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Please Turn Off All Cell Phones 

Please Turn Off All Cell Phones . Pharmacy Reimbursement for Cognitive Services. David Greer, Christian Hamm, Mary McKay, Rebecca Morrell, Alissa O’Connell, Jenny Riddell, Kevin Whalen. We can save boxes of money. We are trusted. We are highly educated. Cognitive services.

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Please Turn Off All Cell Phones 

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  1. Please Turn Off All Cell Phones 

  2. Pharmacy Reimbursement for Cognitive Services David Greer, Christian Hamm, Mary McKay, Rebecca Morrell, Alissa O’Connell, Jenny Riddell, Kevin Whalen

  3. We can save boxes of money We are trusted We are highly educated

  4. Cognitive services Disease state monitoring Diabetes Hypertension Asthma Smoking cessation Emergency contraception* Immunizations* Etc.

  5. The Law is in our Favor RCW 48.43.045 Mandates that insurance companies reimburse any category of provider When the service is: - covered under the Basic Health Plan - within practitioner’s scope of practice - cost effective and efficacious WAC 284-43-205 Effectuates RCW - no providers licensed in Washington may be denied when the stipulations of the RCW hold true - carriers may rule out some services when relevant evidence show that services are not cost effective and efficacious As it stands, pharmacists are not being reimbursed for their services, so we set out to change that…

  6. What we thought the problem was -- Private Insurance companies (not Medicare & HMO) rejected pharmacists reimbursement for cognitive services Insurance companies Us

  7. BUT - Are we so innocent?

  8. Surprise Problem YES I would like to be paid for my services but NO I have not tried billing APATHY is defined as lack of interest or concern

  9. More certification needed? *Demonstrate there is a need for pharmacist clinical services * Show how these services save health care $$$ *Reimbursement under the current system requires accountability from all health care providers. Competency *Periodic reexaminations *Certification *NCPA - Pharmacist Care diploma credentials

  10. NCPA certificationDisease State Management Certificates Availablein: • Arthritis and Pain Care • Diabetes Care • Immunization Skills • Lipid Management • Nutrition and Weight Management • Osteoporosis Care • Respiratory Care • Therapeutic Footcare

  11. Pharmacist’s Value • “Community pharmacists providing pharmaceutical care to asthma patients in an HMO decreased hospitalizations by 77% and decreased emergency room visits by 78%. • Journal of the American Pharmaceutical Association; 1997 Nov-Dec; 37(6):694-9 • “Pharmacists providing disease management services in their community saved an average of $2700 per year per patient in total medical costs.” • Clinical Therapeutics. 1997; 19(1):113-23.

  12. Alternatives

  13. Conclusion Increase awareness Continued involvement Informed pharmacists • It’s time to take action!!!! • Apply Pressure to Insurance Companies

  14. Make sure to check your e-mail for Mary’s Article – hopefully to be published!

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