In my work with AIMM, I’ve found that in every community, there exist organizations and people ready to convene and lead efforts to create an optimal medication-coordinated care service. Who these stakeholders are and what they partner around might vary. However, the process of finding those who want to be involved in improving medication management is similar.
As detailed in a previous post by AIMM consultant Mark Hawkins, the convener plays a critical role in bringing stakeholders together. Ideally, these groups will include at least some, if not all of the following:
- Payers: insurance companies and government organizations that underwrite patient care costs
- Providers: medical, health, and social service professionals who care for patients
- Patient advocates: caregivers, social workers, and/or other advocates that represent the voice of the patient
- Partners and sponsors: individuals or organizations that fund start-up costs
What happens when conveners bring stakeholders together
Every community we gather is unique, depending on the participants and goals involved. However, there is a general approach to this process. The first step is always relationship development. This involves the convener bringing together individuals and organizations who haven’t been together before and engaging them in a relationship-building process. Together, we work to identify the goals and priorities of various stakeholders and look for common ground.
There are two primary stages to the work of building or improving medication management services in a region. Intentional consideration of the strategy for both stages is critical.
- Pre-implementation: We Identify stakeholders in the region who are invested in the opportunity to improve medication use. Stakeholders may be medication management service providers and health care payers. Through one-on-one conversations, stakeholder interviews, and in-person events, AIMM helps the group identify priorities. A shared understanding of each group’s needs and priorities emerges through a series of facilitated conversations. The group naturally transitions from relationship building to making commitments to one another to move forward in action.
- Implementation: The process of gathering stakeholders and conducting meetings is similar to pre-implementation. At this stage, the agenda shifts to putting priorities into action. This may include gathering data and seeking funding to support programs long-term.
Whether we begin in the pre-implementation or implementation stage, the process typically takes six months. AIMM’s goal is to help the group reach an agreement on which actions will generate the greatest value for the community.
The following are examples of what this process has looked like for communities AIMM has worked with:
Empire Health Foundation (EHF) Medication Care Coordination Program
Our work with Empire Health Foundation (EHF), located in Spokane, WA, began in 2015. Together, we focused on identifying opportunities to combine the role of pharmacists providing medication management services with community-based care coordination services. In 2021, after investments in pilot programs to demonstrate results, EHF launched a specialized version of care coordination called Medication Care Coordination (MCC).
Stakeholders in this effort include:
- Two social service organizations (Rural Resources and Aging and Long-Term Care of Eastern Washington),
- A medication management provider (Medication Review Inc.)
- A health system (Newport Hospital and Health Services)
- The Washington State University College of Pharmacy
This group created and implemented a care process for how a medication care coordinator will meet with a patient to assess needs, while collaborating with the patient’s other health care providers, including the pharmacist, physician, and/or social worker.
AIMM supported the group’s efforts by:
- Providing leadership and implementation coaching for stakeholders
- Providing resources to pace the development of the MCC care process
- Assisting with design and performance measurement systems to show results during the pilots
- Facilitating stakeholder convenings in which shared priorities emerged and groups moved into action
In this example, EHF provided funding to create a proof of concept for services. Now, our focus with EHF has shifted to involving local health care payers to sustain this service.
University of North Carolina (UNC) Eshelman School of Pharmacy Medication Optimization Event Series
Our work with the UNC Eshelman School of Pharmacy primarily focuses on community development. Efforts center on creating a series of convenings that facilitate conversations to form new partnerships and launch pilot programs.
Working with AIMM, UNC launched a series of Catalyst Events with the goal of:
- Creating a community of leaders in medication management from across the state
- Seeking opportunities to advance comprehensive medication management throughout North Carolina
As a convener, UNC had a strong network of influential health care and pharmacy groups. For the Catalyst Events, they brought together a diverse group of more than 25 organizations including payers, pharmacy benefit managers, community pharmacists, and health systems. AIMM provided a process to help start relationship-building within this diverse group. Through that process, we helped UNC turn its one-on-one relationships into a community of relationships.
Over six months, we helped UNC initiate new partnerships between the School of Pharmacy payers, health systems, and community pharmacists as well as generate interest in future Catalyst Events.
University of Utah College of Pharmacy UP4 Alliance
The University of Utah College of Pharmacy had already established collaboration with multiple health systems to provide medication management programs when they sought AIMM’s support. While these health systems were committed to providing medication management services and expanding to other locations, opportunities for payment from state health plans were minimal.
With AIMM’s help, the University approached the payer community, saying, “If you partner with us and invested health systems, in return, we will work to create value-based payment agreements for sustainability.”
As a result, this group was able to form an alliance of two payers (including state Medicaid) and three health systems. Through this alliance, they launched a pilot to provide comprehensive medication management to more than 2,100 payer-identified beneficiaries. Now, their focus is finding a way to leverage that limited-time funding to sustain these pilot programs long-term.
Support for creating community-based change in medication management
AIMM is a non-profit organization working to support the widespread adoption of team-based medication management services in the care of high-risk, high-cost patients suffering from multiple chronic health conditions. For more information, contact AIMM.
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Paul Scanlon is an economics and financial professional with experience guiding organizations through leadership and finance decisions. Paul serves as project lead and learning coach for the Alliance for Integrated Medication Management and previously served on the performance information team for the Patient Safety and Clinical Pharmacy Services Collaborative.