Pharmacists interact daily with patients about their medication therapies.  For some of these patients, other clinical interventions may be needed to monitor their health conditions and improve their quality of life. There are three chronic disease states which impact the Medicare population the most: hypertension, diabetes, and high cholesterol. In 2023, PQS is connecting health plan partners with pharmacy staff members to engage with these chronic disease patients for a chance to earn additional revenue.

Hypertension (HTN)

Hypertension or high blood pressure is one of the most diagnosed chronic health conditions in patients. Consequences of high blood pressure may include vision loss, heart failure, stroke, and heart attack. Pharmacy staff members play an integral role in supporting these patients. Patients interact directly with pharmacies as a Healthcare Provider 2X more than any other provider¹.

The pharmacy’s position as a partner in managing blood pressure can influence patient behavior by having meaningful conversations related to how a high blood pressure could impact a patient’s day-to-day life. Staff can begin engaging by inviting a patient into the pharmacy to have their blood pressure electronically recorded. This may reassure the patient that they can rely on pharmacy staff to assist in their health, and pharmacies can be seen as a valuable resource. Through patient education and proper monitoring of conditions, pharmacists can better patient health outcomes.

Diabetes

Diabetes is a chronic health condition impacting how your body turns food into energy. The elevated levels of blood glucose may lead to serious damage to the heart, eyes, kidneys, and nerves. Patients with diabetes must monitor their A1C to ensure their current treatment is the best course of action. Pharmacists have a tremendous opportunity to provide diabetes education to these patients and connect with their prescribers in the event a patient’s A1C value is too high. Pharmacists can educate diabetic patients on the health risks associated to A1C values greater than 9 and provide counseling on lifestyle changes that could positively impact their condition. For some pharmacies, you may have the ability to complete A1C testing at point of care creating another opportunity for reimbursable clinical intervention in the pharmacy.

• Within the EQUIPP® platform, pharmacies who have eligible patient opportunities could receive a bonus for documenting patient encounters and conducting A1C testing. PQS encourages you to review your performance data monthly and check for new patient opportunities weekly within the dashboard.

2023 is the year to create your pharmacy’s blueprint and develop a tactful plan for patient engagement beyond dispensing. Pharmacy staff members are an extremely valuable resource and can assist patients with health outcomes improvement on more than just these chronic conditions.

For more information on these opportunities and others to come, be sure to review your EQUIPP refresh notices and follow us on LinkedIn for other updates.

¹Pharmacists as accessible health care providers: quantifying the opportunity. Published in final edited form as: J Manag Care Spec Pharm. 2022 January ; 28(1): 85–90. doi:10.18553/jmcp.2022.28.1.85.