Third-party Reimbursement of Pharmacist-Led Cardiovascular and Diabetes Preventive Health Services for Workplace Health Initiatives: A Narrative Systematic Review

  • Brandon Tong University of British Columbia Faculty of Pharmaceutical Sciences
  • Anita Kapanen University of British Columbia Faculty of Pharmaceutical Sciences http://orcid.org/0000-0001-6091-9818
  • Jamie Yuen University of British Columbia Faculty of Pharmaceutical Sciences
Keywords: cardiovascula, preventive health, reimbursement

Abstract

Objective: To summarize available literature describing third-party payer reimbursement models for pharmacist-led preventive health services as part of workplace health initiatives.

Methods: A combination of search terms related to pharmacists, preventive health, and third-party reimbursement were searched in MEDLINE, EMBASE, and PubMed. Included studies described community pharmacist-led cardiovascular and diabetes preventive health service to employees older than 18 years of age as part of a workplace health program with corresponding third-party reimbursement models. Programs that were reimbursed by government resources or studies lacking reimbursement model details were excluded. One reviewer performed level 1 screening and three reviewers analyzed included studies.

Results: The search criteria yielded 863 results. Sixteen articles were reviewed after level 1 screening and 13 were ineligible and excluded. Three studies with varying quality of reporting were included. Reimbursement models varied from $40 USD for a 20-minute visit to $391 to $552 USD total per patient with an average of 6 visits per patient.

Conclusion: There is a lack of quality literature describing third-party reimbursement models for pharmacist-led preventive health services, which hinders the ability to implement a standardized model. High quality studies evaluating the cost of reimbursing pharmacist-led cardiovascular preventive health services compared to the savings to the third-party payer should be performed to inform the standardization of payment models.

article type

Review

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Dates
Submitted: 2020-11-23
Accepted: 2020-12-21
Published: 2021-01-08
Section
Pharmacy Practice & Practice-Based Research