BCACP Ambulatory Practice Management 5 — Questions and Answers
Question 1: A pharmacist is reviewing medication adherence data using proportion of days covered (PDC). A patient's PDC for their antihypertensive is 0.72. How should this be interpreted?
- The patient is adherent; PDC ≥0.70 meets the threshold for most quality measures
- The patient is non-adherent; PDC must be ≥0.80 for most HEDIS measures (Correct answer)
- The patient has refilled too early; PDC >0.70 indicates overuse
- The patient's data is insufficient; PDC requires at least 365 days of follow-up
Correct answer: The patient is non-adherent; PDC must be ≥0.80 for most HEDIS measures
Most HEDIS and quality measures define adherence as PDC ≥0.80; a PDC of 0.72 falls below this threshold, classifying the patient as non-adherent.
Question 2: In population health management, which strategy is considered the most effective first step to identify high-risk patients who would benefit most from pharmacist intervention?
- Mailing a newsletter to all patients in the practice
- Risk stratification using clinical and claims data (Correct answer)
- Offering walk-in medication reviews to all comers
- Reviewing only patients referred by physicians
Correct answer: Risk stratification using clinical and claims data
Risk stratification uses clinical data, utilization patterns, and social risk factors to identify patients with the highest disease burden or risk for adverse outcomes who need proactive intervention.
Question 3: A pharmacist is documenting a clinical encounter and uses CPT code 99497 for advance care planning. What does this code specifically describe?
- Annual wellness visit with medication reconciliation
- Voluntary advance care planning discussion with or without completing advance directives, first 30 minutes face-to-face (Correct answer)
- Transitional care management within 7 days of hospital discharge
- Complex chronic care coordination, first 60 minutes per month
Correct answer: Voluntary advance care planning discussion with or without completing advance directives, first 30 minutes face-to-face
CPT 99497 covers the first 30 minutes of voluntary face-to-face advance care planning discussion, which may include completing advance directive forms.
Question 4: Which measurement framework, commonly used in ambulatory care pharmacy, assesses quality across Structure, Process, and Outcome domains?
- Triple Aim Framework
- Donabedian Model (Correct answer)
- Balanced Scorecard
- Six Sigma DMAIC
Correct answer: Donabedian Model
The Donabedian Model evaluates healthcare quality through three domains: Structure (resources/settings), Process (care delivery activities), and Outcomes (patient results).
Question 5: A pharmacist is developing a business proposal for a new transitions of care (TOC) service. Which outcome metric would be most compelling to hospital administration for justifying this service?
- Number of discharge counseling sessions completed per week
- 30-day hospital readmission rate reduction (Correct answer)
- Pharmacist documentation turnaround time
- Number of patient satisfaction surveys collected
Correct answer: 30-day hospital readmission rate reduction
Reducing 30-day readmission rates is a high-priority metric for hospitals due to CMS's Hospital Readmissions Reduction Program (HRRP) financial penalties.
Question 6: When a pharmacist identifies a drug therapy problem during a comprehensive medication review, which action best aligns with the PPCP's 'Implement' step?
- Documenting the problem in the assessment section of the SOAP note
- Communicating the recommended therapy change to the prescriber and patient and initiating the plan (Correct answer)
- Collecting the patient's complete medication history
- Analyzing lab values to confirm the clinical significance of the problem
Correct answer: Communicating the recommended therapy change to the prescriber and patient and initiating the plan
The Implement step involves initiating the care plan in collaboration with the patient and other providers, which includes communicating recommendations and making or facilitating therapy changes.
Question 7: Which accreditation body offers the Ambulatory Care Pharmacy Practice residency (PGY-1 or PGY-2) accreditation that validates training standards for ambulatory care pharmacists?
- The Joint Commission (TJC)
- American Society of Health-System Pharmacists (ASHP) (Correct answer)
- Accreditation Council for Pharmacy Education (ACPE)
- National Committee for Quality Assurance (NCQA)
Correct answer: American Society of Health-System Pharmacists (ASHP)
ASHP accredits pharmacy residency programs, including PGY-1 Pharmacy Practice and PGY-2 Ambulatory Care Pharmacy residencies, through its standardized accreditation process.
BCACP Ambulatory Practice Management 5
A pharmacist is reviewing medication adherence data using proportion of days covered (PDC).
A patient's PDC for their antihypertensive is 0.72.
How should this be interpreted?