URSA-PHARM | Medication Therapy Episodes & Hospital Utilization

Overview

Creating and deploying a successful pharmacy optimization population health strategy requires analyses that go beyond singular events such as medication fills and instead look at medication therapy episodes. This report builds on the concept of Medication Therapy Episodes first introduced in the Basics of the Ursa Pharmacy Module report and provides pre-built boards with frequently used views for analyzing inpatient and outpatient hospital utilization for patients by the types of active medication therapy episodes.

Use this report to

• Identify and monitor patients with active high-risk or priority adherence medications.
• Compare costs (PMPM) across cohorts of patients by active medication.
• Identify patients and/or medications correlated with significant hospital utilization that may require close medication management.
• Monitor over time financial and hospital utilization across patients with different active medication therapy episodes.

Potential takeaways

• What percent of my patients have an active high-risk medication?
• What percent of my patients have an active priority adherence medication?
• How many patients have multiple types of medication therapy episodes active at the same time?
• What is the cost profile of patients across different types of medication therapy episodes?
• How much of spending is directly related to pharmacy versus other services or encounters?
• What variation exists in hospital utilization across patients with different types of medication therapy episodes?
• Which patients, by medication episode category, have high hospital utilization and have not had a recent PCP visit?
• Which patients, by medication episode category, have had a recent hospitalization and what was the reason for that admission?

Measures included in this report

• URSA-PHARM-R03: Targeted Medication Episodes
• URSA-PHARM-R05: Patients with Chronic Medications
• URSA-PHARM-R06: Patients with Priority Adherence Medication
• URSA-PHARM-R07: Patients with Active High Risk Medication
• URSA-PHARM-001: Outpatient Pharmacy PMPM Plan Spending
• URSA-PHARM-002: PMPM Plan Spend for Patients w/ Outpatient Fill
• URSA-PHARM-011: Admits per 1000 Chronic Med Member Years
• URSA-PHARM-012: ED Visits per 1000 Member-Years Chronic Meds
• URSA-PHARM-013: Patients with Hospital Admit in the Prior 6 Months
• URSA-PHARM-014: Hospital Encounters per 1000 Member-Years
• URSA-PHARM-021: Chronic Med Patients with Recent PCP Visit