Financial implications of pharmacist-led Medicare annual wellness visits.

Objective: To determine if pharmacist-led Medicare Annual Wellness Visits (AWVs) are a feasible mechanism to financially support a pharmacist position in physicians' offices.

Setting: Large, teaching, ambulatory clinic in North Carolina.

Practice Description: The Mountain Area Health Education Family Health Center is a family medicine practice that houses a large medical residency program. The Department of Pharmacotherapy comprises five pharmacists and two pharmacy residents providing direct patient care.

Practice Innovation: In April 2012, pharmacists began conducting Medicare AWVs for patients referred by their primary care physicians within the practice.

Main Outcome Measures: Visit reimbursement, annual revenue, number of patients who must be seen to cover the cost of a pharmacist's salary.

Results: A small practice requires all eligible Medicare patients to complete an AWV to generate enough revenue to support a new pharmacist position. A medium-sized practice requires a 54% utilization rate, and a large practice requires an 18% utilization rate. Two additional AWVs per half-day of clinic are needed to support an existing pharmacotherapy clinic. A total of 1,070 AWVs per year are required to support a pharmacist's salary, regardless of practice size.

Conclusions: AWV reimbursement may significantly contribute to supporting the cost of a pharmacist, particularly in medium- to large-sized practices. In larger practices, enough revenue can be generated to support the cost of multiple pharmacists.