Expansion of a postgraduate year 2 ambulatory care pharmacy residency program utilizing Medicare annual wellness visits within primary care.

Background: Funding for pharmacy residency programs is traditionally allocated by the Centers for Medicare and Medicaid Services. In 2003, funding for postgraduate year 2 (PGY-2) was retracted. PGY-2 sites must develop additional funding methods to facilitate program expansion.

Objective: To describe the impact of expanding a PGY-2 ambulatory care pharmacy residency through an innovative funding model.

Practice Description: St. Joseph's/Candler Health System (SJC) employs pharmacists, including ambulatory care pharmacists, supported by revenue from Medicare annual wellness visits (AWVs) and pharmacy residents.

Practice Innovation: The PGY-2 ambulatory care program at SJC historically offered 1 position supported by SJC. The program expanded in 2020 to further patient outreach with disease state management by increasing the number of pharmacists providing comprehensive patient care. The additional position was primarily supported using funding from AWVs completed by pharmacy residents. To ensure adherence with the American Society of Health-System Pharmacists, residents were evaluated quarterly by preceptor based on feedback provided by clinicians at the practice site.

Evaluation Methods: In addition to conducting AWVs, residents worked with physicians within the state-defined scope of practice to optimize medications, support office visits, promote medication adherence and antimicrobial stewardship improvement activities, and implement a blood pressure monitoring program.

Results: From July 15, 2020 to March 31, 2021, 407 AWVs were completed by SJC PGY-2 ambulatory care residents, and average AWVs per day increased from 4.5 to 6.9. As compared with the previous year, total AWVs at the primary clinic doubled after pharmacy resident addition, increasing from 251 to 550 (P < 0.001).

Conclusion: Through an additional position fiscally supported by reimbursement from AWVs, SJC Ambulatory Care PGY-2 residents increased patient outreach to preventative services as compared with the previous year, expanded pharmacy practice to a new practice site, and generated revenue. This funding method is a viable option to expand postgraduate pharmacy training and ensure optimal patient care in the outpatient setting.