Financial oversight of medication use: an expanded role for consultant pharmacists

Many consultant pharmacists are moving beyond their federally defined role of reviewing resident charts in nursing facilities. They are taking on an expanded role, not only to provide the best possible care, but also to ensure that the spending for medications supports these efforts. This is increasingly important, given the 11% cut in Medicare effective October 1, 2011, which is forcing nursing facilities to operate even more efficiently and effectively. Involvement of the consultant pharmacist in medication finances requires knowledge in several new areas that include the dialysis-medication bundling, vaccine coverage, and responsibility for off-label use of medications. While the financial management of medications is an opportunity for the consultant pharmacist, it is only the first of many. Additional opportunities for consultant pharmacists will develop as nursing facilities become accountable for clinical outcomes-including readmissions-that will impact both hospital referrals to nursing facilities and Medicare payments. Appreciating these opportunities and gaining knowledge and expertise is critical to consultant pharmacists playing a lead role in the nursing facility. Consultant pharmacists need financial management expertise to become able to deal with ongoing changes.