Large Medical Center Benefits from Accountable Care Organization Platform

Medication therapy management (MTM) is a complex but vital component of population health management, and a system delivering real-time data allows for meaningful care coordination, patient engagement, and timely medication interventions, according to a presentation on Thursday, May 14, 2020, at the Pharmacy Quality Alliance (PQA) 2020 Annual Meeting.

Some health care systems have implemented a population health care model to address the complex care needs of a variety of patient groups. Key elements include care management, continued evaluation, interdisciplinary collaboration, risk stratification, and strong data.

Pharmacist-led MTM for high-risk patients is driven by artificial intelligence risk stratification based on claims data, predictive analysis and social determinants of health. Medication therapy problem (MTP) category framework is the tool used to collect and evaluate medication-related issues.

One presenter, Klodiana Myftari, PharmD, BCACP, an assistant professor of pharmacy practice at Midwestern University in Downers Grove, Illinois, and a clinical pharmacist at Rush University Medical Center in Chicago, Illinois, talked about the Medical Home Network’s Accountable Care Organization (ACO), which is a provider-owned and -driven approach to patient health care delivery and population health management for Medicaid patients. Rush University Medical Center is a member of the ACO.

The goal of the ACO is shared decision-making and savings that focus on change, collaboration, delivery improvement, and innovation for all its members.

The components of the care management program are registries and risk stratification, technological infrastructure, and an interdisciplinary team, according to Myftari.

“The key premise is that we are providing patient-centered care,” she said.

Rush University Medical Center uses the ACO’s technology platform and supplements it with artificial intelligence algorithms and integrates that into its own platform, Myftari said.

Part and parcel of this is the lack of adherence and optimizing medication use, according to co-presenter Vidya Chakravarthy, MS-HSM, director of population health at Rush University Medical Center.

Lack of adherence can range from not using an inhaler properly all the way to a patient who has stopped taking their medications entirely, she said.

The PQA endorses 2 MTM measures. One is the MTP, which is divided into 2 categories: adherence and cost.

When asked about the benefits of working for a large health care system that has access to the benefits afforded by the ACO, Myftari said, “I do feel privileged to see medication use in a more comprehensive way” than is seen by community pharmacists.

However, she said that she has worked with community pharmacists and sees their value and how important they are.

Reference

Myftari K, Chakravarthy V. Population health management: evaluation of MTP category framework in an AI driven value-based care model. Presented at: Pharmacy Quality Alliance (PQA) 2020 Annual Meeting, online; May 14, 2020.