The PEP (Patient Experience Program) is comprised of five different billable services for North Dakota Medicaid Expansion patients covered by the Sanford Health Plan.
In providing services, the pharmacist will work with the member and prescriber or other caregiver to establish and achieve drug therapy treatment goals, avoid or minimize undesirable medication effects, and improve clinical outcomes.
HOW IT WORKS
Pharmacist calls or visits with member 3 days after an antibiotic is prescribed to see if medication being taken as directed and patient is getting better.
Glucose Meter Compliance
For each diabetes patient, pharmacist downloads glucose meter results to evaluate testing compliance and creates plan for improvement.
Synchronized Refill Program
Pharmacist identifies patients on 3 or more maintenance medications and transitions patients to synchronized refill program.
Monitor Blood Pressure
Pharmacist gets a blood pressure reading twice a month for patients in the first month after beginning a new prescription or dose change.
ACEI and ARB Therapy
Pharmacist identifies and reviews diabetic patients as to appropriateness of ACEI and ARB therapy and follow-up with prescriber on a quarterly basis.
This program is designed to give patients additional personal care at their pharmacy, to ensure they are getting the most out of their medications and to catch any problems before they could get worse.
- There is no cost to the patient to participate.
- Patients do not need to sign up—they are eligible by having Sanford Health Plan’s Medicaid Expansion Insurance.
- There are no pre-authorization requirements.