December 13, 2013

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December 13, 2013 

United States Congress

Budget deal: Following agreement among budget conferees lead by Senate Budget Committee Chair Patty Murray (D-WA) and House Budget Committee Chair Paul Ryan (R-WI) total funding levels for FY14 and FY15 have been established. The agreement is a true consensus with the $1.012 trillion total funding for FY14 being middle ground between the Senate’s budget total of $1.058 trillion established in SCR 8 and the House budget total of $967 billion established in HCR 23. The budget total funding for FY14 restores some, but less than 50%, of the discretionary funding lost due to the sequester authorized in the Budget Control Act of 2011. The total funding agreed to for FY15 restores less than 20% of discretionary funding lost due to the sequester authorized in the Budget Control Act of 2011. The budget agreement does not change the funding reductions for mandatory programs in FY14 or FY15.

With agreement on total funding for FY14 the appropriations process can be completed. It is expected that the funding levels for the individual appropriation subcommittees, referred to as 302B allocations, will be established by the end of this week allowing staff to begin preparing legislative bills. These bills are likely to be considered in an omnibus package at the start of the second session of the 113th Congress in January.

The House passed the budget agreement on Thursday night. The Senate is expected to consider and pass the legislation early next week.

While the budget agreement is not perfect in that it does not restore all the funding sequestered through the Budget Control Act of 2011 it does provide stability for legislative decision making for the remainder of FY14 and into FY15. The agreement maintained the equal distribution of cuts between defense and non-defense discretionary programs, Maybe more important is the fact that while the restored funding is a result of increased fees and not tax revenues it does not take additional funding from discretionary programs to make up the difference. Another important point is that the agreement allows the appropriations process to regain control over program funding decisions instead of indiscriminate across-the-board cuts required by the sequester. All these points that AACP and hundreds of other organizations advocated for over the past year.

Below are links to documents that provide additional details of the agreement:

Summary of the Bipartisan Budget Act of 2013

Legislative Text of Bipartisan Budget Act

Section By Section Analysis of Bipartisan Budget Act

Analysis of the budget agreement from the Center for Budget Policy and Priorities (CBPP)  


Financial aid toolkit: In a continuing effort to make federal financial aid information easier to understand and more transparent the US Department of Education has developed a financial aid tool kit. Financial aid officer and counselors are encouraged to use the toolkit with prospective and current students seeking information about federal financial aid programs. The availability of the toolkit was announced in a Dear Colleague Letter dated December 4, 2013.  

AHRQ releases draft MTM report: The Agency for Healthcare Research and Quality (AHRQ) has released a draft of its systematic review of medication therapy management (MTM). “This review seeks to catalog MTM intervention components, assess the overall effectiveness of MTM in comparison with usual care, examine the factors under which MTM is effective and optimally delivered, determine what types of patients are likely to benefit from MTM services, and clarify what types of patients may be at risk of harms from the program.” Working from a total of 2228 unduplicated citations including 99 from “grey literature searches, suggestions from technical experts or public comments received during topic refinement, or hand searches of included studies,” this total was pared down, through a double application of the inclusion criteria, to 36 citations for qualitative analysis and 13 usable citations for quantitative analysis.

“We identified 36 studies that offered information on a range of intermediate outcomes, patient-centered outcomes, and resource utilization. Evidence was insufficient on the effect of MTM on most outcomes. For a limited number of outcomes, we found enough evidence to show that MTM results in improvement when compared with usual care (low strength).” The review contrasts its finding of insufficient evidence of benefit to the Chisholm-Burns review that found “Pharmacist-provided direct patient care has favorable effects across various patient outcomes, health care settings, and disease states.” The AHRQ review provides reasons for this discrepancy.

AHRQ seeks comments until December 30, 2013 on this systematic review of which it is imperative that all pharmacy faculty with a stake in MTM research and implementation should take the opportunity to provide. If you provide comments please send a copy to Will Lang at

Equally important is the fact that the AHRQ review provides a very clear guide for future research related to efforts. “…we were unable to identify sufficient evidence on the majority of hypothesized outcomes of MTM. In several instances, our inability to rate evidence as higher than insufficient came from indirect, inconsistent, and imprecise evidence.” Academic pharmacy must improve its capacity to meet research methods standards to move the profession forward.

AHRQ to initiate pharmacy survey: As part of the agency’s efforts to improve patient safety and healthcare quality the Agency for Healthcare Research and Quality will make a new survey available to pharmacies interested in evaluating their culture of patient safety. The Pharmacy Survey on Patient Safety Culture will allow participants to determine their organizations commitment to patient safety and compare that commitment with other participating peer pharmacies. The survey web page includes additional information about the survey and other pertinent resources.

HRSA supports interprofessional education: The reality of team-based care begins with interprofessional education. Over the last couple of years the Health Resources and Services Administration (HRSA) has used its internal authority to modify existing programs to strengthen opportunities for interprofessional health professions education. This allows HRSA to support interprofessional education without the need for legislative authorization. Recently HRSA awarded $6.7 million in grants through its Bureau of Nursing in support of interprofessional education activities that include colleges of nursing.

This approach by HRSA provides a clear rationale for pharmacy faculty to seek partnerships with faculty among other health professions to build interprofessional education programs within your own institutions.

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