Frequently Asked Questions

Comprehensive medication management (CMM) is a patient-centered approach to optimizing medication use and improving patient health outcomes. It is delivered by a clinical pharmacist working in collaboration with the patient and other health care providers. A clinical pharmacist ensures that each patient's medications (prescription, nonprescription, alternative, traditional, vitamins, or nutritional supplements) are individually assessed to determine that each medication is:

• appropriate for the patient,
• effective for the medical condition,
• safe given the comorbidities and other medications being taken, and
• able to be taken by the patient as intended.

Sources: Cipolle RJ, Strand LM, Morley PC. Pharmaceutical Care Practice: The Clinician's Guide. McGraw-Hill; 2004. · CMM in Primary Care Research Team. The Patient Care Process for Delivering Comprehensive Medication Management (CMM). American College of Clinical Pharmacy; 2018. · McInnis TM, Strand LM, Webb CE. The Patient-Centered Medical Home: Integrating Comprehensive Medication Management to Optimize Patient Outcomes Resource Guide. 2nd ed. Patient-Centered Primary Care Collaborative; 2012.

Research on comprehensive medication management points to patients who:

• have not reached, or are not maintaining, their treatment goals;
• are experiencing side effects from their medications;
• have difficulty understanding or following their medication regimen;
• need preventive therapy; or
• are frequently readmitted to the hospital.

Patients living with more medical conditions and taking more medications have the greatest potential to benefit. Costly conditions that involve multiple medications, such as diabetes, cardiovascular disease, COPD, asthma, depression and chronic pain, are strong places to start. Across studies, pharmacists' direct patient care has significantly improved A1c, LDL cholesterol, blood pressure, adverse drug events and medication adherence. We'll help you identify these patients from your panel.

Sources: McInnis T, Strand LM, Webb CE. The Patient-Centered Medical Home: Integrating Comprehensive Medication Management to Optimize Patient Outcomes Resource Guide. 2nd ed. Patient-Centered Primary Care Collaborative; 2012. · Chisholm-Burns MA, Lee JK, Spivey CA, et al. US pharmacists' effect as team members on patient care: systematic review and meta-analyses. Med Care 2010;48(10):923–933.

Every partnership looks a little different based on your culture and priorities. We can work as independently, or as closely alongside your existing care management or population health team, as makes sense for you. As trust builds over time, some relationships grow into a signed collaborative drug therapy management agreement, which lets Lodestar resolve certain medication issues autonomously, but that's something we grow into together, never a starting requirement. Your day-to-day workflow likely won't change, except that you now have additional expertise to consult with or delegate to.

A collaborative practice agreement is the legal agreement that establishes the partnership between our pharmacist and your clinic's providers. It sets out who is participating, the scope of the pharmacist's role on your care team, and how the pharmacist and providers will communicate and share responsibility for patient care. Your providers continue to oversee each patient's care.

Collaborative drug therapy management (CDTM) defines disease state-specific activities that the pharmacist can perform autonomously. For each condition covered, such as diabetes or hypertension, a CDTM protocol spells out which medication decisions the pharmacist can make and which monitoring labs they can order on their own, the criteria they follow, and when they must contact the provider.

Yes. Our pharmacist is onboarded into your EHR and documents every encounter there, with care-gap flags and chart notes routed to the PCP and care team, so our work is transparent.

Both. We use a hybrid model: scheduled on-site clinic days plus telehealth visits, so patients and providers always have an easy way to reach the pharmacist.

Most of the time goes to credentialing, EHR access and agreement setup. A typical partnership is running within 6–12 weeks of signing.

For primary care practices, Lodestar Collaborative Care bills through your clinic's own insurance billing infrastructure and is paid monthly, based on our contract. The goal is that there's no added cost to your clinic beyond the administrative time it takes to get set up and maintain the partnership.

For health plans, Lodestar Collaborative Care charges a fee per member per month for a prearranged panel of patients. This panel can be updated quarterly, or at whichever cadence works best for your operational cycle.

Lodestar Collaborative Care operates under HIPAA and executes a signed Business Associate Agreement (BAA) with every clinic and health plan partner before any patient data is shared. Access to protected health information is limited to what's necessary to deliver comprehensive medication management for the specific patients in scope, consistent with the minimum-necessary standard required of anyone handling PHI.