The Centers for Medicare and Medicaid Services (CMS) has awarded the USC School of Pharmacy a $12,007,677 grant, the largest ever received by the School, that will bring pharmacists into safety-net clinics in Southern California as a way to improve medication adherence and safe and appropriate use of prescription drugs, with the intended result of optimizing patient health while reducing avoidable hospitalizations and emergency visits.
“The project is designed to address both the widespread misuse of prescribed medications and the shortage of primary care providers in low-income populations,” says Geoffrey Joyce, the principal investigator on the project and an associate professor at the USC School of Pharmacy. “Further, pharmacists are remarkably underutilized in the US health care system and this demonstration will test and evaluate the impact of using them in primary care settings.”
Joyce is the director of health policy at the Schaeffer Center for Health Policy and Economics at USC, globally-recognized for work that promotes health and value in health care delivery through innovative research and policy.
Nationally, poor adherence to prescription drugs is reaching epidemic proportions, resulting in suboptimal health outcomes, avoidable hospitalizations, higher risk of death and as much as $290 billion in avoidable medical spending each year. More than half of all Americans have one or more chronic diseases, and for 90 percent of these patients medications are the first-line of treatment. Finding a way to get people to correctly take their medicine is an imperative step in transforming the health care system to improve care and save money, the charge of the Center for Medicare and Medicaid Innovation, the agency within CMS funding the project.
USC will work with AltaMed Health Services, initially launching the project in three treatment clinics in Orange County. The clinics are located in communities with large underserved populations vulnerable to health disparities and often with limited access to care. In many instances, these clinics are the only source of care for this large uninsured population with a high prevalence of uncontrolled diabetes, hypertension, asthma and heart disease. With pharmacists working collaboratively with physician colleagues, the project aims to use evidence-based treatment regimens to improve patient care and health outcomes while reducing costs.
The clinical aspects of the project will be directed by co-investigators Kathleen Johnson, the William A. and Josephine A. Heeres Chair in Community Pharmacy and vice dean for clinical affairs and outcomes sciences at the USC School of Pharmacy, and Steven Chen, the Hygeia Centennial Chair in Clinical Pharmacy at the USC School of Pharmacy. Another part of the project, focusing on a web-based training/credentialing program for pharmacists to replicate the model, will be led by co-investigator Jeffery Goad, the USC School of Pharmacy’s vice chair for continuing professional development, credentialing and distance education.
“This is a tremendous opportunity for us to again demonstrate and evaluate a model of care that uses pharmacists to cost effectively improve health outcomes,” says R. Pete Vanderveen, dean of the USC School of Pharmacy. “Our faculty has over a decade of experience in the safety net, and we appreciate the government’s support in allowing us to expand our work through this important project that promises to provide desperately needed medication management services to some of the most vulnerable in our community.”
The project will target high-risk patients with difficult-to-achieve chronic disease control who will receive individualized services from pharmacists. Outcomes of these patients will be measured against similar patients not receiving pharmacist care in other clinics, determining the impact of the program. The project will eventually extend to AltaMed clinics in Los Angeles County as well. Additionally, working with the East Los Angeles Occupational Center pharmacy technician training program, the project will help develop curricula that support expanded roles for pharmacy technicians.
“This significant award underscores the importance of university-based research in tackling healthcare transformation and contributing the critical ideas necessary to improve health for all Americans,” said Steven O. Moldin, executive director for research advancement at USC. “We’re delighted that USC researchers were selected in this highly competitive program, which fielded more than 8,000 letters of intent and 3,000 full proposals to fund just over a hundred programs, particularly since they will be working with medically underserved populations here in Southern California.”
The Obama administration has allocated $1 billion to fund innovation grants that promise to deliver better health, improved care and lowed costs especially for Americans enrolled in Medicare, Medicaid and the Children’s Health Insurance Program.