logo
 

 

 

Patient FAQ’s

The Patient Self Management Programs administered by LPIHO are available only though participating employers. If your employer is not currently partnering with LPIHO, please direct them to Employers to learn more.

Q: What is a “Patient Self Management” program?

A: In 2003, the Institute of Medicine defined self-management support as “the systematic provision of education and supportive interventions by health care staff to increase patients’ skills and confidence in managing their health problems, including regular assessment of progress and problems, goal setting, and problem-solving support.” Simply stated, a "Patient Self Management Program" provides you with education so that you become a more active part of your health care team. When you become more involved in your health care, the result is that you will be a healthier and more compliant patient!

Q: Why is my employer participating in this program?

A: Employees are one of a company’s most valuable resources, so they have your best interest at heart. By implementing this program, they are showing an investment in you in hopes that you will achieve good health in order to be more productive at work and have a better quality of life. One of the most valuable things employers offer employees is health insurance and by being healthier, you cost the company less money in healthcare dollars; dollars that they can then use to grow the business and take even better care of their employees.

Q: How does the program work?

A: After you volunteer to enroll in the program and complete the enrollment materials, you will be assigned your pharmacist coach who will call you to introduce themselves and set up your first meeting time and place. The pharmacist will try to meet with you at a time that best fits your schedule. You will meet with this pharmacist coach to receive education about your disease. Your pharmacist coach will also help you set goals and monitor your progress as well as teach you techniques to help you gain better control of your disease.

Q: Are there any incentives for participating in the program?

A: It is each employer’s decision to offer incentives and what the incentives will be. Typically, most employers offer waived or reduced copays on medications/supplies for a particular disease. The incentive your employer is offering will be outlined in your enrollment materials.

Example: For diabetes, many employers waive copays on all diabetes medications, blood glucose meters, strips and lancets, as well as a class of medications called ACE Inhibitors that protect the kidney from damage from high blood sugar.

Q: What is the purpose of the incentive being offered?

A: Incentives for this program are offered to encourage you to keep your scheduled appointments with your pharmacist and to motivate you to meet your health care goals. By removing some of the financial burden you have because of your disease the program enables you to:

  • Take your medications everyday or as prescribed

  • Get your medications refilled on time

  • Allow you to use that cost savings to put towards your copay for things like doctor visits, blood work, etc.

You may be removed from the program and incentives taken away by your employer if you do not keep your scheduled appointments with your pharmacist coach, your other health care providers, or meet certain goals of the program.

Q: What qualifies a pharmacist to coach patients?

A: Today, all graduating pharmacists receive their Doctor of Pharmacy degrees from an accredited institution, which constitutes approximately six years of schooling. Many pharmacy graduates opt to complete a one- to two-year residency program, and some continue on to complete a fellowship in a specialized area of practice. As a result, pharmacists receive six to ten years of education.

In addition to college, residencies and fellowships, many pharmacists complete certificate programs that focus on a specific chronic condition. LPIHO requires that any pharmacist participating in the program complete a certificate program for the chronic disease module(s) in which they wish to participate as a coach.

Q: How often do I meet with my pharmacist coach?

A: Visit frequency is as follows:

Diabetes Patient Self Management Program

  • Once a month for the first 6 months (each about 1 hour long), then quarterly (every 3 months) thereafter (each about 30 minutes long).

Cardiovascular Disease Prevention Program

  • Once a month for the first 4 months (each about 1 hour long), then quarterly (every 3 months) thereafter (each about 30 minutes long).

Q: Where do I meet with my pharmacist coach?

A: Some companies allow employees and sometimes spouses/dependents to be seen at the employer worksite. Details will be provided in your enrollment packet if this option is available to you. If the worksite is not an option, your pharmacist coach will work with you to locate a private location for your visits to take place (such as a library, local pharmacy, gym, etc.)

Q: What do I do if I can’t make an appointment?

A: You must contact your pharmacist coach as soon as you know you are unable to make your scheduled appointment. We require 24 hours notice except in the case of emergencies. Our policy is as follows:

  • First Missed Visit (without notice): Call from your coach asking what happened and will reschedule your appointment.

  • Second Missed Visit (without notice): Your coach notifies the Network Coordinator who will then call you to confirm your commitment to the program; your employer WILL be charged for this missed visit.

  • Third Missed Visit (without notice): Your employer will be advised to remove you from the program and your program incentives removed.

  • Continuous missed visits (with notice): You will be contacted to confirm your commitment to the program; if visits continued to be canceled or not scheduled, removal from the program will be recommended and program incentives removed.

Q: Does this take the place of my doctor’s visit?

A: No! Your visit with the pharmacist is in NO WAY intended to replace your visit with your Doctor. In fact, your pharmacist will ensure that you are keeping your regular appointments with your doctor. Our goal is to provide you with education and increased knowledge of your disease so that your time with your physician is more productive for you both.

Q: Do I need my doctor’s permission to enroll in the program?

A: No, you do not need your doctor’s permission to enroll, however you are encouraged to discuss the program with your doctor. Your doctor will be contacted by your Pharmacist coach shortly after you have enrolled to explain the program and the benefits to you, the patient. The Pharmacist will also continue to communicate to your Doctor after each visit to communicate how you are doing and make any recommendations for their consideration. Your pharmacist coach will also request copies of your labs to help monitor your progress and to use in educating you about how well you are meeting your goals.

Q: What should I expect during my visits with my pharmacist coach?

A: Our programs are structured as follows:

Initial visit: Your Pharmacist coach will review the program guidelines, review your medical history, make sure you have functional medical equipment if needed (i.e. blood glucose monitor, home blood pressure monitor, etc.), and administer a knowledge exam. This exam is used only to see which areas you are strong in and which areas the pharmacist should spend more time providing education to you.

Visits 2-6 (diabetes) & 2-4 (cardiovascular):

  • Your pharmacist coach will educate you on various topics about your disease, including

        • Disease overview

        • Generally accepted standards of care (ADA, JNC7, ATP III, etc.)

        • General nutrition/healthy eating

        • Monitor use/monitoring

        • Medications/compliance/adherence counseling

        • Hypo-/hyperglycemia

        • Chronic complications/reducing risks

        • Smoking cessation

        • Exercise

        • Healthy coping/stress/depression

        • Review of guidelines/laboratory results/goal setting

        • Sexual health/erectile dysfunction

        • Sick day/travel/emergency preparedness

        • Problem solving

        • Follow-up

  • At the end of your monthly visits, before moving out to quarterly, your coach will administer a skills and a performance assessment to see how well you can apply everything that you have learned.

Ongoing visits (quarterly): Your pharmacist will continue to review all recent lab work with you to help you monitor your health as well as continue to monitor your clinical markers (such as blood pressure, weight, etc). You will continue to try and meet your program goals as well as set new goals on your way to optimal health!

Q: How do I sign up for the program?

A: If your employer is participating in the program, either see your contact person in Human Resources (HR) or contact LPIHO (see “contact us”) to receive an enrollment packet.

Q: After I complete and return my enrollment packet, how do I know if I am active?

A: If we have a coach for you right away, you will be contacted by your coach to set up your first appointment. If you wish to be seen in an area where we do not currently have a certified coach, we will contact you to let you that you are in the program and that we are looking to train a pharmacist coach for you as soon as possible. As soon as this pharmacist coach is identified and trained, they will call you set up your first appointment.

Q: How long until the program incentives take effect?

A: Program incentives typically take place within one week of completion of your enrollment packet; however some employers do not put the incentive into effect until after the first visit with the pharmacist coach. Your employer’s program guidelines will be outlined in your enrollment packet.

Q: Will this affect my insurance coverage?

A: No! Your insurance coverage and premium will remain exactly the same.

Q: Will this affect where I get my prescriptions processed?

A: No! You may continue to have your prescriptions filled at ANY pharmacy, including mail order pharmacies.

Q: I use mail-order pharmacy. Can I still participate?

A: Yes! In fact, many patients who use mail order pharmacy find the face-to-face visits with a Registered Pharmacist to be very valuable, with regards to the medications they are taking.

Q: What will I need to do to prepare for the first visit?

A: You may be asked to complete a medical history form prior to your first appointment. You should also make a list of ALL of the medications you are taking on a regular or "as needed" basis. This should included all herbal and "over the counter" medications or dietary supplements like vitamins. If you use an at-home monitoring device (blood glucose meter, blood pressure monitor, etc) you should bring that to your first visit as well as any supplies that you use (test strips, lancets, log book, etc.)

Q: What will I need to do to prepare for subsequent visits?

A: Your pharmacist will help you set attainable "self management" goals at each visit. In addition, your Pharmacist will help to ensure that you are getting laboratory tests done on a timely basis. Do your best in between visits to apply what you are learning to meet the goals you set for the next visit.

Q: I don’t have a chronic disease to be eligible for this program, but one of my family members does. Can they enroll in the program?

A: Typically, most employers offer the program to employees, retirees and any dependents (family members) that are covered on your insurance plan through the company. Please contact your Human Resources Department or LPIHO to find out exactly who your company is allowing to participate.

Q: How long does the program last?

A: The program continues for as long as your employer wishes to participate.

Q: What happens if I decide I no longer want or need to participate?

A: You may withdraw from the program at any time for any reason. We ask that you notify both your employer and your coach that you no longer wish to participate. Your program incentives will then be removed.

Q: What happens if our company changes insurance carriers?

A: LPIHO’s programs are portable, so even if your company changes carriers, the program continues without interruption.

Q: How will I know if the program is successful?

A: LPIHO presents the employer with annual clinical, economic and satisfaction reports, provided the employer obtains the necessary information from their insurance carriers in a timely manner. In order for LPIHO to receive this information, we request that you sign a consent form that allows LPIHO to receive your economic data from your insurance carrier. Your information is then de-identified and reported in the aggregate (i.e., it is reported in a group format and your information cannot be identified)

If you feel our program would benefit you, we encourage you to provide your employer with the information found on this website.

Do you have questions or concerns that were not addressed here?

If so, please contact a member of LPIHO’s Care Team


Content copyright 2013. LPIHO All rights reserved