Insurer invests in CV coaching

June 2015—After two months, more than 300 pharmacists have completed the mandatory training in order to be able to bill for services under Green Shield Canada’s (GSC’s) new pharmacist coaching program for cardiovascular health. Considering that the training is currently available only in Ontario and B.C., GSC is happy with uptake so far, says David Willows, vice-president of strategic market solutions. “Our primary goal this year is to train pharmacists. As the year progresses and we get into 2016, the greater focus can turn to identifying more and more patients.”

GSC launched the program as a core benefit in February, after a 2012-2013 pilot project with Ontario Pharmacists Association (OPA) on hypertension management—funded in part by Canadian Foundation for Pharmacy’s Innovation Fund showed positive outcomes for both patient health and lower drug spending. Plan members taking medications for hypertension and dyslipidemia are eligible for the recently launched cardiovascular health coaching program, which pays certified pharmacists $60 for the initial consult and $20 for each follow-up consultation (up to three per year).

The online training is available through provincial pharmacy associations. OPA and the B.C. Pharmacy Association were the first to come on board, and Alberta, Quebec and Newfoundland are expected to join in the coming months. The goal is for all pharmacy associations to offer the training by the end of the year.

The next few months will also see the availability of software support so that pharmacy systems can automatically flag eligible GSC plan members. However, it remains up to pharmacists to approach members and gather consent for enrollment. Once coaching and adjudication are underway, GSC will track outcomes based on adherence measures, drug spending and qualitative feedback from both pharmacists and participating plan members.

“We anticipate a two- to three-year build to get enough volume of pharmacists and plan members] for meaningful insights. We’re really hoping to have well over 1,000 trained pharmacists by this time next year,” says Willows.

GSC is the first insurance carrier in Canada to add pharmacist coaching services as a standard offering in its plan design. Out of more than 1,000 plan-sponsor clients, only three have opted out so far. “We’re seeking to make programs like this the new normal in benefits plan design, because when you look at what’s driving health care, it’s the prevention and management of chronic disease,” says Willows. He adds: “Based on our clients’ reaction, employers are waiting for new ideas and ready to embrace them. We hope that pharmacists are too.”