Practice Transformation
UnitedHealthcare plans to pay pharmacists in Ohio to deliver primary care to Medicaid patients—in particular, to help patients better manage chronic conditions such as diabetes and high blood pressure. Keeping these populations healthy could lower health care costs and could free up hospital beds during the COVID-19 pandemic. Ohio enacted a law in January 2019 that allows insurers to pay pharmacists as medical providers, but the state’s Department of Medicaid has yet to create a provider code. UnitedHealthcare also plans to develop a system under which pharmacists will be compensated for positive health outcomes. (Becker’s Hospital Review; Columbus Dispatch)
While still in its early stages, “Precision medicine appears to be an unstoppable force that could revolutionize how physicians diagnose and treat patients,” says Joel Diamond, MD, FAAFP. Writing for a physician audience, he discusses how to use the power of genomics and precision medicine to improve patient care. Among his observations: “The formula for value-based success aligns with the objectives of precision medicine: treating patients effectively, faster and without unnecessary cost.” (Medical Economics)
Pharmacists can provide COVID-19 testing, but that’s just one aspect of what pharmacists can do, writes Steven W. Chen, PharmD, of the University of Southern California. They can dramatically improve control of medical conditions, avoid the need for hospital admissions and reduce health care costs, he says, citing comprehensive medication management research. “COVID-19 has created new and unprecedented challenges for our health-care system. With more than 90% of the U.S. population within five miles of a pharmacy, pharmacists are well-situated to step in to help beat this national crisis.” (The Conversation)
Evidence & Innovation
Gilead’s drug remdesivir, a front-running COVID-19 treatment, was shown to effectively treat a small number of COVID-19 patients in the U.S., Europe and Canada, according to a study this month in the New England Journal of Medicine. The study tracked 53 patients, half of whom needed ventilators and four of whom were on heart-lung bypass machines. The results, while encouraging, are far from conclusive. (NEJM)
Scientists at the University of Missouri have helped advance a patient-specific, precision medicine treatment for bone cancer in dogs. By creating a vaccine from a dog’s own tumor, scientists worked with ELIAS Animal Health to target specific cancer cells and avoid chemotherapy. The researchers hope to continue immunotherapy discovery with dogs in order to optimize the new therapy for future human clinical trials with the hopes of treating osteosarcoma and other cancers, especially metastatic osteosarcoma in children. (Medical X Press)
Policy Solutions
The coronavirus pandemic is accelerating the move to the way care is delivered and paid for, says the LA Times. The proximate driver: a steep decline in primary care visits. To address that, Medicare and some commercial plans have begun offering advance payments to providers, effectively giving physicians a lump sum based on an estimate of how much they would expect to collect from seeing a normal stream of patients. “That would mark one of the first clear examples of how the coronavirus outbreak—and the gaps it has exposed—may catalyze profound changes in the healthcare system,” The LA Times observes. (LA Times)
Doctors have more flexibility to refer Medicare patients to providers with whom they have financial ties—at least while the pandemic rages. The Trump administration has relaxed enforcement of some aspects of the Stark Law and Anti-Kickback Statute. (McGuire Woods)
