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The American Journal of Accountable Care June 2018
Amazing Grace: A Free Clinic's Transformation to the Patient-Centered Medical Home Model
Jason Alexander, BS, PCMH CCE; Jordon Schagrin, MHCI, PCMH CCE; Scott Langdon, BA; Meghan Hufstader Gabriel, PhD; Kendall Cortelyou-Ward, PhD; Kourtney Nieves, PhD; Lauren Thawley, MSHSA; and Vincent Pereira, MHA, PCMH CCE
Lessons Learned in Implementing Behavioral Screening and Intervention
Richard L. Brown, MD, MPH
The Intersection of Health and Social Services: How to Leverage Community Partnerships to Deliver Whole-Person Care
Taylor Justice, MBA, President of Unite Us
Case Study: Encouraging Patients to Schedule Annual Physicals
Nicholas Ma
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Effects of an Integrated Medication Therapy Management Program in a Pioneer ACO
William R. Doucette, PhD; Yiran Zhang, PhD, BSPharm; Jane F. Pendergast, PhD; and John Witt, BS
Utilizing Community Resources, New Payment Models, Technology to Deliver Accountable Care
Laura Joszt, MA
Cost-Effectiveness of Pharmacist Postdischarge Follow-Up to Prevent Medication-Related Admissions
Brennan Spiegel, MD, MSHS; Rita Shane, PharmD; Katherine Palmer, PharmD; and Duong Donna Luong, PharmD

Effects of an Integrated Medication Therapy Management Program in a Pioneer ACO

William R. Doucette, PhD; Yiran Zhang, PhD, BSPharm; Jane F. Pendergast, PhD; and John Witt, BS
This article reports that an integrated medication management program in a Pioneer Accountable Care Organization was associated with decreases in all-cause hospitalization and Medicare costs.

Objectives: The objectives of this study were to: (1) assess the effects of an integrated medication therapy management (MTM) program for accountable care organization (ACO) patients on all-cause hospitalization rates, (2) evaluate the impact on 30-day hospital readmission rates for the ACO patients, and (3) assess the effect of an integrated MTM program on per capita Medicare parts A, B, and D costs for ACO patients.

Study Design: A quasi-experimental nonequivalent design compared utilization and costs for ACO patients in an MTM program with those of patients in a Medicare Shared Savings Program (MSSP) but not an MTM program.

Methods: The integrated medication management program linked a network of community pharmacies with ACO practitioners. Analyses included Medicare parts A and B claims data from January 1, 2013, through December 31, 2014, with a 9.5-month baseline period and a 14.5-month intervention period. The outcome variables were all-cause hospitalization rate (per 30 days), 30-day hospital readmission rate (per 100 discharges), and average monthly per capita costs for Medicare parts A and B. Longitudinal analyses (generalized estimating equations) were used to compare across groups and over time, controlling for age, gender, and race.

Results: Data comparing 885 ACO patients with 642 MSSP patients showed significant decreases in hospitalization rates and Medicare costs over time, but no significant differences across the groups. No significant decreases were found in 30-day readmission rates.

Conclusions: An integrated medication management program was associated with lower hospitalization rates and costs of care over time, although these reductions were not significantly different from decreases found in a comparison MSSP group.

The American Journal of Accountable Care. 2018;6(2):20-25

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