The Pharmacy Post

Chronic Care Management for Your Pharmacy

Would you like to increase your pharmacy’s business, with a low cost and low maintenance investment? Chronic Care Management might be just the thing your pharmacy can do to add another revenue stream while providing critical care to the most vulnerable patients.

A majority of Medicare patients suffer from two or more chronic conditions requiring additional oversight and care. To combat this, physicians and pharmacists can create a comprehensive care plan. This plan will not only help the patient have more oversight and more frequent touchpoints with healthcare professionals, but Medicare will also reimburse that time at a lucrative rate. Last year, reimbursement rates for CCM were $41.17/20 minutes, but now in 2022, are $64.03/20 minutes, split between the physician and pharmacist.

With so many chronic conditions being managed by medications, pharmacists are the perfect partner for physicians to create a CCM plan. What work is required will vary by patients and their needs, but frequently involves preventative care measures, disease state management, and coordinating care activities. You can also bill CCM time with things other than direct treatment, like connecting people with social services and transportation. The other great thing about CCM is the majority of the work is often done on the phone, so it’s a flexible addition to your existing work schedule. The monthly required 20 minutes of care is also split among the physician and pharmacist, so you would not be required to spend a full 20 minutes a month with each patient.

The hardest part of CCM truly is getting started. You’ll need to find a physician partner interested in providing CCM and create a contract with them about what you will provide and how payment sharing will be handled, since it’s the physician who bills and gets reimbursed by Medicare. A good place to start is with the physicians you already share a large customer base with, or any other provider you work closely with. If you already offer additional services like immunizations or compounding, that can make your pharmacy a lot more appealing as a partner to physicians. A system for electronic health records is also a huge bonus as it makes it a lot easier to share information about a patient’s care plan.

Because the majority of the work is provided via phone and has very low overhead, a CCM program is one of the cheapest pharmacy programs you can start. They do however require dedication to the program with finding partners and learning the necessary background information, as well as good time management skills. However, if you’re willing to do the work required up front, there are few cheaper options to increase your revenue while helping the most vulnerable patients in your community. You can read more about chronic care management at PBAHealth.com