Prescriber Perceptions of Clinical Pharmacists within Alternative Payment Models: A Report from ACORN SEED (Accountable Care Organization Research Network, Services and Education)

Objective: The purpose of this cross-sectional study is to evaluate the perception of clinical pharmacists by prescribers within a primary care-based ACO. Background: The Alternative Payment Model (APM) is a payment approach that incentivizes high quality patient care. It includes the Medicare Shared Savings Program and the Next Generation Accountable Care Organization (ACO) Model. Within primary care-based, clinical pharmacists are in an ideal position to manage multiple aspects of patient care. Methods: A qualitative, anonymous survey consisting of seventeen items divided into four domains was created and disseminated electronically and/or by hand to prescribers within two Accountable Care Organizations in South Florida. Survey construction was performed utilizing information retrieved during the literature search as well as consulting the expert opinions of current pharmacists who work within the APM models. The survey was then given to six pharmacy faculty, two physicians, one Director of Quality Improvement who work within the ACO model to screen for readability. Results: 11 prescribers completed the survey with 81.8% of prescribers having had the opportunity to collaborate with clinical pharmacy services. Overall, prescribers were more likely to refer patients with chronic conditions to clinical pharmacy services. Almost all of the prescribers who took the survey believed clinical pharmacists help to improve patient quality outcomes (90.9%). However, 5 of 11 (45.5%) surveyed prescribers felt comfortable signing a Collaborative Practice Agreement (CPA) with a clinical pharmacist. Conclusion: Although clinical pharmacists were perceived as having high value in the ACO setting, many prescribers were not comfortable signing a CPA