Universal American pilots Rx network emphasizing pharmacist-practitioner collaboration

WHITE PLAINS, N.Y. -- Universal American announced Monday that the Accountable Care Coalition of the Tri-Counties, a Medicare Shared Savings Program ACO formed with primary care physicians in Charleston, S.C., will conduct a pilot with a network of independently-owned pharmacies. The pharmacies are part of Community PerformanceRx MSO, the first nationally-integrated pharmacy management services organization and a wholly owned subsidiary of PrescribeWellness.

“We are eager to launch a pilot that encourages primary care physicians and pharmacies to work together," stated Michael Barrett, SVP  Southeast Region for Collaborative Health Systems, a subsidiary of Universal American, and member of the governing body of ACC of the Tri-Counties. "The medical community struggles with managing medication from a cost and patient safety perspective. We believe these challenges can be addressed through closer collaboration between physicians and pharmacists given the invaluable role pharmacists play in supporting patients’ health.”

“Pharmacists offer expertise in medication optimization and polypharmacy risk assessment," commented Mindy Smith, VP pharmacy practice innovation for PrescribeWellness. "They also have strong loyalties within their community that can help address patient engagement problems common among the Medicare population. As healthcare shifts from fee-for-service to value-based models the focus is on driving higher quality and reducing unnecessary costs. The pilot is an exciting opportunity to leverage the skills and relationships of independent community pharmacies to achieve these goals in partnership with ACO primary care physicians.”

Primary care physicians of the ACO will collaborate with independent community pharmacies to demonstrate that a comprehensive care model that includes pharmacies drives better patient health outcomes and improves preventive care. The physicians and pharmacists will share patient data and engage in frequent communication to offer evaluation of polypharmacy risk and predictive outcomes among beneficiaries in the ACO.

Community PerformanceRx is seeking to build partnerships in a variety of reimbursement models, including risk sharing. The pilot is expected to open the doors to discussions with additional ACOs, Medicare Advantage plans, Medicare Part D plans, Independent Physician Associations, collaborative care model commercial plans, self-insured employers and physician MSOs who are or will be taking pharmacy cost risk.

Login or Register to post a comment.