CMS chief Berwick is driving hard to spur health innovation, report says
WASHINGTON The recently installed head of the federal Medicare program is pushing hard to promote new and more cost-effective ways to treat patients and improve the nation’s health scorecard.
On Monday, The Boston Globe reported that Donald Berwick, tapped by President Obama in July as administrator of the Centers for Medicare and Medicaid Services, is working to expand health-innovation projects around the country in line with the massive health-reform law enacted earlier this year. Berwick envisions as many as 300 test sites devoted to developing new, integrated models of patient care by physician groups and other health professionals, according to The Globe.
Spurring those innovative pilot projects will be billions of dollars allocated by the health-reform bill for a health innovation center, and for the development of health information technology to eliminate waste and promote better decision-making among doctors, pharmacists and other health providers.
To that end, Medicare will designate provider groups participating in the innovation pilot projects as “accountable care organizations’’ under the program, the newspaper reported. The underlying goal: to replace the costly and increasingly unwieldy fee-for-service model that now dominates such public health programs as Medicare and Medicaid, with “global payments” that reward healthier patient outcomes and coordinated care among physicians and other providers, according to The Globe.
Berwick, the report noted, is a strong advocate for experimentation in new, outcomes-based models of patient care, and is working to double the size of the innovation center and promote its involvement in new healthcare demonstration projects. Test sites for new collaborative care models will be up and running by the end of 2011, The Globe reported.
NACDS, NCPA in joint statement praise CMS’ move to withdraw provisions of AMP rule currently blocked by injunction
ALEXANDRIA, Va. National Association of Chain Drug Stores president and CEO Steve Anderson and National Community Pharmacists Association acting EVP and CEO Douglas Hoey issued a statement praising the proposed rule by the Centers for Medicare and Medicaid Services that would withdraw existing provisions of the Medicaid pharmacy reimbursement formula under the average manufacturer price model.
"We are pleased that the Centers for Medicare and Medicaid Services has proposed a rule that would withdraw provisions of what is known as the Medicaid average manufacturer price rule. The proposed rule calls for the withdrawal of existing provisions that define AMP, that determine the calculation of federal upper limits, and that define ‘multiple source drug.’ Put simply, all of these provisions relate to the reimbursement to pharmacies for generic Medicaid prescriptions, and thus impact patients’ access to pharmacies. The move to withdraw these provisions is a victory for patient care as it is delivered in America’s pharmacies every day."
"When we filed the lawsuit in 2007 we knew that patient care was at stake. It is important to point out that the withdrawal of these provisions is another step toward reducing what would have been major cuts to pharmacy reimbursement. The end result is not an increase in reimbursement to pharmacy, but rather the lessening of cuts that previously would have involved pharmacies selling most generic drugs at a loss, thereby threatening their long-term ability to provide patient care."
“We insisted that this policy was not appropriate. Separately, we also have urged that policy-makers should recognize the ability of pharmacies and pharmacists to help improve health and reduce healthcare costs. We are gratified that this sense is reflected in the pharmacy provisions of the new healthcare-reform law. The new law contains provisions ranging from dramatically reducing the AMP cuts to advancing medication therapy management, through which pharmacists can help patients take their medications correctly. … The costs related to poor medication adherence have been estimated to reach $290 billion annually, or 13% of all healthcare expenditures. We urged that patient care should not be jeopardized, but rather that pharmacy be engaged more strategically for the good of patient health and healthcare delivery."
“We anticipate issuing formal comments on CMS’ proposed rule to withdraw these provisions of the AMP rule, and we will continue to work with Congress and with CMS to advocate for access to pharmacy services for patients.”
Once again, study results underscore need for broader role of pharmacy
WHAT IT MEANS AND WHY IT’S IMPORTANT Add another plank to the increasingly solid platform that supports pharmacy’s long-standing fight for a full seat at the healthcare table.
(THE NEWS: ASHP: Healthcare teams with pharmacists improve patient care. For the full story, click here)
Anew health-outcomes study — this one from the American Society of Health-System Pharmacists — yet again demonstrates the unmet potential of community pharmacy as its leaders work to convince policy-makers and health plan payers that pharmacists can do far more than dispense drugs, provide basic counseling and monitor drug interactions. When published in the October edition of the journal Medical Care, the study will add to the growing mountain of evidence supporting pharmacy’s longstanding argument that it brings improved patient outcomes and real cost savings to a fractured healthcare system in dire need of solutions.
The ASHP study, called “US Pharmacists’ Effect as Team Members on Patient Care: Systematic Review and Meta-Analyses,” analyzed the impact on patient health and safety of numerous interventions by pharmacists. Researchers cast a wide net, tracking the results of dozens of pharmacy-care initiatives by reviewing nearly 300 articles and professional papers on the topic.
It was a worthwhile documentation project. Looking at the overall impact of pharmacist interventions and integrated-care programs from the 30,000-ft. level, ASHP found a clear pattern: Community pharmacists working in concert with other members of a patient’s healthcare team can make a big difference in healthier patients and reduced health costs.
One example: An analysis of those many interventions and disease-management efforts found that patients who worked with their pharmacist were 47% less likely to suffer an adverse drug event. And early 90% of studies tracking pharmacists’ impact on managing hemoglobian A1c showed favorable results.
Industry leaders at last week’s National Association of Chain Drug Stores 2010 Pharmacy and Technology Conference made impassioned pleas on behalf of a broader role for pharmacy in a new, reformed U.S. healthcare system. Among them was NACDS president and CEO Steve Anderson, who noted that the pharmacy profession and industry are undergoing a “historic paradigm change” as pharmacists and pharmacy leaders expand their patient-care and clinical capabilities and provide new solutions to a “broken” healthcare system undergoing rapid change.
Also issuing a call to action at the San Diego event was NACDS chairman and CVS/pharmacy president Larry Merlo. “We must ensure that the value of the pharmacy industry and its pharmacists are recognized by payer reimbursement policies — not just for the products we sell but for the services we provide,” Merlo told NACDS members. “We’re positioned to help control the costs of health care by advocating for the value of … pharmacy care.”