Considerations in establishing fees for home-care pharmaceutical services

The activities of home-care pharmacists are highlighted, and factors that should be considered in establishing a reimbursement schedule are described. Pharmacists are important members of the home health-care team. Responsibilities of the pharmacist include assisting in the development of a therapeutic plan, reviewing and monitoring drug therapy, and ensuring that appropriate and correctly prepared medications are available to the patient. The degree of pharmaceutical service depends on the therapy prescribed. The traditional type of third-party reimbursement--cost of drug plus dispensing fee--is often inadequate and can discourage pharmacists from becoming involved in home health care or from providing services of optimal quality. An appropriate reimbursement schedule should take into account the variety of pharmaceutical services provided to home-care patients and should give special consideration to activities, such as discontinuation of unneeded drug therapy, that lower medical costs. Whether pharmacists are able to provide high-quality home health-care services may depend on how adequately they are reimbursed.