Pharmacy
Pharmacy costs have had the greatest increase in expenditures for Medicaid overall and for CCNC networks. The purpose of the pharmacy initiative is to improve quality and reduce costs. The pharmacy initiative looks to drive prescribing patterns with the use of the Prescription Advantage list (PAL) and by adhering to Medicaid mandated prior authorization programs. Each network has employed a pharmacist to develop and pilot effective strategies to achieve local and statewide pharmacy goals.
Partnership For Health Management Network Pharmacist Responsibilities:
- Education of community pharmacists and medical providers on CCNC and/or Medicaid pharmacy initiatives.
- Develop and pilot effective outreach strategies to achieve the goals of local and statewide pharmacy initiatives.
- Conduct patient chart reviews.
- Serve as an informational resource for network physicians and case managers on general drug information and Medicaid pharmacy policy issues.
- Oversight of the FORM process ({Focused risk management} formerly MTM)
- Implement the Pharmacy Home Program
Pharmacy Home Program
Pharmacy Home is a communication vehicle that can be used to exchange patient information between case managers, physicians, and local pharmacists. It is a computer software application that serves as a data source for medication related information. It serves to address some of the problems of polypharmacy: multiple providers and lack of knowledge between providers about a patient's drug regimen, poor patient self-management, and multiple drug therapies.
The Pharmacy Home Program has 3 criteria for enrollment:
- 24 or more drugs in 3 months
- visits to 3 or more practices in 6 months
- Enrollment request by prescriber, case manager, or network pharmacist
For More Information contact:
Katina J. Rice, PharmD
Network Clinical Pharmacist
Partnership for Health Management
1050 Revolution Mill Drive, Studio 4
Greensboro, NC 27405
336-235-0930 ext 319
krice@p4hm.org
