Practice models used by pharmacists in rural Minnesota to obtain Medicare reimbursement

(1) Define "incident-to" rules for Medicare reimbursement; (2) Describe how pharmacists can meet incident-to rules; (3) Provide examples of models of practice in rural areas that could be useful for meeting incident-to rules; and (4) Develop a strategy for creating a pharmacy practice model that could meet Medicare reimbursement rules in rural areas.

A survey of participants from the Pharmacy Rural Education, Practice and Policy Institute and the College of Pharmacy, University of Minnesota.

Community, hospital, and clinic practice sites in rural Minnesota.

Four distinct models of practice have evolved that meet the incident-to rules of Medicare for reimbursement. Travel, proximity to physicians, and employment are the major determinants of the models described.

Pharmacists in rural areas have demonstrated the ability to satisfy the incident-to rules for Medicare reimbursement. Collaborative agreements with physicians must include specific employment, practice, and supervisory relationships in order to satisfy these rules.