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

The advancement of clinical services in the community pharmacy setting hinges on workflow augmentations that will assist pharmacies in successful implementation. Community Pharmacy Enhanced Services Network (CPESN) Mississippi is a network of community-based pharmacies collaborating to optimize medication use to promote positive patient health outcomes.

The purpose of this study was to evaluate barriers to and best practices for implementing patient care services while participating in payer engagements.

This qualitative, quality improvement study was approved as exempt by the University of Mississippi Institutional Review Board. Subjects included owners or managers of pharmacies participating in CPESN Mississippi, an accountable pharmacy organization. Investigators developed two interview guides using the Exploration, Preparation, Implementation, Sustainment (EPIS) Framework. One interview guide was intended to gather information on best practices for the implementation of services, while the other was geared toward assessing barriers to implementation. Pharmacies were sorted into 2 groups to receive either the barriers or best practices questions based on their participation in a payer program in the fall of 2021. Interviews were conducted via telephone and were digitally recorded. Three attempts to contact each pharmacy were made on different days and times. Interviews were transcribed via Trint and underwent analysis for thematic content.

A total of 21 pharmacists at community pharmacies in CPESN Mississippi were interviewed for a response rate of 41%. There were 8 interviews in the best practices group and 13 in the barriers group. The content analysis identified 4 themes in best practices (role specialization, clear communication, support from leadership, and patient engagement) and 4 themes in barriers (infrastructure needs, documentation complications, staff buy-in, and reimbursement).

Study findings concluded that community pharmacists are eager to find alternative sources of revenue but require support with implementation. The use of the EPIS Framework allows for the identification of specific implementation strategies for testing in future studies and creating sustainable and scalable change in the community pharmacy setting.