Genoa Healthcare Rolls Out Its Proven Model in California
By Mark Peterson, RPh
A young man who suffered from schizophrenia — we’ll call him Andrew — was due for a monthly injection of his long-acting antipsychotic medication. But his regular prescription was held up due to a discrepancy over Andrew’s insurance benefits. Days went by without Andrew having access to his critical treatment. A full week later, having still not received his injection, Andrew attempted suicide, hoping to silence the voices in his head.
As pharmacy practitioners, we all know that when individuals like Andrew are not able to stay on their medications, they suffer. Far from hyperbole, that's a reality, as witnessed by Andrew’s true story.
Medication adherence – ensuring that individuals remain on their prescribed treatments – is vital in managing any chronic disease, but it is especially critical in treatment for mental health and substance use disorders. If a person with high cholesterol forgets to take his cholesterol medication for a few days, the likelihood of having a heart attack immediately is relatively low. But if a person with severe schizophrenia misses a few doses of antipsychotic medication, the risk of relapse and hospitalization is a very real and imminent possibility.
Yet barriers to medication adherence can make it especially difficult for individuals with mental illness Imand substance use disorders to manage their treatment. These barriers may include a patient’s reluctance to accept a diagnosis and begin treatment due to stigma, a lack of reliable transportation, failure to attend appointments regularly, and the inability to understand and follow a prescribed course of therapy.
Integrated pharmacies: an adherence model that works
For individuals living with serious and persistent mental illness or addiction, on-site pharmacies integrated into community mental health centers can make a significant difference in the rate of medication adherence.
Integrated pharmacies can offer personalized services and provide extra support that many patients need to stay on complicated medication treatment plans. Being on-site, pharmacists and technicians can work closely with prescribers, nurses, and caseworkers, providing the best possible care for each individual consumer.
At Genoa Healthcare, we’ve been focusing on ways to improve medication adherence for the individuals we serve for over a decade. Our more than 400 pharmacies are embedded in community mental health centers, which allows our pharmacists and technicians to provide personalized care to patients and collaborate with their healthcare providers.
Our adherence-focused tools and services include medication synchronization, interdisciplinary care team participation, pre-filled pill organizers to keep patients on track, prior authorization support for the clinic and online tools that enable the pharmacist to see more easily which patients need additional support and outreach.
Our model has proven to help patients stay on their medications at a rate of more than 90 percent, compared to an average rate of about 50 percent with a traditional approach. A study published in a peer-reviewed journal found that this type of integrated pharmacy also reduces emergency room visits by 18 percent, hospitalizations by 40 percent and significantly reduces the total cost of care.
Bringing the Genoa Healthcare model to California
Earlier this year, we opened our first California pharmacy, at a social service agency in Orange County.
As California practitioners are well aware, in California, a staggering 1 in 6 adults suffer from some form of mental illness, and 1 in 20 adults (1 in 13 children) have a severe mental illness that makes it difficult to perform daily activities.
For these individuals, having access to mental health care that promotes medication adherence can mean the difference between life and death. And, this kind of care not only improves lives – it reduces costs. The peer-reviewed study mentioned earlier found that by increasing medication adherence through integrated care, on-site pharmacy services in mental health centers can reduce the cost of care by $700 per person per year. In California, the savings could potentially reach $1.3 billion annually.
The individuals served by community mental health centers and pharmacies such as Genoa are sons and daughters, sisters and brothers. Yet too many suffer when faced with limited access to care and medications and healthcare challenges such as lack of medication adherence.
Fortunately for Andrew, the young man referenced at the beginning of the article, he eventually found help. He stabilized when his pharmacist, who works on-site at his community mental health facility, contacted the insurance provider to resolve the error.
Andrew’s story demonstrates the positive impact that a personalized, monitored and high-touch environment can have on treatment for mental illness.
Mark Peterson is the chief commercial officer of Genoa Healthcare, which specializes in helping people with substance abuse and mental health issues. Genoa Healthcare is the fifth largest drug chain in the country, with more than 400 full-service pharmacies in 46 states, plus the District of Columbia.
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