Payment for pharmacist services: AACP, like many national professional pharmacy organizations including ACCP, AMCP, APhA, and ASHP, is on record as supporting Medicare coverage of pharmacist delivered services. Our cumulative policies include statements of the academy’s support. In February 2012 our Board of Directors passed a motion to support AACP’s participation in discussions related to pharmacist payment. First steps in creating a successful strategy for payment for services include national organizations, including AACP, working toward consensus regarding the scope of services and appropriate pharmacist credentials necessary for delivering those services.
Your thoughts regarding payment for services are valuable to AACP. We know that our members have been influential in developing payment strategies in their state and employer‐based insurance plans. Please share with us your success in developing payment for pharmacist delivery of non‐dispensing services that explicitly state the scope of services and the credentials required of the pharmacist to be eligible to participate in the program.
Examples of state‐based plans:
University of Minnesota and UPlan: the University’s health insurance plan.
University of Minnesota and the Minnesota State Medicaid plan: MN Statute 256B.0625 Subd. 13h, 2005
Iowa Medicaid Pharmaceutical Care Management
Connecticut Integrated Care Organization demonstration.
HHS approves 106 additional ACOs: The U.S. Department of Health and Human Services, through the Centers for Medicare and Medicaid Services, announces the approval of an additional 106 participants into the accountable care organizations program. ACOs are a part of the shared savings program authorized under Section 3022 of the Affordable Care Act (PL 111‐148). ACOs are expected to improve health, improve healthcare and reduce costs for the Medicare program and improve the health outcomes of enrolled Medicare beneficiaries. CMS has developed over 30 quality measures that ACO’s must meet in order to share in any savings this coordinated‐care model of health services delivery may generate. The announcement of these 106 brings the total to 250 ACOs covering over 4 million Medicare beneficiaries.
Is your institution a part of an ACO? Please let AACP know if these 106 new or any of the now 250 ACOs include pharmacists from your institution.
ACA is contributing to slower spending: Along with the notice of the new ACO approvals, HHS released a memo indicating that the Affordable Care Act is slowing the rate of Medicare spending. Medicare spending per beneficiary has hit a historic low during 201‐2012. Additional savings are expected as the bulk of ACA provisions are scheduled for implementation in 2014. The memo solicits that while the recession has slowed health expenditures, Medicare beneficiaries are somewhat protected from increased costs through Medicare and supplemental insurance. The need to restrain per beneficiary costs is important as the number of Medicare beneficiaries will continue to rise in the coming decades meaning Medicare will account for an increasing proportion of U.S. GDP even if costs are well controlled.
New effective healthcare resources: The Agency for Healthcare Research and Quality, through the Effective Healthcare program has three new resources available of interest to pharmacy faculty and clinical pharmacists. These resources include information on psoriasis, rheumatoid arthritis and hepatitis C.
AHRQ seeks comment on new paper: The Agency for Healthcare Research and Quality (AHRQ) seeks comments on a recently published paper regarding case management. Outpatient Case Management for Adults With Medical Illnesses and Complex Care Needs: Future Research Needs, published in January 2013 provides answers to three questions:
1. Is case management effective in improving patient‐centered outcomes, quality of care and resource utilization;
2. Do patient characteristics impact the effectiveness of case management; and
3. Do intervention characteristics impact the effectiveness of case management?
The Oregon Evidence‐based Practice Center reviewed 109 studies and concluded that case management interventions had limited impact on outcomes, quality and resource utilization. Most importantly the review identified significant gaps in the literature that make limit the ability to make conclusions as to case management effectiveness. Researchers asked stakeholders to rank the topics identified for further research. "Studies that establish clear definitions of specific models of CM based, for example, on their components, intensity and duration," was ranked number one. The paper clearly identifies these gaps which are significant research opportunities for pharmacy faculty.
The paper is open for comment until February 7, 2013.
IOM adds fuel to the health policy fire: Why does the United States pay more for healthcare, but have poorer health outcomes, including life expectancy than other high‐income countries? This question has perplexed policy makers, health analysts and the general public for decades. U.S. Health in International Perspective: Shorter Lives, Poorer Health suggests that this disparity is not just a result of our ethnic and economic diversity. The Institute of Medicine, Committee on Population, Division of Behavioral and Social Sciences Education, makes the recommendation that the public health consequences of this disparity be raised higher on the public and political agendas so that resolution may eventually be forthcoming for priority issues such as obesity, smoking and accidents.
The IOM report Web page also includes a video in which the Chair of the Committee, Steven Woolf, explains the report.
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Founded in 1900, the American Association of Colleges of Pharmacy (AACP) is a national organization representing the interests of pharmacy education and educators. Comprising all accredited colleges and schools of pharmacy including more than 6,400 faculty, 57,000 students enrolled in professional programs and 5,700 individuals pursuing graduate study, AACP is committed to excellence in pharmacy education.