Q&A: Tony Willoughby on driving clinical performance
After speaking at the Health Mart Annual Meeting Tuesday morning, Tony Willoughby, Health Mart’s chief pharmacist, sat down with DSN to talk about how pharmacies can drive adherence and excel in today’s changing healthcare environment.
DSN: Medication adherence is a major focus of the Medicare Part D Star ratings. Why is this important for community pharmacies and how are they positioned to excel in this changing healthcare landscape?
Tony Willoughby: The Affordable Care Act continues to shift the industry toward payment for patient outcomes, and reimbursement in the form of bonus dollars for Medicare Advantage plans is increasingly tied to performance as measured by Star ratings.
While pharmacies are not specifically included in the Star ratings, five of the 15 Part D quality measures are medication-related and are tripled weighted. This means that pharmacies have a direct impact on quality measures that make up about 48% of the total summary score for Prescription Drug Plans. As a result, pharmacies that perform well and can demonstrate quality performance are well positioned for inclusion in networks to maintain access to lives.
Research has shown that appropriate medication therapy management and improving adherence has a sizable impact on decreasing total healthcare costs. This is an opportunity for pharmacists to be recognized for the outcomes they drive beyond dispensing — it goes well beyond “the right pill in the right bottle to the right patient.” Community pharmacists are very well positioned to support all stakeholders, whether it’s payers, physicians, ACO groups or patient-centered medical homes to make sure that patients are on the correct therapy and remain adherent to that therapy.
DSN: Tell us more about the “Know Your Number” town hall meetings and how this helps Health Mart stores improve pharmacy performance and patient outcomes?
Willoughby: Health Mart has partnered with Pharmacy Quality Solutions (PQS) to provide our franchisees access to the PQS EQuIPP pharmacy performance data so they can understand their current performance on the medication-related Medicare Part D Star ratings measures.
One component of Health Mart’s overall pharmacy performance strategy, the “Know Your Number” town hall meetings have focused on building understanding of what’s happening around value-based reimbursement, why the Star ratings are important and how they are beginning to impact access. This first round of nearly 100 town hall meetings has also touched on how Health Mart pharmacies can improve their stores’ performance to drive inclusion in limited pharmacy networks.
During the Health Mart Annual Meeting this week, we announced that we will be kicking off another round of town hall meetings in the fall. These meetings will emphasize action steps to improve quality performance. At McKesson and Health Mart, one of our primary goals is to make sure that our Health Mart stores get credit for the quality care they provide. In order for them to get credit, they have to understand the numbers and perform. We see this as an ongoing cycle of awareness of the change that’s going on, adopting the right tools to be effective and helping to support them in delivering and demonstrating that performance.
DSN: The Pharmacy Intervention Program (PIP) has been a centerpiece of the clinical message at McKesson ideaShare for a few years. Can you elaborate on the importance of this program and how it works?
Willoughby: While not exclusive to Health Mart, the McKesson Pharmacy Intervention Program is a great way to demonstrate how pharmacists can drive adherence. Offered through our Sponsored Clinical Services (SCS) network, the program is built upon the foundation of behavioral coaching, which empowers pharmacists to engage with the patient, use the relationship capital that they have and then ask the right questions to understand why that particular patient is not adherent.
This program has led to tremendous results. For example, for our diabetes portfolio of programs, patients who received face-to-face behavioral coaching showed an average of 1.5 to 2 incremental refills with adherence increasing approximately 30%. Even more impressive, our studies showed sustained adherence impact for these patients through the 18-month mark, demonstrating true health behavior change.
The Pharmacy Intervention Program helps pharmacists understand the tremendous impact of face-to-face conversations and how that influences patient behavior. It’s important that they work with the entire pharmacy team to optimize their workflow, enabling the pharmacist to practice at the top of his/her license and become proficient at using the behavioral coaching approach so that the pharmacist is continuously out front having conversations with those patients, understanding their true barrier to adherence and then looking at their suite of tools that they have to solve those barriers or help the patient overcome those barriers.
DSN: How else should pharmacists look to play an increasing role in improving adherence in the evolving environment?
Willoughby: While not a new concept, medication synchronization has really gained a foothold in the industry based on its ability to improve adherence and script retention through greater patient convenience.
Studies have shown that med synch programs have demonstrated an increase of refills for chronic medication from an average of 6 to 7 times a year to 8 to 10 times a year. With the development of the Simplify My Meds program by the National Community Pharmacists Association, medication synchronization has really gained traction among independent pharmacies. When we surveyed the top 20% of Health Marts from a quality performance perspective, more than half are embracing med sync in certain patient populations.
As we saw with Pharmacy of the Year winner Hashim Zaibak, and his team at Hayat Health Mart Pharmacy, a well-run med synch program not only improves adherence, but can also offer pharmacies a powerful tool for maintaining customer loyalty, as well as building strong relationships with other healthcare providers in the community.