Rural health care providers operate in conditions of tremendous uncertainty, uncertainty that affects their local communities' access to affordable high-quality care. Northern Maine Medical Center (NMMC), which serves rural, lower-income community of approximately 15,000 people near the Canadian border, sees diversification as a key strategy for the hospital and the community's well-being.
Convenience, Affordability and Post-Discharge Medication Compliance
In response to local need, they developed an inpatient psychiatric unit, partnered to offer home health care services and purchased a long term care facility. Their latest acquisition, a retail pharmacy, helps them to expand their services and reach as well as help to ensure access and pharmaceutical compliance.
NMMC already had a satellite facility at the locally-owned pharmacy and when the owners were preparing to retire, they approached the hospital about acquiring it. NMMC saw an exceptional opportunity to increase consumer convenience, increase affordability and manage post-discharge medication compliance. They created a multidisciplinary team to examine feasibility and once the auditing team determined that the proposition was financially sound, develop a strategy.
A "Beds to Meds" Pathway
The logistics of the transition included new contracts with pharmacy benefit managers, converting staff to NMMC employees, ensuring compliance with Medicare and securing accreditation for durable medical equipment services. In terms of patient services, it also involved giving pharmacists full access to NMMC's medical records, which include diagnoses, physician notes, lab results, a full medication record and discharge instructions. This gives them the information they need to educate patients on their medications. To help with compliance, patients can request medication packaging that organizes pills by time of day and day of the week. The hospital's discharge planning was revised to integrate pharmaceutical services so that hospital staff can assess if patients can afford their medications and have transportation to the pharmacy and confirm that the pharmacy has the needed medications in stock. The pharmacy also offers home delivery services for those living within a 20 mile radius.
The pharmacy is designed to feel like a health care provider rather than the typical chain drug store. It has consultation rooms so that patients and pharmacists can discuss medications in a private, quiet space. It also features a conference room where hospital staff provide free services such as prevention and wellness education, immunizations and education on Medicare. A financial counselor helps patients with affordability issues, such as providing people who don't have insurance with 340-B cards to get them discounts on pharmaceuticals.These changes and NMMC's active promotion of the pharmacy and its services led to an increase in usage, from approximately 800 prescriptions filled per week to more than 1,000. Based on this success, the hospital plans to add another retail pharmacy onsite at the medical center, making it truly "beds to meds."
This posting features interviews with:Alain BoisChief Operation OfficerNorthern Maine Medical CenterFort Kent, MaineScott Richards, D.Ph.Director of PharmacyNorthern Maine Medical CenterFort Kent, Maine