The Pharmacist: An Integral Component of the Care Coordination Team for High-Cost, Medically Complex Population

Monday, September 17, 2012
The Pharmacist: An Integral Component of the Care Coordination Team for High-Cost, Medically Complex Population
Timothy Cummins, MBA, BS, RPh
University of Massachusetts Medical School

A pharmacist’s medication management skill can enhance health outcomes and quality of life for members of Medicaid, Medicare, and commercial health plans — especially for members who have serious medical conditions or need closely coordinated pharmaceutical care. For this reason, UMass Medical School’s Clinical Pharmacy Services program has developed a specialized medication therapy management program for high-cost populations with complex medical conditions or other issues that put them at risk.

The Clinical Pharmacy Services pharmacists who work within this program have expertise with high-cost, high-risk populations. They also understand coverage limits and can nimbly navigate the health care system. Currently, these pharmacists work as part of care coordination teams for the following populations:

  • Medically fragile children under age 22

  • Adults with multiple chronic, complex conditions, such as acquired brain injury with other co-morbidities

  • Children in the care of social services

  • Children in the care of, or about to enter, the foster care system

  • Members with complex medical needs being discharged from hospitals