National Assessment of Reimbursement Models for Clinical Faculty Services in Academic Pharmacy Practice

ABSTRACT Background Colleges and Schools of Pharmacy (C/SoP) collect revenue from tuition and indirect cost recovery related to teaching and research. Clinical faculty services are frequently exchanged for experiential opportunities, but this practice undervalues pharmacists and their impact on patient care. Some C/SoP have adopted innovative strategies to secure reimbursement for faculty‐delivered patient care services, but they have not been well described. The objective is to describe academic pharmacist payment for clinical services and to provide recommendations on how to increase clinical service revenue based on a national survey of C/SoP. Methods The 19‐item survey was distributed to 143 (71 public/72 private) C/SoP. The survey covered: faculty billing, insurance sources, state regulation, revenue models, and barriers. Results The response rate was 73% (80% public, 65% private). Nearly all C/SoP provided clinical services (97%), but only 54% bill for those services. Many public (58%) and private (49%) C/SoP bill for clinical services. Offset revenue (39%) and flat‐fee contracts (19%) were the most common revenue models. The most common billable services included: Chronic Care Management (CCM) (79%), Medication Therapy Management (MTM) (71%), Immunizations (66%), and Annual Wellness Visits (45%). Of those utilizing incident‐to billing services, 78% bill at level 1, but only 33% bill at level 3 or higher. Nine C/SoP reported having an employee certified in medical billing. The main barriers to collecting revenue were sites being used only for faculty provision of academic service, legal regulations, lack of pharmacist provider status, cost and difficulty of billing, and lack of interest or knowledge. Conclusions Current pharmacist care payment models indicate opportunities for all C/SoP to increase the revenue they collect from clinical services. All C/SoP should have a designated employee credentialed in medical billing and coding. Increased utilization of “incident‐to” billing can generate revenue for C/SoP regardless of what happens to pharmacist provider status federally.