title: Comparison of two Medication Therapy Management Practice Models on Return on Investment.
abstract: OBJECTIVE
  To compare the return on investment (ROI) of an integrated practice model versus a "hub and spoke" practice model of pharmacist provided medication therapy management (MTM).
  
  
  METHODS
  A cohort retrospective analysis of MTM claims billed in 76 pharmacies in North Carolina in the 2010 hub and spoke practice model and the 2012 "integrated" practice model were analyzed to calculate the ROI.
  
  
  RESULTS
  In 2010, 4089 patients received an MTM resulting in 8757 claims in the hub and spoke model. In 2012, 4896 patients received an MTM resulting in 13 730 claims in the integrated model. In 2010, US$165 897.26 was invested in pharmacist salary and $173 498.00 was received in reimbursement, resulting in an ROI of +US$7600.74 (+4.6%). In 2012, US$280 890.09 was invested in pharmacist salary and US$302 963 was received in reimbursement, resulting in an ROI of +US$22 072.91 or (+7.9%).
  
  
  CONCLUSIONS
  The integrated model of MTM showed an increase in number of claims submitted and in number of patients receiving MTM services, ultimately resulting in a higher ROI. While a higher ROI was evident in the integrated model, both models resulted in positive ROI (1:12-1:21), highlighting that MTM programs can be cost effective with different strategies of execution.
authors.affiliation: 1 UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Gazda
authors.affiliation: 2 Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA.
authors.forename: Lucas A
authors.initials: LA
authors.lastname: Berenbrok
authors.affiliation: 3 Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Stefanie P
authors.initials: SP
authors.lastname: Ferreri
mesh_terms: D015331:Cohort Studies; D003157:Community Pharmacy Services / Q000191:economics* / Q000592:standards; D003362:Cost-Benefit Analysis / Q000592:standards; D006801:Humans; D007449:Investments / Q000191:economics* / Q000592:standards; D054539:Medication Therapy Management / Q000191:economics* / Q000592:standards; D018803:Models, Economic; D009657:North Carolina; D010595:Pharmacists / Q000191:economics* / Q000592:standards; D012189:Retrospective Studies
keywords: community pharmacy; medication review; medication therapy management; reimbursement; return on investment