Size:

Collaborating with Our Pharmacists

The foundation of our Community CCRxSM Medicare Part D Prescription Drug Plans is our exclusive affiliation with the National Community Pharmacists Association (NCPA).

Our members tell us they trust their community pharmacist. And, community pharmacists tell us they want to use their clinical knowledge and experience to counsel patients to achieve better health outcomes.

That’s why the community pharmacists in our Community CCRxSM Medicare Part D Prescription Drug Plans and Medicare Advantage plans "powered by CCRx" are engaged in the care of our members.

Our community pharmacists embody the ideals of our Healthy CollaborationSM. They:

  • Help our members understand their drug regimens so they take the correct medicines and dosages.
  • Counsel their patients to help prevent dangerous drug interactions.
  • Work to save members money by helping them switch to lower-cost, equally-effective medications when appropriate.

For example, in our Houston-based Medicare Advantage Prescription Drug Plans (MA-PDs), we’ve launched a pilot program to drive collaboration between our plan, our doctors and our community pharmacists.

The project focuses on increasing the ability of our members who have specific chronic diseases – like cardiovascular disease and diabetes – to follow their doctors’ orders for taking necessary medicines. We compensate our community pharmacists for meeting with these members – either in-person or over-the-phone – to answer the members’ questions about their drug treatment.

Other examples of our collaboration include:

  • Clinical programs to enhance and improve our members’ health. By analyzing the de-identified data we have on our members, we design programs to help address their most common concerns. Whenever appropriate, we enlist the assistance of our community pharmacists to deliver the programs.
  • We reach out to doctors and members as appropriate, to inform them of potential cost-savings that may be realized if they switch to different brand-name or generic drugs when appropriate.
  • Our medication adherence program focuses on helping members achieve success from their long-term drug therapy. We review our members’ drug refill claims for selected chronic diseases, such as osteoporosis and asthma, to determine if the members are taking their medicines appropriately. If not, we notify their doctors and request that they take action.

"We are convinced we will have healthier members, who will have better quality of life, because their healthcare is being reviewed by many professionals – each of whom is part of a collaborative team," said Michael Bukach, R. Ph., Universal American Senior Vice President Pharmacy Network and Clinical Operations.

"When all the members of a healthcare team work together, it has to be better. A plan with medical and pharmacy coverage, like our MAPD plans, treats the entire patient."

Helping to Improve the Health of Our Members with Diabetes

Two classes of medications – ACEIs (Angiotensin Converting Enzyme Inhibitors) and ARBs (Angiotensin Receptor Blockers) – have been proven to help reduce the progression of kidney and cardiovascular disease associated with diabetes.

We contact our members’ doctors and suggest they prescribe ACEIs or ARBs, when appropriate, for our members with diabetes. As a result, doctors prescribed an ACEI or ARB for 41% of the members targeted in the program in 2008.