Impact of quality measures performed through pharmacist collaboration with a primary care clinic

Objective: The objective was to assess the clinical and financial impact of a pharmacist integrated within a primary care practice on quality measures of the merit-based incentive payment system (MIPS).

Setting: The study was conducted in a multidisciplinary primary care practice in Charlotte, NC.

Practice description: A collaborating pharmacist from an independent community pharmacy is integrated within clinic workflow. In this team-based model, pharmacists work alongside providers to furnish comprehensive care, focusing on MIPS quality measure improvement through Medicare annual wellness visits (AWVs) and chronic care management (CCM).

Practice innovation: Quality measure achievement was assessed from completed face-to-face AWVs, phone call CCM, or both.

Evaluation: From January 1, 2017, to December 31, 2018, 403 patients in 2017 and 565 patients in 2018 were eligible to be seen by the collaborating pharmacist for either an AWV, CCM, or both services. Measure achievement was characterized using descriptive statistics. Billing reports were used to determine the average monthly dollar amount of Medicare Part B claims submitted.

Results: The percentage of patients achieving quality measures increased for 3 measures, decreased for 2 measures, and was neutral for 1 measure. The percentage of patients achieving quality measures resulted in a MIPS quality performance score of 60 of 60 points, which contributed to a final MIPS score of 100 of 100 points and a positive (+) 1.88% payment adjustment in 2019. Extrapolating from previous volume, the provider's total MIPS payment adjustment may result in an additional $16,920 in annual reimbursement.

Conclusion: Pharmacist-provided collaborative clinical services in the primary care setting appear to ensure achievement of MIPS quality measure benchmarks, potentially increasing the practice's annual MIPS reimbursement by $16,920.