Patient Self-Management Credentialing and Value-Based Health Benefits Design Considerations in Patient-Centered Team-Based Care

Introduction

Patient credentialing is a unique concept where the patient’s knowledge, skills, and performance associated with their chronic disease, lifestyle requirements, and therapy adherence strategies are assessed so health care providers can tailor education, support and care that effectively meets the specific needs of individual patients. The Patient Self-Management Credential (PSMC) is a psychometrically validated care resource that empowers health care providers and patients to work together in meaningful and efficient ways to identify and address areas for improvement in the self-management of health. With a progressive evidence-base that has evolved over the past 14 years, use of the PSMC has consistently produced patients that are more engaged and empowered to manage their own health care. 

Convening a Consortium of Key Stakeholders

The APhA Foundation convened a consortium to further explore challenges within the current healthcare system as well as opportunities for potential system changes. The consortium provided insights and principles that could be used to guide institutions in making value-based health benefit decisions.

Perspectives from four key constituencies were considered:

1) patients who have been empowered by their providers through use of the PSMC,

2) practitioners who have utilized the PSMC in their practices to customize care,

3) payors who make data-driven decisions to inform their coverage, and

4) value-based health decision makers from benefit managers and health systems.

Recommendations from Consortium

A synthesis of the information, opinions, and expertise that emerged from the Consortium discussion produced six key themes that provided the basis for developing a principle-centered approach that will contribute to optimizing health and costs of care.

The Key Principles for Transforming the Delivery of Patient Care that could IMPACT effective health care system changes and improve patient outcomes are to:

Inspire patients, providers and payors to transform the health care system

Make the patient the center of all health care decisions

Promote access to evidence and information that elevates clinical decision-making

Align the incentives for patients, providers and payors

Cultivate quality improvement and practice enhancement

Take accountability for the financial, clinical and humanistic outcomes of patient medication use

 

The APhA Foundation will continue to work with system stakeholders to develop tools and resources that will guide stakeholders on “how” to translate these principles into practice and invent a preferred future for our health care delivery system.

IMPACT

 

Expert Panel Participants

Name

Title

Organization/Affiliation

Amanda Applegate

Pharmacy Clinical Services Coordinator

Balls Food Stores

Tery Baskin

President and CEO

RxResults

John Beckner

Senior Director, Strategic Initiatives

National Community Pharmacists Association

Dean Benton

Clinical Coordinator

Dillons Pharmacy

Benjamin Bluml

Senior Vice President, Research and Innovation

APhA Foundation

Kelly A. Brock

President

KB Pharmacy Solutions

Barry Bunting

National Practice Leader, Health Plan Innovation

Ateb

Mark Cziraky

Vice President of Research

HealthCore, Inc., an Anthem Company

John Forbes

Owner

Medicap Pharmacy

Scott Hamstra

Infectious Disease Specialist

U.S. Indian Health Service

Elizabeth K. Keyes

Executive Director

APhA Foundation

Sandra Leal

Vice President for Innovation

SinfoniaRx

Thomas Menighan

Executive Vice President and CEO

APhA

Shannon Peter

Clinical Pharmacy Manager

Think Whole Person Healthcare

Pete Sheldon

Vice President, Education & Patient Engagement

Med-IQ

Steve Simenson

Managing Partner

Goodrich Pharmacies

Jaan B. Skelton

President

Silver Pennies Consulting 

Parisa Vatanka

Project Development Manager 

 APhA Foundation