BCACP Population-Based Care 5 — Questions and Answers
Question 1: A pharmacist working in an accountable care organization (ACO) is asked to help reduce total cost of care. Which strategy most directly supports this goal?
- Increasing the use of brand-name medications to improve adherence
- Optimizing medication regimens to prevent disease complications and avoidable hospitalizations (Correct answer)
- Expanding the number of specialty pharmacy services offered
- Prioritizing patients who request appointments most frequently
Correct answer: Optimizing medication regimens to prevent disease complications and avoidable hospitalizations
Medication optimization that prevents complications and hospitalizations directly reduces total cost of care, a core ACO objective.
Question 2: The Pharmacy Quality Alliance (PQA) measure 'Medication Adherence for Diabetes Medications' uses which metric to assess adherence?
- Medication Possession Ratio (MPR) >0.70
- Proportion of Days Covered (PDC) ≥0.80 (Correct answer)
- Number of refills dispensed per year ≥10
- Patient-reported adherence score ≥85%
Correct answer: Proportion of Days Covered (PDC) ≥0.80
PQA adherence measures use PDC ≥0.80 (80%) as the threshold for 'adherent,' as PDC is considered more rigorous than MPR.
Question 3: A pharmacist identifies that patients with depression in a primary care panel have significantly lower rates of antihypertensive adherence. This finding supports the concept of:
- Comorbidity-driven care gaps requiring integrated population health approaches (Correct answer)
- Prescribing depression medications before antihypertensives
- Excluding mental health patients from hypertension quality metrics
- Deferring hypertension management to psychiatry
Correct answer: Comorbidity-driven care gaps requiring integrated population health approaches
Mental health comorbidities frequently undermine chronic disease management, reinforcing the need for integrated, whole-person population health strategies.
Question 4: When a pharmacist participates in a Comprehensive Medication Review (CMR) as part of Medicare Part D MTM, the PRIMARY population-health goal is to:
- Generate revenue through documentation of additional drug-related problems
- Identify and resolve drug therapy problems to optimize outcomes in high-risk beneficiaries (Correct answer)
- Ensure all patients switch to generic medications
- Reduce the number of prescriptions per patient to lower costs
Correct answer: Identify and resolve drug therapy problems to optimize outcomes in high-risk beneficiaries
CMRs target high-risk Medicare Part D enrollees to proactively identify and resolve drug therapy problems, improving safety and outcomes.
Question 5: Which of the following is the best example of secondary prevention in a population-based pharmacy program?
- Providing flu vaccinations to all adults ≥65 years
- Screening all adults for hypertension and initiating treatment for newly diagnosed patients (Correct answer)
- Managing complications of established end-stage renal disease
- Educating healthy individuals about a heart-healthy diet
Correct answer: Screening all adults for hypertension and initiating treatment for newly diagnosed patients
Secondary prevention involves early detection and treatment of disease before symptoms or complications occur, such as screening for and treating hypertension.
Question 6: A clinic implements a team-based care model where the pharmacist manages the diabetes population independently within a collaborative practice agreement. The primary advantage of this model for population health is:
- Pharmacists can bill independently without physician oversight
- It allows efficient, protocol-driven optimization of therapy for a large patient panel (Correct answer)
- Physicians are no longer responsible for diabetes management
- Patients can bypass primary care visits entirely
Correct answer: It allows efficient, protocol-driven optimization of therapy for a large patient panel
Collaborative practice agreements allow pharmacists to manage panels efficiently using evidence-based protocols, expanding care capacity without compromising safety.
Question 7: A population health dashboard shows that 68% of patients with atrial fibrillation are on anticoagulation therapy. The most appropriate benchmark to compare this rate against is:
- National average statin use in heart failure patients
- Evidence-based guideline recommendations and peer health system comparators (Correct answer)
- The pharmacy's historical dispensing volume for anticoagulants
- Individual patient satisfaction scores with anticoagulation counseling
Correct answer: Evidence-based guideline recommendations and peer health system comparators
Benchmarking against clinical guidelines and peer health systems provides meaningful context for evaluating and improving population-level performance.
BCACP Population-Based Care 5
A pharmacist working in an accountable care organization (ACO) is asked to help reduce total cost of care.
Which strategy most directly supports this goal?