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Utilizing Wellness as a Portal for Medication Therapy Management (MTM) and Condition Care Services in a Community Based Employer Setting

Mark J. Johannigman, R.Ph., Michael Leifheit, Pharm.D., BCPS, Nicholas J. Bellman, Pharm.D., BCPS, Tracey Pierce, R.Ph., CGP, FASCP, Angela Marriott, C.Ph.T., Cheryl Bishop, C.Ph.T.

The Center for Medication Management, Blanchard Valley Health System, Findlay, Ohio

The development of a pharmacy business model utilizing wellness, disease prevention, and traditional medication therapy management (MTM) services provides pharmacists an opportunity to expand their services and improve the overall health of people in their community.

The business model developed by The Center for Medication Management (CMM) involves contracting directly with a company’s benefit department as a defined wellness service. The program is divided into two components, an initial wellness and MTM session and an ongoing condition care program. The initial wellness and MTM session acts as a screening tool for patient entry into the condition care program. A three pronged approach to outcomes including patient satisfaction, financial savings, and clinical results is used to justify the cost of the program to the employer.  The condition care program can be customized to fit the needs of the employer and may include any or all of the five pathways of care used by the CMM staff.  Current pathways include diabetes, hypertension, asthma, hypercholesterolemia, and heart failure.  Services can be provided in a variety of settings including the employer’s workplace.

The three pronged approach has proven successful and demonstrates overall value. The patient satisfaction survey had a combined average score of 4.81 (range 4.74 to 4.93) with 5 being rated as “excellent” and 4 being “good”.  Two additional questions revealed that, on average, 99.68% of patients completing the survey would recommend our services to others and 98.01% thought it was a good use of their time.  Financial savings showed an average hard dollar cost savings of $253 per patient per year and total cost savings including both hard and theoretical (soft) dollars of $1,011 per patient per year based on year one results for each company.  Key clinical outcomes for the program include a statistically significant reduction in low-density lipoproteins (LDL) levels for all patients and an even greater reduction in LDL for diabetic patients, and an improvement in the percentage of patients at a goal A1c level.  An overall average reduction of 6.3 mg/dL in LDL levels was observed (p=0.003, n=274) with an initial visit average of 120.4 mg/dL (+/- 46) and a last visit average of 114.1 mg/dL (+/-39).  LDL levels in diabetic patients showed a drop of 15.6 mg/dL (p=<0.0001, n=52) with an initial visit average of 106.6 mg/dL (+/- 42) and a last visit average of 91.0 mg/dL (+/- 33).  The percentage of diabetic patients at goal with a target A1c level of less than 7% also showed improvement.  Thirty five patients were at goal on their initial visit (66.04%) compared to forty patients on their last visit (75.47%).  The CMM has conducted more than 2100 face-to-face-MTM sessions since inception of the program.

The incorporation of wellness activities into traditional pharmacy MTM services provides an additional avenue for pharmacists to positively impact the patients they serve and their community. Additionally, this business model allows pharmacists to provide direct patient care outside traditional settings and can move pharmacists into the patient’s workplace.

View a pdf of the poster from the Midyear Meeting (401 KB).