L.A. Care Health Plan, Inland Empire Health Plan Announce Launch of Pharmacist Provider Program

Through USC’s California Right Meds Collaborative, L.A. Care Health Plan and Inland Empire Health Plan refer patients to community pharmacists for help in managing medications for chronic diseases that worsen COVID-19 outcomes; pharmacists will be reimbursed for clinical services and if health goals are met.

LOS ANGELES — As COVID-19 continues to impact the Southern California region, L.A. Care Health Plan and Inland Empire Health Plan (IEHP) are announcing their partnership in the California Right Meds Collaborative, a pharmacist-led initiative founded at USC to improve health outcomes in local communities, decrease health care costs, better allocate physician resources, and reduce unnecessary hospitalizations.

Pharmacists in the California Right Meds Collaborative program provide clinical services to Medi-Cal, Medicare and Covered California patients in Los Angeles County and the Inland Empire who have persistently uncontrolled health conditions like diabetes, high blood pressure and asthma. L.A. Care Health Plan and IEHP – which together serve over three million members – provide payment to participating pharmacists based on accomplishment of treatment goals.

“By leveraging community pharmacies as neighborhood-based health hubs, patients who struggle with chronic disease control have easy access to Comprehensive Medication Management, a service that optimizes medication therapy,” said Steven Chen, associate dean for clinical affairs at USC Mann, who founded the program. “The California Right Meds Collaborative, focusing on population health priorities, allows pharmacists to collaborate with physicians to fully utilize their training for the benefit of patients, physicians and health plans and the community.”

With more than 90% of the U.S. population within 5 miles of a pharmacy, pharmacists are in a key position to play a greater role in managing diabetes, obesity, high blood pressure, asthma and other chronic disease conditions that greatly increase the risk of hospitalization and death from COVID-19.

“As the country’s largest publicly operated health plan, L.A. Care recognizes the expertise and value pharmacists provide as an integral part of the health care team,” said John Baackes, CEO of L.A. Care. “By pioneering a value-based payment program that engages community pharmacists, California Right Meds Collaborative connects patients with the most accessible and trusted health care providers right in their own neighborhoods.”

Patients love the program

Diabetes patients referred to participate in the L.A. Care California Right Meds Collaborative pilot program meet regularly with their pharmacist in-person or through telehealth visits for Comprehensive Medication Management, which includes evaluating all medications and making changes or recommendations in partnership with the patient’s physician. Patients receive education and counseling on proper medication use and self-management, and they receive extensive monitoring for efficacy/safety and dose adjustments. Pharmacists can also alert doctors if problems come up or the patient’s health doesn’t improve.

Earlier this year, Dana Prince of Los Angeles was referred to the California Right Meds Collaborative program by her physician, who told her that her 20-year history of uncontrolled diabetes put her at high risk for hospitalization and possible amputations.

Prince began meeting with her local pharmacist Dr. Christal Pham via video-chats, learning how to change her eating habits, exercise, monitor her blood sugar levels consistently and regulate her medications. Today she is meeting the health goals set by her physician. “I truly appreciate my pharmacist,” Prince says. “I just needed the push that said, ‘you can do it.’.”

Many of the pharmacists selected to participate in the California Right Meds Collaborative pilot program say the initiative is giving them a way to leverage their training and contribute to the health of their local community.

“Pharmacists have so much to offer in improving health outcomes,” said Dr. Annie Thai of 986 Pharmacy. “We can spend time counseling patients to make sure they are adhering to their medication regimen, and we can make sure the doctor, patient, the whole team is in line with each other. That’s a win for everyone—patients, physicians, pharmacists, the community—particularly in this time of COVID-19.”

Physicians who partner with pharmacists in the collaborative benefit in many ways. The shortage of primary care providers has made physicians busier than ever, with limited time to address the medication-related needs of patients. In addition, physician payments today are frequently tied to the disease control status of their patients such as blood pressure or asthma control. Through the California Right Meds Collaborative, incentives are aligned to put the patient’s needs first, allowing patients to spend time with pharmacists to optimize medication therapy leading to increased physician, availability/access, and satisfaction.

To support members with uncontrolled asthma, IEHP will roll out the program as well.

“California Right Meds Collaborative is a bold and innovative way we can enhance the health and wellness services we offer our members,” said Jarrod McNaughton, IEHP chief executive officer. “This program meets our most vulnerable members right in their own communities and provides an invaluable amount of resources to them. We look forward to working with and financially supporting our local participating pharmacists in their service expansion.”

Founded at the USC School of Pharmacy, the California Right Meds Collaborative is a consortium of health plans, pharmacies, academic and professional organizations in Southern California to deliver high-impact comprehensive medication management through a value-based payment model. Learn more at www.calrightmeds.org.