Enhancing Performance in Primary Care Medical Practice through Implementation of Comprehensive Medication Management (CMM)

Study Description and Methods

One of the greatest barriers to improving the quality of health care in the United States is the misuse, underuse, and overuse of medications. Prescription drug spending accounts for 10% of total health expenditures with $271 billion of the nearly $3 trillion spent on overall US Health Care in 2013. Most surprising is that health care costs attributing to the improper and unnecessary use of medicines exceeded $200 billion, suggesting that for every dollar spent on drugs an additional dollar is spent addressing a medication misadventure. There is no question that optimizing medication use is a critical component of care that must be addressed to improve national health care.

As health care continues to transition toward value-based care, it is imperative to demonstrate the value-added role of the clinical pharmacist as an integral member of the health care team in optimizing medication use and improving patient care. This will require a demonstration of ability to integrate effective strategies for optimizing medication use into busy medical practices, articulate and carry out a consistent approach to optimizing medication use, build the business case that integrates medication optimization into value-based payment models across diverse care delivery systems, and, importantly, support practices in their ability to integrate these services into their workflow and business model.

Specific Aims and Objectives

AIM 1: Assess baseline demographics, state of CMM within each practice and practitioner, and organizational readiness and capacity for CMM service development, refinement, and expansion.

AIM 2: Determine best practices in the design and delivery of CMM in primary care that optimize medication use (i.e., how CMM is best delivered to patients in primary care).

AIM 3: Determine the structural and system-level elements (i.e., the practice management system) that are needed to support the effective and efficient delivery of CMM and establish initial benchmarks for practice quality and efficiency.

AIM 4: Determine the key performance measures that support the value proposition for CMM from the perspective of stakeholders internal and external to the providing organization, and evaluate performance of study sites individually and collectively according to these key measures.

AIM 5: Accelerate the adoption of CMM best practices through replication across the 36 study sites, dissemination across a facilitated community of learning to primary care practices throughout the United States and development and dissemination of the business case to key stakeholders.

Timeline

January 2016-December 2017

Status

Active implementation phase

Key Findings and Publications

Check back for key findings and publications

Contact Information

For additional information about this study, please contact:

Jennifer Carroll, MD MPH
Co-Principal Investigator
jcarroll@aafp.org

Robin Liston, MPH
Senior Research Project Manager
1-800-274-2237 ext. 3175
Rliston2@kumc.edu

This project is being conducted in collaboration with the University of North Carolina Eshelman School of Pharmacy and the University of Minnesota College of Pharmacy. This study is funded by the American College of Clinical Pharmacy. .