Empowering collaboration to cut costs, improve care and validate outcomes

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Collaborative Care
For Complex Patients

Our healthcare system is under tremendous pressure—from changes in legislation to a challenging economy—making it difficult to deliver healthcare that provides both improved outcomes and cost savings for the most complex patients.

Physicians Pharmacy Alliance understands this. We also understand that our industry can’t tackle these challenges in silos, and that true collaboration is necessary to manage exorbitant costs. Chronically ill patients require support that stretches beyond the walls of a physician’s office or pharmacy window: personalized care that hinges on collaboration and visibility across care teams to ensure patients understand and have access to prescribed medication regimens, along with the help they need to maintain long-term adherence.

PPA partners with payors and providers to simplify the management of complex patients, reduce healthcare costs, provide validated outcomes to meet reporting requirements, and equip care teams with the resources and support they need to deliver results.

State of the Industry: Tackling the Complexities of Disjointed Healthcare

PAYORS Learn how we can reduce medical costs together.

PROVIDERS Learn how we can improve regimen adherence together.

PATIENT Learn how we can simplify your care together.

ABOUT PPA

Our Mission

Physicians Pharmacy Alliance, Inc. (“PPA”) is an integrated pharmacy services organization specifically focused on patient populations with high potential for poor outcomes due to complex medication regimens. We understand that chronically ill patients require a specialized approach, both clinically and culturally. PPA has proven results caring for this unique patient group, and works in partnership with Medicaid, Medicare and ACO/PCMH programs.

The statistics for this population are staggering: Medicare patients with multiple chronic illnesses see an average of 13 different physicians and fill approximately 50 different prescriptions per year. They also account for more than 75% of all hospital admissions, and are 100 times more likely to experience a preventable hospitalization – which presents incredible challenges for those charged with reducing costs while providing quality care.


Our Unique Approach

PPA provides hands-on patient care that hinges on collaboration across payors, providers and caseworkers to simplify complex regimens, identify gaps in care, provide at-home interventions, monitor adherence and report therapeutic outcomes. We also empower patients with the adherence tools and support they need to better manage their health.

Our proven methods of collaboration and personalized support reduce hospital readmissions and deliver significant improvements in adherence, outcomes and cost savings for the high-risk patient population we serve.

Shared visibility is the foundation of our collaborative approach. PPA’s web-based collaboration portal, AlliancePoint, ensures transparency across all members of the care team by integrating data from multiple physicians, hospital visits and caseworker interactions. Everyone has a shared reality—not just shared records—of the patient’s healthcare, enabling us to quickly identify discrepancies in care and remove medication redundancies.

AlliancePoint’s rigorous data capture and analysis capabilities provide validated outcomes from interventions, medication changes and regimen adherence that will assist you with reporting and measurement requirements.

UPCOMING CONFERENCES


Academy of Managed Care Pharmacy (AMCP) Conference
April 19, 2012 | San Francisco, CA

AMCP is a society dedicated to the practice of pharmaceutical care in managed health care environments. PPA will be presenting in conjunction with our valued client, University Family Medicine of University of Maryland Medical Center, to discuss the results of integrating pharmacy services into a PCMH model.


20th Annual Medicaid Managed Care (MMC) Conference
April 30, 2012 | Baltimore, MD

MMC brings together over 350 state officials and health plan executives to provide best practices for improving clinical and financial outcomes for chronic care management. PPA will be presenting the key components for a successful integration of pharmacy services into PCMH programs and ACOs.

FOR PAYORS

Reducing the Cost of Care

Physicians Pharmacy Alliance partners with private and government third-party payors to control the cost of care for high-need patients on complex drug regimens. We’re ideally suited for case management initiatives and emerging PCMH and ACO models.

Our integrated medication management program consists of collaborative technology—a web-based collaboration portal, AlliancePoint, for tracking, measuring and reporting regimen data and therapy outcomes—as well as engagement with providers and personalized patient care to improve adherence and reduce hospital readmissions.

We believe both intelligent technology and hands-on support are needed to reduce medical costs without sacrificing quality of care. This uniquely collaborative approach creates shared visibility of patient medication activity across care teams, allowing us to quickly identify and manage discrepancies, consolidate duplicative therapies, recognize gaps in care and track adherence. We also provide validated outcomes data for reporting requirements.

This collaborative approach to healthcare has allowed us to:

  • Deliver over 80% adherence rates, resulting in fewer hospital readmissions
  • Deliver a 95% patient satisfaction rating
  • Identify gaps in care to avoid unnecessary treatment
  • Interact directly with providers to reduce their workload
  • Provide validated outcomes for reporting requirements
  • Remove nearly $2,700 in medication redundancies per patient, per year

KEY ELEMENTS
OF OUR PROGRAM

Patient Identification & Engagement
Home Visits & Medication Inventory
Reconciliation & Regimen Assessment
Synchronization & Alignment
Ongoing Adherence &
Compliance Support
Continuous Collaboration &
Validated Outcomes

Patient Identification & Engagement

To reach plan members who are best suited for our program, we work with payors and providers to identify patients who are at the highest risk for hospital readmissions or have challenges adhering to complex drug regimens.

Because PPA has been managing complex patients for more than a decade, we’ve developed specific methods and tools to engage with hard-to-reach Medicaid, Medicare and other high-need populations.

Home Visits & Medication Inventory

Our first step toward containing costs is to assess the patient’s existing regimen.

We begin by conducting a complete medication inventory at the patient’s home, which includes collecting information on unfilled prescriptions, supplements and vitamins. We also interview the patient and caregiver to capture information about the patient’s existing medication regimen, and conduct assessments/surveys to learn how we can best equip them with tools and resources to assist in regimen adherence.

Reconciliation & Regimen Assessment

Our clinical pharmacy team conducts a comprehensive medication reconciliation based on the data captured from the initial in-home visit and, if available, the original primary provider medication list. All medications, including unfilled prescriptions, are reconciled for a holistic review by the provider.

During this process, we identify duplicate therapies, omissions in care, medications on the health plan’s preferred medication list and any medications that require prior authorization or have coverage/quantity limitations. To monitor polydoc and polypharmacy activities, we identify all providers who have prescribed the patient medication and the pharmacies that filled the prescriptions.

Upon final reconciliation, the provider develops a preferred medication regimen. All of the patient’s providers—including specialists—receive access to the full medication regimen to reduce the likelihood of duplicate prescriptions.

Synchronization & Alignment

To simplify regimen activity for the patient and improve adherence, PPA synchronizes the provider’s medication regimen so the patient receives just one at-home delivery each month. We also provide patients with educational tools, such as easy-to-read bottle tops and descriptive wallet cards—updated monthly—with the current medication regimen, to help them understand their therapy and the purpose of each medication.

Should the regimen change or patient need an acute medication during the month, we make the changes necessary, deliver the medication and educate the patient on the new regimen. If a patient is hospitalized, we work with the provider to ensure the patient’s medications are reconciled with the hospital medications, reducing duplications in therapy and readmissions due to non-compliance.

As needed, PPA will conduct additional in-home patient visits if non-adherence or stockpiling of medications is suspected, or if the provider requests additional check-ins and assessments.

Ongoing Adherence & Compliance Support

To consistently monitor adherence and uncover changes in a patient’s medication regimen, a certified therapy coordinator speaks with the patient and/or caregiver at least once a month to capture medication challenges, changes in health, and information from ER visits, hospital stays and physician appointments. We communicate with each patient and/or caregivers roughly five times per month.

Your patients and their caregivers can also connect with one of our patient care representatives 24 hours a day, 7 days a week with any questions.

To continuously identify gaps in therapy and provide one-on-one adherence coaching to improve outcomes, caseworkers and providers have access to real-time adherence reporting through our collaborative portal, AlliancePoint.

Continuous Collaboration & Validated Outcomes

We understand the importance of tracking medication regimen activity and therapy outcomes to ensure patients receive the most appropriate care, and to ensure we’re doing everything possible to reduce costs.

To foster ongoing communication and to provide unhindered care team visibility of real-time regimen activity, we provide a web-based, data-driven collaboration portal, AlliancePoint.

AlliancePoint allows you to see all your members’ prescribed medications, who prescribed them and when they were delivered. Our system analyzes and reports patient regimen activity, adherence data and therapy outcomes, giving you instant access to the information you need for HEDIS, NCQA, PCMH, ACO and other reporting requirements.

Using AlliancePoint, you can communicate directly with providers and clinical pharmacists, and receive alerts (along with the prescribing providers) of any changes in patient regimen activity or treatment issues that arise.

FOR PROVIDERS

Improving Adherence & Therapy Outcomes

We understand the challenges of working with complex patients who are unable to follow your prescribed medication regimen. These chronically ill patients often see multiple providers and utilize several pharmacies, making your efforts to improve outcomes and keep them out of the hospital even more challenging.

Adding to the complexity, with new rules associated with EMRs, ePrescribing, PCMH programs and ACOs, as well as other state and federal regulations, you may find it difficult to spend enough time with the patients who require additional personalized care.

Physicians Pharmacy Alliance has been assisting physicians with the management of complex patients for more than a decade. We serve as a collaborative partner who helps ensure your patients begin the therapy you’ve carefully established—and then works continuously to help them adhere to that therapy.

We visit patients in their homes, and provide education and adherence tools designed to empower both patients and caregivers—across diverse cultural and economic backgrounds—with the resources they need to manage compliance. And because chronically ill patients often receive duplicate or conflicting therapies from multiple providers, we offer AlliancePoint: a collaborative web-based portal that tracks and measures patient adherence and regimen activity, to provide unprecedented visibility across caseworkers, pharmacy services, multiple providers and payors.

PPA is dedicated to working alongside providers to improve therapy outcomes for complex patients and to help you meet your clinical goals.

KEY ELEMENTS
OF OUR PROGRAM

In-home Medication Inventory
& Assessments
Medication Synchronization
& Home Delivery
Patient & Caregiver Adherence Tools
Compliance Monitoring & 24/7 Support
Outcome Tracking & Reporting

In-home Medication Inventory & Assessments

To provide complex patients and their caregivers with the personalized support they need, we meet them where adherence starts: at home.

Once a patient is referred to and enrolled in our program, we conduct an in-home medication inventory and assess both the patient and caregiver environments to determine which tools and resources will help them comply with your prescribed regimen.

The home medication inventory, which includes collecting unfilled prescriptions from all existing pharmacies, is compared to your original medication list to ensure the patient is adhering to the correct regimen and prescribing instructions.

Medication Synchronization & Home Delivery

Using the in-home medication inventory and provider medication list, PPA clinical pharmacists identify any discrepancies, such as potential gaps in treatment and duplicate therapies, and then submit a fully reconciled recommended medication regimen to you for final approval.

To eliminate confusion and adherence challenges when medications run out at different times of the month, we synchronize the patient’s medication regimen to allow for one-time, at-home delivery every month.

Should the regimen change or patient need an acute medication during the month, we make the changes necessary, deliver the medication and educate the patient on the new regimen.

Patient & Caregiver Adherence Tools

Our clinical pharmacy team conducts a comprehensive medication reconciliation based on the data captured from the initial in-home visit and, if available, the original primary provider medication list. All medications, including unfilled prescriptions, are reconciled for a holistic review by the provider.

During this process, we identify duplicate therapies, omissions in care, medications on the health plan’s preferred medication list and any medications that require prior authorization or have coverage/quantity limitations. To monitor polydoc and polypharmacy activities, we identify all providers who have prescribed the patient medication and the pharmacies that filled the prescriptions.

Upon final reconciliation, the provider develops a preferred medication regimen. All of the patient’s providers—including specialists—receive access to the full medication regimen to reduce the likelihood of duplicate prescriptions.

Compliance Monitoring & 24/7 Support

To simplify regimen activity for the patient and improve adherence, PPA synchronizes the provider’s medication regimen so the patient receives just one at-home delivery each month. We also provide patients with educational tools, such as easy-to-read bottle tops and descriptive wallet cards—updated monthly—with the current medication regimen, to help them understand their therapy and the purpose of each medication.

Should the regimen change or patient need an acute medication during the month, we make the changes necessary, deliver the medication and educate the patient on the new regimen. If a patient is hospitalized, we work with the provider to ensure the patient’s medications are reconciled with the hospital medications, reducing duplications in therapy and readmissions due to non-compliance.

As needed, PPA will conduct additional in-home patient visits if non-adherence or stockpiling of medications is suspected, or if the provider requests additional check-ins and assessments.

Outcome Tracking & Reporting

To consistently monitor adherence and uncover changes in a patient’s medication regimen, a certified therapy coordinator speaks with the patient and/or caregiver at least once a month to capture medication challenges, changes in health, and information from ER visits, hospital stays and physician appointments. We communicate with each patient and/or caregivers roughly five times per month.

Your patients and their caregivers can also connect with one of our patient care representatives 24 hours a day, 7 days a week with any questions.

To continuously identify gaps in therapy and provide one-on-one adherence coaching to improve outcomes, caseworkers and providers have access to real-time adherence reporting through our collaborative portal, AlliancePoint.

FOR PATIENTS

Focused On Your Health

Physicians Pharmacy Alliance is not your typical corner drugstore. We work one-on-one with you and your doctor to make sure you’re getting the most from the medications prescribed by your doctor. We also remove the hassle of picking up those medications by delivering them directly to your doorstep.

We know how difficult it can be to manage all the information and instructions you receive at the doctor’s office. We also understand that traveling to the pharmacy multiple times per month to pick up your medications can be challenging.

That’s why we take care of all this for you.

Not only do we visit you in your home to discuss your medications, we personally deliver all your prescribed medications each month to make sure you don’t run out. Our therapy coordinators also talk to your doctor regularly to make sure you’re always getting the medications you need. And, we call you each month to check in and answer any questions you may have.

There is no extra charge to our patients for the unique services we provide—and your medication co-pays are the exact same as they would be at any other pharmacy.

We believe it’s important to help patients stay on the treatment plan carefully prescribed by their doctors. That’s why we work with you and your entire care team to make managing your medications as simple and easy as possible.

If you’re a patient or caregiver interested in learning more about our program, please ask your doctor to refer you to Physicians Pharmacy Alliance, or give us a call at 866-463-5550 to speak with one of our care representatives.

If you are already a patient and need assistance, we are available 24 hours a day, seven days a week at 866-463-5550.

OUR APPROACH
TO PERSONAL CARE

Easy Access to Medications
Help Staying On Your Medications
Support That's Always Available

Easy Access to Medications

Our goal is to help you manage your prescribed medications by making things as simple and clear as possible.

We start by visiting you in your home to review all the medications you’re currently taking. We talk through any challenges you may have to make sure we understand how we can best assist you.

We then work with your doctor to review all your medications, helping your doctor develop a medication plan that’s easy for you to manage. We also make sure your medications are filled all at once, instead of at different times of the month. And so you don’t have to worry about making multiple trips to the pharmacy, we personally deliver those medications to your home each month. If your doctor prescribes additional medications throughout the month, or if your prescription changes, we’ll make sure to deliver those to you as well.

One of our therapy coordinators will call you at home often to check in and give you the chance to discuss your medications and ask questions. You can also reach our patient care representatives 24 hours a day, 7 days a week at 866-463-5550 should you have any questions.

Help Staying On Your Medications

All of our medications are delivered to you with easy-to-read labels and unique bottle caps that describe which health issue the prescription is typically used for (for example, cholesterol, pain or allergies)—making it easier for you to identify medications when you’re talking with your doctor or caregiver.

When we deliver your medications to your home each month, we also include an important medication card that lists all the prescriptions you are taking, their dosing instructions and the doctors who prescribed them. This card should be kept in your wallet and given to your doctor during office visits. Or, in the event of an emergency, it should be given to the hospital doctor.

Support That's Always Available

At least once a month, one of our therapy coordinators will contact you to discuss your medications and talk through any difficulties or questions you may have. This ongoing communication makes certain that you’re receiving the most appropriate medications, and helps us work with your doctor to adjust your prescriptions and care, as needed.

And if you ever need to reach us, you can always call one of our patient care representatives—24 hours a day, 7 days a week—at 866-463-5550.