The P4CC Pharmacy Team works closely with the interdisciplinary care management team to improve patient outcomes and cost savings through the CCNC model of transitional care and complex care management. Medication reconciliation is initially performed by the patient’s care manager in order to identify and address potential medication non-adherence and/or discrepancies. P4CC Pharmacists then perform a comprehensive review of the medication regimens of targeted, high-risk patients then communicate any pertinent findings/recommendations to all members of the patient’s healthcare team. Medication review components include, but are not limited to recommending evidence-based interventions, resolving therapeutic duplications, identifying contraindications/drug interactions, and promoting the use of cost-effective therapies.
PROVIDER AND PHARMACY SERVICES
The P4CC Pharmacy Team provides education and troubleshooting services to providers and pharmacists regarding Medicaid programs and related prescription claims:
- Preferred Drug List (PDL) – Medicaid prescription coverage listing; prescribers are encouraged to write prescriptions for preferred products; if a prescriber deems that the patient’s clinical status necessitates therapy with a non-preferred drug, the prescriber will be responsible for initiating a prior authorization request. *Because the PDL is lengthy, use the Find feature to locate the drug or drug class you are searching for by selecting Edit-Find or holding Ctrl+F on your keyboard.
- Prior Authorizations – additional documentation requirements that is required for certain medications/classes of medications; requests for approval are most easily submitted via the NCTracks secure prior authorization portal; PA criteria, forms, and FAQ are located on the NCTracks website.
- Medicaid Pharmacy Monthly Newsletter – provides updates to Medicaid Pharmacy Programs and Policies including prescription coverage changes.
- A+KIDS – safety monitoring program designed to ensure that children aged 17 and under enrolled in Medicaid and HealthChoice who are prescribed an antipsychotic medication are monitored according to generally accepted guidelines.
- ASAP – safety monitoring program for adults aged 18 and over enrolled in Medicaid who are prescribed an antipsychotic medication that targets off-label prescribing of these agents.
- Behavioral Health edits – program that aims to ensure dose, frequency, and in-class therapeutic duplications related to behavioral health classes of medications align with FDA recommendations.
- Narcotic Lock-In Program – program that restricts identified patients to a single prescriber and pharmacy in order to obtain opioid analgesics, benzodiazepines, and certain anxiolytics.
- P4CC Pharmacists can also work with providers and pharmacies to identify areas that may be negatively impacting quality performance metrics for their Medicaid patients (e.g. HEDIS).
COMMUNITY PHARMACY ENHANCED SERVICES NETWORK (CPESN)
The P4CC Pharmacy Team provides training and support for local CPESN pharmacies. The CPESN is a network of high-performing North Carolina pharmacies committed to broadening the availability of medication management resources to our state’s highest-needs population through active integration of pharmacist activity within the larger care team as well as the provision of enhanced services such as synchronization of a patient’s chronic medication fill dates, adherence packaging, home delivery, and comprehensive medication review with in-depth patient counseling. Currently participating pharmacies in Guilford, Randolph, and Rockingham counties include:
- Archdale Drug (Archdale) – 336.434.1323
- Belmont Pharmacy (Reidsville) – 336.342.4221
- Bennett’s Pharmacy (Greensboro) – 336.272.7477
- Carolina Apothecary (Reidsville) – 336.342.4090
- Carolina Pharmacy (Asheboro) – 336.625.6146
- Carter’s Family Pharmacy (Asheboro) – 336.625.8650
- Deep River Drug (High Point) – 336.454.3784
- Eden Drug (Eden) – 336.627.4854
- Gate City Pharmacy (Greensboro) – 336.292.6888
- Genoa QoL Pharmacy (Greensboro) – 336.252.5608
- Greensboro Family Pharmacy (Greensboro) – 336.938.0111
- High Point Family Pharmacy (High Point) – 336.355.2323
- Liberty Family Pharmacy (Liberty) – 336.795.0052
- Midtown Pharmacy (Whitsett) – 336.446.0099
- Prevo Drug (Asheboro) – 336.625.4311
- Stokesdale Family Pharmacy (Stokesdale) – 336.644.7288
- Summit Pharmacy and Surgical Supply – 336.763.7282
PHARMACY HOME PROGRAM
The P4CC Pharmacy Team utilizes the Pharmacy Home program developed by CCNC in response to the silos of care that can emerge around medication records. It is part of the larger CCNC Provider Portal that allows providers and other members of the care team to access contact information, visit history, labs, and prescription claims data for Medicaid-enrolled patients. The Provider Portal is available to practices, hospitals, and agencies engaged in quality improvement and care coordination through CCNC networks. Please contact us if you are interested in gaining free access.