At a luncheon last week for the benefits industry, the Ontario Pharmacists Association (OPA) unveiled its chronic disease management program for diabetes, developed with the workplace in mind.
OPA is making the pitch to work directly with insurance carriers or plan sponsors to implant the program as a coaching service for eligible plan members. It would be covered as a core health benefit or under a healthcare spending account.
The good news for plan sponsors is that a separate government-funded pharmacy service—the MedsCheck for Diabetes medication review—can kick-start the process. Available to anyone in the province with diabetes, the review “gives patients high-level information about their medications and about diabetes. It’s a great stepping stone for private payers to offer much more focused care for those who need it,” said Allan Malek, OPA’s senior vice-president of professional affairs.
If the MedsCheck for Diabetes review uncovers issues that need followup—such as non-adherence to medications or challenges with lifestyle changes—pharmacists would invite plan members to enrol in OPA’s chronic disease management program. Pharmacists then schedule a series of appointments at the pharmacy, with documented outcomes. In some cases, those outcomes could include a reduced use of medications.
Pharmacist associations can be good partners for the benefits industry because of their access to plan members through pharmacists as well as their internal educational and research capabilities. “We can develop, promote, launch and evaluate programs or pilot projects, and create paper and online tools to drive employee engagement,” said Malek.
In fact, OPA appears to be building on its experience working with Green Shield Canada (GSC), which recently implemented a new core benefit for pharmacist-coaching services for cardiovascular health based on the results of a pilot project with the association. In order to submit claims for the service, pharmacists must complete an OPA training program. The provincial pharmacy associations in B.C., Manitoba and Newfoundland-Labrador have since picked up the training and all of the remaining associations are in the process of doing so, enabling GSC to provide the benefit to clients outside of Ontario.
OPA’s program for diabetes can similarly roll out into other provinces, noted Malek, adding that it can be adapted for other disease states or health objectives as well, such as asthma or smoking cessation.
Karen Welds is a freelance writer based in Toronto. kjwelds@gmail.com