Gone are the days of pharmacists simply being known for filling prescriptions. A pharmacist can do so much more for a patient’s health and quality of life. They are clinically trained to offer an array of enhanced services that can improve their patients’ health outcomes and manage their disease states. This includes performing medication therapy management (MTM), identifying social determinants of health, monitoring vital signs, tracking progress through lab results, educating patients, setting care goals, and more. But these additional services require time and effort, and pharmacists should be reimbursed for the value of their services.
The Pharmacist eCare Plan is a way for pharmacists to document these critical patient interactions and submit them electronically to payers for reimbursement. Care plans have been used by nurses for years as a way to document and outline patient care. However, historically there have been barriers to the use of care planning in pharmacy. These barriers include:
- Lack of understanding by third-party payers of the pharmacists’ role in patient care
- Pharmacists fighting to gain provider status and expand their scope of practice to allow for clinical reimbursement
- Lack of the appropriate technological infrastructure within pharmacy software workflow to capture these interactions and document them in the proper formats
In recent years, pharmacy groups began creating a new kind of care plan that would work specifically for pharmacists. CPESN, a clinically integrated network of pharmacies, and the Pharmacy HIT Collaborative have been key players in this initiative. Joining pharmacy organizations like these is a great way for pharmacists to get involved in ways to expand their impact and grow their business. The Pharmacy HIT Collaborative has worked to standardize the eCare Plan and ensure interoperability between healthcare providers and payers. In order to get paid, pharmacies can submit eCare Plans directly to CPESN, who then sends them to the appropriate payers if applicable. But how can pharmacists know what to submit? And how to submit it?
Pharmacy software providers have begun incorporating eCare Plans into their software system to make it easier for pharmacists to start documenting their services within workflow. This comparison chart lists the different software vendors and additional third-party vendors that offer eCare Plan functionality. When choosing a software for your pharmacy, it’s important to consider if it will have the proper functionality to support the growth of your business through opportunities like care planning. Some things to consider when it comes to eCare Plan functionality:
- Can you document and submit eCare Plans within your pharmacy software? Or will you need to purchase an additional third-party software?
- If it is included in your pharmacy software package, will it be free or an additional monthly cost?
- Will you be able to fully document all of the necessary fields?
- Is it intuitively embedded within workflow to make it easy to document and submit eCare Plans?
Getting paid for clinical services is a huge part of building sustainability and transforming the future of independent pharmacy. Pharmacists are expanding their scope of practice, and having the proper technology is essential for taking things to the next level and being recognized for the value they bring to their patients and to the healthcare system as a whole. Independent pharmacists are some of the most accessible healthcare professionals and their patient interactions can provide valuable information when documented properly. Make sure your pharmacy software can help you document eCare Plans properly and set you up for reimbursement opportunities when they come your way!
According to CPESN, the top 4 reasons why pharmacists should use eCare Plans are:
- Improve your workflow with better documentation - Each team member will be keeping a detailed record of every patient interaction they perform, making it easier to keep track of who did what.
- Tell your story and share the impact of your pharmacy - You will have concrete evidence of the lives your pharmacy is impacting and have a systematic way to share that information.
- Improve patient health outcomes - By creating care goals for patients and accomplishing them through an established plan of action, you can improve your patients’ health and quality of life.
- Be ready for payer opportunities - By implementing the right processes in your pharmacy from the start, you can be prepared when a payer opportunity comes your way. Use your technology to work for you and start building up a database that proves the value of your pharmacy.