Building the Business Case and Value-Based Payment Models for Enhanced Medication Management

For people with complex health and social needs who also have complicated drug regimens, pharmacists can provide patient-centered, enhanced medication management services in coordination with other providers aimed at reducing risks and improving outcomes. However, due to many pharmacy and drug services being carved out from other medical services within health plans, it can be challenging to arrange Medicaid reimbursement for community-based pharmacy services, such as comprehensive medication review, mediation home delivery, and tailored packaging.

In an effort to address this issue, pharmacists and health care organizations across the country are experimenting with value-based payment approaches. During this 90-minute webinar, participants from two sites participating in the Community Management of Medication Complexity Innovation Lab, a national initiative led by the Center for Health Care Strategies with support from the Gordon and Betty Moore Foundation, will describe their innovative reimbursement models and tips for building the business case for payers to cover enhanced medication management services.

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