Evaluation of Comprehensive Annual Care Plans by Pharmacists in Alberta for Patients with Complex Conditions

Abstract Background Chronic diseases are the largest drivers of healthcare costs worldwide. In 2012, the provincial government introduced a remuneration model for pharmacists to develop a comprehensive annual care plan (CACP) for patients with complex needs in Alberta. The effectiveness of the CACP model in enhancing care for patients with chronic diseases remains unknown. Objectives 1) to characterize the population of patients who received a reimbursed CACP by pharmacists and 2) to evaluate any changes in health care utilization for such patients, including physician visits, hospitalizations and emergency department (ED) visits. Methods We used administrative data from Alberta Health to identify all individuals in Alberta who received a pharmacist CACP between 2012-2015. Two control patients were identified for each CACP patient, matched on age, sex, provider, date of service, and qualifying conditions. Controlled interrupted-time series analyses were used to evaluate changes in physician visits, all-cause and ambulatory care sensitive condition (ACSC)-related hospitalizations and ER visits in the 12 months before and after the CACP index date. Results Between 2012 to 2015, 188,640 pharmacy CACPs were billed in Alberta. Of these, 137,178 CACP patients were matched to 241,658 control patients. Those who received a CACP were associated with an overall decrease in all-cause hospitalizations, ACSC-related ED visits and physician visits (181, 144, and 1,206 events per 10,000 people respectively, p Conclusion The uptake of the pharmacy CACP reimbursement model has been substantial since 2012. Overall, the CACP philosophy of a single yearly assessment has demonstrated limited impact on major healthcare utilization.