College of Pharmacy receives $2.5 million to establish therapy management for Medicare prescription patients

The University of Florida College of Pharmacy is lending its knowledge – and ears – to Medicare and Medicaid patients, starting this spring.

In a partnership with national health-plan company WellCare Health Plans Inc., the College of Pharmacy is receiving $2.5 million to establish a medication therapy management call center. The call center satisfies a government requirement for health-plan providers of Medicare prescription drug benefits to provide once-a-year comprehensive medication review with quarterly follow-ups, called Medication Therapy Management.

The importance of the MTM center is to see if patients are following their medication plans and to identify any nonprescribed drugs the patient could be taking that may react dangerously with other medications or cause them to be ineffective, said David Angaran, M.S., a clinical professor at the college and director of the center.

The faculty and student pharmacists use listening skills and empathetic conversation to establish trust with the patients, Angaran said.

“One of our biggest challenges is we have no prior relationship with the plan member. It’s really perfect strangers talking to perfect strangers,” Angaran said. “But the great thing about this is we’re giving these patients our time and attention.”

A pharmacist would have a difficult time trying to have a 30-minute uninterrupted conversation with even one patient during the workday, Angaran said. Using new MTM patient management software developed by Gold Standard/Elsevier, the call center can better reach thousands of patients to uncover and document details that the patients’ health-care providers may not know.

“When you go to a pharmacy you get this sense that everyone’s rushing. You’re standing, and you have no privacy,” Angaran said. “Our belief is that the patients open up more because they are in the comfort of their homes.”

The UF call center has begun contacting patients among WellCare’s 800,000 members who have three or more chronic diseases and take eight or more medications that exceed $3,000 in total costs annually. WellCare provides the center a record of all the prescribed medications each patient takes, how they should be using them, and their disease states, Angaran said.

Qualified patients are sent a letter informing them that they are automatically included for the service but may opt out by contacting the center. Student pharmacists, on educational rotations in the center, call patients to confirm participation and schedule a time when patients can have their medications in front of them and speak over the phone for up to an hour.

Before placing a second call, the team reviews patients’ pharmacy records to see what prescriptions they are taking, to identify potential drug interactions, to assess compliance and cost issues, and to form questions to assist in the medication review.

After spending 30 to 60 minutes with each patient, the students work with clinical pharmacy faculty to develop a medication action plan. The call center team sends a copy of the plan to patients and a list of potential drug-related issues, with possible solutions and references to their physicians.

Besides patient care, the call center brings academic and research opportunities to the college, too. Teresa Roane, Heather Hardin and Anna Hall, all doctors of pharmacy and clinical assistant professors, will supervise the student pharmacists and gather data to publish research findings about the effectiveness of the center’s patient outreach efforts.

“From a task as simple as educating a patient on the benefits of using a pillbox, to one as serious as identifying a heart failure patient taking a ‘black-box warning’ drug with adverse risks, the impact we’ve had as students far exceeded my expectations,” said Rosanne Pagaduan, a call center student pharmacist.

Michele Lawson, an MTM trainer, teaches the students how to be empathetic pharmacy-care consultants, often offering these words of advice:

“You can hear a smile through the phone, so always smile,” she said. “When you’re on the phone you should feel like you’re holding their hand.”