When discussing this issue of Academic Pharmacy Now with staff, I remarked how thankful I was to have studied managed care in the 1980s. Several of the earliest health maintenance organizations (HMOs) took root in Minnesota, which influenced my enrollment in the social and administrative pharmacy graduate program at the University of Minnesota. Had I not seen the birth of national pharmacy benefit management firms, such as the Physicians Health Plan of Minnesota (now Express Scripts), I might still be struggling to understand the many elements of the healthcare system. Little did I appreciate how much influence the sector would have, both positive and negative, on the pharmacy profession.
Fast forward 30 years. HMOs fell out of favor because consumers and healthcare professionals thought these organizations focused more on managing cost than managing care. New organizations emerged and got better at managing “big data.” This provided opportunities to introduce interventions for better managing risks and costs—and, in some cases, improving care. The pharmacy benefit became much more central to care costs and outcomes. More practitioners entered the managed care pharmacy workforce, and many students demanded key competencies to ensure they’d be competitive in the industry.
So where are we in 2013 on the eve of implementing the Affordable Care Act? Achieving the triple aim of improved patient health outcomes, enhanced population health and lowered costs requires managing patient medications effectively. Many schools play central roles in designing and delivering such services. Today that means more than just brand-to-generic switches and therapeutic interchange activity. Pharmacists help manage transitions of care and continuity of care service delivery models. All Pharm.D. graduates must be equipped with the knowledge, skills and abilities to serve as the medication use specialist in medical homes, accountable care organizations and other care management models. Aligning financial incentives in health organizations and funding is essential.
We continue to work on AACP President J. Lyle Bootman’s charge to get academic pharmacy to all the right tables of influence. Occasionally it is not a table at all, but instead a disaster recovery site where students and faculty provide timely and compassionate services to people in great need. My personal thanks to all of you who make the commitment to do so.
Lucinda L. Maine, Ph.D., R.Ph. CEO and Publisher