Financial performance and reimbursement of pharmacist-led chronic care management.

PURPOSE: The purpose of this study was to evaluate the financial performance and reimbursement of chronic care management (CCM) provided by clinical pharmacists in a primary care setting using Current Procedural Terminology codes that were added to the Medicare Physician Fee Schedule in 2017. METHODS: A retrospective study assessing financial performance of pharmacist-led CCM was conducted for the 12-month period from May 1, 2018, through April 30, 2019, at an academic multiclinic medical practice. Pharmacist-led CCM encounters included a combination of telephone and in-clinic visits. Return on investment, a ratio of net income to financial investment, was the primary outcome. Secondary outcomes included the number of CCM encounters, time spent by pharmacists delivering CCM (ie, "time-on-task"), and third-party claim reimbursement. RESULT: Sixty-five patients were enrolled in CCM during the 12-month study period. Pharmacists provided 236 CCM encounters, including 31 enrollment visits and 102 hours of clinical time-on-task. Gross revenue for CCM during the 12-month period was $7,433.91, and expenses totaled $6,430.36, resulting in a 15.6% return on investment. Out of 158 CCM claims, 131 (83%) were paid and 27 (17%) were unpaid or remained in adjudication at study completion. CONCLUSION: Pharmacist-led CCM resulted in a modest positive return on investment compared to other reimbursable pharmacy services. Practitioners should evaluate opportunities to synergize CCM with other fee-for-service and quality-based reimbursement programs.

Cross Racial Identity Scale (CRIS) scores: stability and relationships with psychological adjustment.

We examined the structural validity, internal consistency (alpha and omega), and test-retest reliability of scores on the Cross Racial Identity Scale (CRIS; Vandiver et al., 2000 ; Worrell, Vandiver, & Cross, 2004 ), as well as the relationship between CRIS scores and several variables related to psychological adjustment. Participants consisted of several groups of African American college students (34 ≤ n ≤ 340) attending a predominantly White university in a Western state. Confirmatory factor analyses indicated an acceptable fit of the data to the theoretical model, and alpha and omega coefficients indicate that CRIS scores have moderate to high internal consistency. CRIS scores also demonstrated stability over periods between 2 and 20 months in ranges that suggest long-term stability of racial attitudes. As predicted by the expanded nigrescence model (Cross & Vandiver, 2001 ), only self-hatred attitudes had consistent, meaningful relationships with psychological adjustment.

Psychometric properties of scores on three Black racial identity scales.

In this study, we examined the internal consistency and the structural validity of scores on the African Self-Consciousness Scale (ASCS), the Multidimensional Inventory of Black Identity (MIBI), and the Cross Racial Identity Scale (CRIS). Participants consisted of 225 African American college students--75 attending predominantly White institutions (PWIs) and 150 attending historically Black colleges and universities (HBCUs). Internal consistency estimates were above .60 for scores on one ASCS subscale, six MIBI subscales, and six CRIS subscales. Exploratory factor analytic procedures supported a two-factor structure for ASCS scores, a five-factor structure for MIBI scores, and a six-factor structure for CRIS scores. Implications for Black racial identity and scale development are discussed.