Best practices and barriers to implementing value-based payer programs in community pharmacies: An application of the...

Area of Science:

• Pharmacy Practice
• Health Services Research
• Implementation Science

Background:

• Community pharmacies are crucial for medication use optimization and patient health outcomes.
• The Community Pharmacy Enhanced Services Network (CPESN) Mississippi facilitates collaboration among community-based pharmacies.
• Advancing clinical services in community pharmacies requires effective workflow augmentations.

Purpose of the Study:

• To evaluate barriers encountered during the implementation of patient care services.
• To identify best practices for implementing patient care services within community pharmacies.
• To assess challenges and successes in community pharmacy participation in payer engagements.

Main Methods:

• A qualitative, quality improvement study design was employed.
• Interviews were conducted with 21 owners or managers of pharmacies within CPESN Mississippi.
• The Exploration, Preparation, Implementation, Sustainment (EPIS) Framework guided the development of interview guides for barriers and best practices.

Main Results:

• Four key themes emerged for best practices: role specialization, clear communication, leadership support, and patient engagement.
• Four primary themes were identified as barriers: infrastructure needs, documentation complexities, staff buy-in, and reimbursement issues.
• The study achieved a 41% response rate with 8 interviews focusing on best practices and 13 on barriers.

Conclusions:

• Community pharmacists are motivated to pursue alternative revenue sources through enhanced services.
• Implementation support is essential for pharmacists to successfully adopt new patient care services.
• The EPIS Framework provides a foundation for developing strategies to create sustainable and scalable change in community pharmacy practice.