospital readmissions. Pharmacists—by helping manage pharmacotherapy as part of a transitional care team—will be able to play major roles in preventing these events. Transitional care activities might include medication reconciliation, improved use of personal medication records, and discharge planning that may include MTM services.

Medicare Advantage Plan Incentives. The law provides bonus payments to Medicare Advantage plans that conduct care coordination and management activities. In particular, it acknowledges the need for MTM programs to address medication use issues such as poly-pharmacy through medication reconciliation, periodic reviews of drug regimens, and integration of medical and pharmacy care for chronically ill, high-cost beneficiaries.

Workforce. The law establishes a National Health Care Workforce Commission that will study health care workforce supply issues and make recommendations to Congress.

A nice summary from the American College of Clinical Pharmacy (ACCP) regarding the clinical pharmacist provisions in the Health Care and Education Affordability Reconciliation Act of 2010 (H.R. 4872).