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Pharmacy Management Initiative

Medication Reconciliation Improves Safety & Quality

Pharmacy represents the greatest cost to the Medicaid Program. In an effort to contain these rising costs, Community Care of NC (CCNC) created Pharmacy Management Initiatives to provide needed information based on Medicaid paid claims on medication use to the primary care provider, network pharmacist, and care manager.  Our nurse care managers and network pharmacists work with primary care providers and patients to ensure they receive proper medications, avoid over medication and duplicate medication theapies. 

The web-based Pharmacy Home application allows primary care providers access to pharmacy claims history and real time connections to Pharmacy Benefit Managers and Retail Pharmacies which are loaded into the application database. Data is available on patient prescription history, adherence calculations, gaps in therapy (days elapsed since the most recently dispensed pill supply would have expired), and other clinical care alerts (e.g., indicator of beta agonist overuse, which may indicate poor asthma control).

Providers and pharmacists can use Pharmacy Home to review a patient level profile and medication history for point-of-care activities and see other providers who have prescribed for the patient to better coordinate care. They can identify patients that may benefit from pharmaceutical care delivery via pharmacists, case managers and PCPs in the medical home.

Carolina Community Health Partnership has a part-time network pharmacist and a full-time network clinical pharmacist who work with network providers, care managers, and patients on medication questions and education. Our pharmacist can conduct patient medication reconciliation using patient chart reviews, hospital discharge lists, actual patient medications etc. to help prevent duplication in medication therapy and assist in patient medication education.

Pharmacists also serve as an informational resource for network physicians and case managers on general drug information and Medicaid Pharmacy Home Initiative policy issues. They collaborate with community pharmacies to educate them on Community Care and Medicaid pharmacy policies and initiatives as well.

To contact a network pharmacist, please call 980-484-5152.