Improving Pharmacy Quality, Health Outcomes, and Patient Experience Through Health Plan and Pharmacy Value-Based Partnerships

Session Description: Value-based programs reward health care providers with incentives for the quality of care they provide. While medical providers are often at the center of value-based care conversations, health plans & pharmacies can mutually benefit from establishing partnerships to advance the quality of care provided to at-risk patients. By using data & advanced analytics to select the patients most likely to benefit from intervention, designing personalized pharmacy care programs to enable improvements in health outcomes, & aligning incentives, health plans & pharmacies can work together to advance value-based care.

This session will outline specific ways to leverage value-based payment models to support pharmacies in driving patient engagement & improved medication outcomes. Together, RxAnte & Centene Pharmacy Services have facilitated value-based partnerships between the health plan & pharmacies. Two of these models will be discussed in this session including a community pharmacy-based incentive program & a comprehensive pharmacy care management program for complex & vulnerable seniors. Finally, this session will highlight the impact of pharmacy care management services on the effects of these value-based programs on pharmacy quality measures & patient & caregiver experience.

Attendees will learn how to structure value-based pharmacy programs & their potential impact on pharmacy quality measures, member experience & health outcomes such as hospital admissions & total cost of care.