Clinical Pharmacy Services Planning Tool for Safety-Net Providers (CPPT)

While clinical pharmacy services have often been shown to improve health outcomes while saving health care delivery costs, these services often do not provide enough revenues to a primary care safety net organization to cover the costs of service delivery. This is because revenue opportunities are not consistently available from all health care payers and the savings realized from the delivery of these services are largely realized by health care payers (Medicaid, Medicare and commercial insurers) or potentially safety-net organizations that include acute care services. However, this tool provides a road map of existing sources of service financing and may be useful in developing a business plan that would allow an organization to justify investment in these services or potentially approach health care payers or private foundations to obtain funds to support service delivery.

During development of this tool, several safety-net organizations that have implemented clinical pharmacy services have been interviewed. Almost uniformly, these organizations report that clinical pharmacy services provide value to their patients, medical providers and organization as a whole well beyond the compensation captured and thus, they have placed a priority on finding ways which they can maintain these services despite a less-than optimal cost-to-revenue ratio. This tool will take the user through the following sections to help the user determine a best estimate for clinical pharmacy expenditures:

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