We’re highlighting the major impact our pharmacists have on supporting care teams and patients in value-based care
Meet Roshan Hussain, PharmD, MPH – Executive Director of Pharmacy at On Belay, Pharmacy Quality Alliance (PQA) Member.
Roshan says she was always drawn to finding solutions to help people, leading her on the path of population health management (PHM).
After moving to the U.S., she pursued her education, first earning a Bachelor of Pharmacy degree from Ohio Northern University and a few years later with a Doctor of Pharmacy degree from Shenandoah University. To top it off, she earned a Master of Public Health degree from George Washington University. The public health training helped Roshan develop a population-based perspective of healthcare that incorporates a broad understanding of health systems.
Now, Roshan is part of On Belay’s clinical team. She works as the Executive Director of Pharmacy, supporting independent practices daily by making patient satisfaction a priority, identifying root causes of medication misuse, and developing team-based chronic disease management models. Not only does she measure patient outcomes by tracking disease-based markers, but she also communicates upstream to providers about changes likely to improve outcomes and prevent unnecessary utilization. By using analytic data and technology, she can identify the highest-risk and rising-risk patients to measure value and performance. For Roshan, medication synchronization and optimization through medication therapy management is high priority, along with focusing on closing gaps in care.
When asked about the impact pharmacy has on Value-Based Care, Roshan says, “In Medicare’s quality measurement Star Rating System and MSSP quality measures, pharmacists have a direct impact on the measures surrounding hypertension, kidney health evaluation, comprehensive medication reviews and drug adherence, but they also have an indirect effort on measures like Influenza and Pneumonia vaccination rates, fall screening, depression management, osteoporosis management, diabetes, transitions of care, hospital readmissions and hospital admissions. Similarly, for commercial plans, pharmacists directly relate to Healthcare Effectiveness Data and Information Set measures (HEDIS) on medication management for diabetes and controlling high blood pressure, whereas they can indirectly contribute to post-discharge medication reconciliation and monitoring the appropriateness of therapy.”
Value-based care models require a focus on population health. In value-based care settings, providers are held accountable for risk that goes beyond the in-clinic encounter, and payment is tied to quality measures that reflect clinical and humanistic outcomes across the health care continuum. Pharmacists in a Primary Care team-based care practice model help with medication optimization and provide equitable health care delivery to patient population which targets the quadruple aim of CMS and other payors.
As Roshan and the rest of the team work to improve value-based care, she recognizes that the biggest struggle she faces is optimizing use of high-cost medications for Medicare part B spending and tracking patient reported outcomes for medication related quality measures. Pharmacy interventions need cohesive teamwork with other health professionals at the practice level, which takes time to build in a value-based care environment.
Thank you to our pharmacists for your important contributions in supporting primary care teams and their patients.
