Pharmacist Impact on Provider Productivity and Billing: Ambulatory Care Clinic

Pharmacists are frequently viewed as primarily working in community pharmacies, counting pills, and counseling patients. More recently, pharmacists have fought to find their place in clinical settings, providing important medication information to collaborative care teams. As a result of their contributions, pharmacists have found places in many different health care settings.

Researchers from the University of Florida College of Pharmacy have investigated the impact of placing a pharmacist in the rural ambulatory care setting. By tracking work relative value units (wRVU), researchers compared physicians’ change in productivity when working in collaboration with a pharmacist and independently.

Investigators collected data retrospectively from a single institution. Using the institution's electronic medical record, researchers recorded both the number of patients seen and the level of service billed in each patient visit. Afterwards, they calculated the wRVU for collaborative and non-collaborative physicians to compare productivity.

With a pharmacist in the care team, providers in collaboration with pharmacists saw 19.25 patients versus 12.9 patients for providers who worked independently. Collaborative providers also generated a higher average wRVU per patient visit. Therefore, physicians were more productive, saw more patients, and increased access to care.

Compared to the non-collaborative providers, those working with pharmacists billed at a higher level of service as a result of their generated wRVU. Even though the average wRVU difference for a single patient was not large, an immense difference in productivity and revenue generated could be seen when extrapolated over a year. The collaborative physicians averaged 1.45, 1.48, 1.55 wRVU respectively versus 1.37 and 1.30 for independent physicians.

These investigators concluded that higher billing from physicians suggests a higher level of productivity. Although this study showed that implementation of a pharmacist in ambulatory care setting benefits the patient, provider, and the institution, further studies are required.

Future studies need to include a larger number of patients, expand from the rural setting, and research other interdisciplinary sources. Further research will help promote the profession.

References

1. DeRemer CE, Perez NA, Middleton K, Konopack J, Dietrich E. Impact of an ambulatory care pharmacist on provider relative value units in a rural clinic. Explor Res Clin Soc Pharm. 2021;5:100098. Published 2021 Dec 14. doi:10.1016/j.rcsop.2021.100098