Current trends in outpatient pharmacy services and billing

Beatty, Stuart J.; McCormick, Kelly M.; Beale, David; Bruggeman, Athena M.; Rodis, Jennifer L.; Mehta, Bella H.; Bennett, Marialice S.

doi:10.1331/japha.2012.11213

Cited by 26 publications

(26 citation statements)

References 16 publications

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“…One of the biggest challenges is the lack of framework for pharmacist reimbursement for HIV testing and counseling 62 in an already time-limited practice setting. 71 Some reimbursement mechanisms for direct patient care services are in place via pharmacist-specific Current Procedural Terminology codes for medication therapy management, 58,72 but these codes do not cover preventive testing and counseling. Legal definitions of pharmacists as health care providers also vary state to state and impact potential compensation for health counseling and screening.…”

Section: Pharmacy-based Testingmentioning

confidence: 99%

Missed Opportunities for HIV Screening in Pharmacies and Retail Clinics

Dugdale¹,

Zaller²,

Bratberg³

et al. 2014

JMCP

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SUMMARY In the wake of new recommendations to offer HIV screening to everyone aged 13–64 years and to start all people living with HIV/AIDS on highly active antiretroviral therapy (HAART) regardless of CD4 count, the need to generate widespread, scalable HIV screening programs is greater than ever. Nearly 50,000 new HIV infections occur in the United States each year, and the Centers for Disease Control and Prevention estimates that approximately half of these new infections are transmitted by individuals who are unaware of their HIV serostatus. Numerous barriers to screening exist, including the lack of primary care for many at-risk patients, expense of screening in traditional settings, and need for repeat testing in high-risk populations. With their relative accessibility and affordability, community pharmacies and retail clinics within those pharmacies are practical and appealing venues for expanded HIV screening. For widespread pharmacy-based testing to become a reality, policymakers and corporate pharmacy leadership would need to develop innovative solutions to the existing time pressures of pharmacists’ behind-the-counter functions and absence of reimbursement for direct patient care services. Pharmacists nationwide should also receive training to assist with risk reduction counseling and linkage to care for customers purchasing the new over-the-counter HIV test.

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Section: Pharmacy-based Testingmentioning

confidence: 99%

Missed Opportunities for HIV Screening in Pharmacies and Retail Clinics

Dugdale¹,

Zaller²,

Bratberg³

et al. 2014

JMCP

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“…23,33,34 Adequate reimbursement is essential to sustain new MTM services for HIV disease. The value of these services will need to be clearly demonstrated to secure payers' support.…”

Section: Reimbursement For Servicesmentioning

confidence: 99%

HIV medication therapy management services in community pharmacies

Kauffman

Nair

Herist

et al. 2012

Journal of the American Pharmacists Association

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Objectives-To present a rationale and a proposed structure to support pharmacist-delivered medication therapy management (MTM) for human immunodeficiency virus (HIV) disease and to outline challenges to implementing and sustaining the service. Data sources-Professional literature.Summary-Historically, the effect of pharmacy services for HIV-infected persons has been demonstrated in inpatient and clinic-based settings. Developing similar programs adapted for community pharmacists could be a model of care to improve patient adherence to antiretroviral therapy and retention in care. Initiation of antiretroviral therapy and regular monitoring of CD4+ cell count, HIV RNA viral load, adverse drug events, and adherence form the backbone of successful medical management of HIV infection. Support for these services can be provided to HIV-infected patients through pharmacist-managed HIV MTM programs in community pharmacy settings in collaboration with primary providers and other health care professionals.Conclusion-Community pharmacists can help meet the growing need for HIV care through provision of MTM services. Although resources have been developed, including the general MTM framework, challenges of adequate training, education, and support of community pharmacists need to be addressed in order for HIV MTM to be a successful model.

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“…33,34 Various reimbursement models and billing practices have recently been assessed. [35][36][37][38] Literature supports the pharmacists' concern that figuring out feasible ways to reimburse for the provision of MTM services is necessary and important for the profession. 39 Research is needed in this area on feasible business models and reimbursement strategies for pharmacist-provided MTM services.…”

Section: Discussionmentioning

confidence: 99%