Exam 1 - Pharmacy Services: Traditional & Value Added Flashcards
Name the four Traditional Pharmacy Services.
1) Community retail pharmacy
2) Hospital pharmacy
3) Home infusion pharmacy
4) Compounding (non-sterile) pharmacy
Name the five types of Value-Added Pharmacy Services.
1) Point of care services
2) Wellness/health promotion and monitoring/screening services
3) Pharmacy based immunization delivery
4) Disease state management
5) Case management/pharmaceutical care
What is the difference between traditional pharmacy services and value-added services?
Value-added pharmacy services is anything beyond traditional services (i.e. dispensing)
What type of value-added pharmacy services occur with dispensing function?
Point of care services
T/F: All pharmacists participate in point of care services.
TRUE
What type of value-added pharmacy service collects non-comprehensive information such as allergies to specific meds?
Point of care services
T/F: Wellness/health promotion and monitoring/screening services require more patient data.
TRUE
T/F: Wellness/health promotion and monitoring/screening services occur with the dispensing function.
FALSE
-Wellness/health promotion and monitoring/screening services occur separate from the dispensing function
Name the 3 examples of Screening/Health Promotion.
1) Smoking cessation
2) Osteoporosis screening
3) Lipid screening w/ cardiovascular assessment
Name examples of monitoring in wellness/health promotion and monitoring/screening services.
- Pharmacist managed anticoagulation service
- Lipid management service
Who sponsors a Pharmacy Based Immunization Delivery program?
APhA
What is the role of the pharmacist in a pharmacy based immunization delivery program?
- Advocate through education
- Facilitator
- Immunizer by administering vaccines
What vaccinations can pharmacists administer?
- Influenza
- COVID-19
- Pneumococcal
- Herpes zoster (Shingrix)
- T-dap
Name the 4 ways to be compensated for a pharmacy based immunization program.
1) Pt payment out of pocket
2) Medicare Part B - Influenza, Pneumococcal
3) Medicare Part D - all vaccines not covered by Medicare Part B (i.e. herpes zoster)
4) Private third party
T/F: Disease state management programs occur separate from dispensing.
TRUE
Disease state management programs contain ____ ____ education.
Disease state management programs contain ongoing patient education.
How long could a disease state management appointment last?
15-60 minutes
Name 3 examples of disease state management.
1) DM
2) HTN
3) Lipid
What type of pharmacy service is case management/pharmaceutical care?
Value-added pharmacy services
What are the 4 components of value-added pharmacy services?
1) Data collection
2) Lab monitoring
3) Medication management protocols
4) Patient education
What is collected in data collection of value-added pharmacy services?
- Pt hx
- Pt medical hx
- Medication hx
- Authorization to release medical information
What lab monitoring would be included in value-added pharmacy services?
- A1c
- Bone mineral density (bone densitometer)
- Weight
- INR
- Lipids
- Blood glucose
What does CLIA stand for?
Clinical Laboratory Improvement Amendments
What ensures that all labs meet quality standards?
CLIA
T/F: Lab tests used by pharmacists are waived because the FDA considers them simple to administer and having little risk of error.
TRUE
What are the outcomes of value-added pharmacy services?
- Clinical control of disease states (BP, lipids, DM, weight)
- Humanistic - QOL
- Economic
- Pt knowledge
What are the 6 P’s of marketing value-added services?
1) PRODUCT
2) PLACE
3) PRICE
4) PROMOTION
5) PROCESS MANAGEMENT
6) PERSONNEL
What do you consider in PLACE?
Pt privacy and space
What is meant by PROCESS MANAGEMENT?
Create an appointment schedule
How can you reward pharmacists for their effort in a program?
- Cover CE costs
- Cover costs of one national pharmacy meeting per year
What does CLIA stand for?
Clinical Laboratory Improvement Amendments
What does CPT stand for?
Current Procedure Terminology codes
____ ____ ____ (___) __ are numerical codes that are used to describe specific types of pt visits, procedure, and lab tests.
CURRENT PROCEDURE TERMINOLOGY (CPT) CODES are numerical codes that are used to describe specific types of pt visits, procedure, and lab tests.
Name the two forms used in claims submissions.
1) CMS 1500
2) CMS 1450
Which claims form is used for Medicare patients?
CMS 1500
Which claims form is used for hospital outpatient clinics?
CMS 1450
What is CMS 1500 used for?
It is a claims form for Medicare patients
What are the 3 costs associated with value-added services?
1) FIXED COSTS
2) VARIABLE COSTS
3) SALARIES
Name examples of fixed costs associated with value-added services.
- Space
- Office equipment
- Advertising
- Pt care equipment
- License to perform lab tests
- Lab equipment
Name examples of variable costs associated with value-added services.
- Sharps containers
- Alcohol pads
- Cost of vaccines, syringes, bandages
T/F: Salaries are viewed as only fixed costs.
FALSE
-Salaries can be viewed as fixed or variable costs
What are the compensation strategies for value-added pharmacy services?
- Cash paying pt
- Third party
What is an advantage to cash paying pts?
Ask for and receive immediate payment
What is the term for HMO reimbursement based on a uniform fee per pt?
Capitation
Name the 3 third party types.
1) Medicare
2) Medicaid
3) Private third party - i.e. Aetna, United Health Care, Coventry, etc.
What does CMM stand for?
Comprehensive Medication Management
What are the essential functions of CMM?
- Collect and analyze information
- Assess information and formulate a medication therapy problem list
- Develop the care plan
- Implement the care plan
- F/U and monitor
Who is likely to receive CMM (MTM)?
ELDERLY
