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Practice Transformation

In the haste to address the opioid epidemic, some chronic pain patients have been forced to rapidly taper, or discontinue altogether, their use of the drugs. But abrupt changes to an opiod prescription can be dangerous. So Health and Human Services has issued new guidelines that recommend a deliberate approach to lowering doses for chronic pain patients who have been on long-term opioid therapy. “It must be done slowly and carefully,” says Adm. Brett P. Giroir, MD, assistant secretary for health at HHS. “If opioids are going to be reduced in a chronic patient it really needs to be done in a patient-centered, compassionate, guided way.” (NPR; new guidelines)

Evidence & Innovation

Pharmacist-led chronic care management services can improve access to care and the capacity to manage chronic diseases, according to a paper published in the Annals of Family Medicine. However, the authors note that a sustainable, successful program may require significant infrastructure investment. They draw from their own experience: The Pharmacist-Led Chronic Care Management Services at the University of North Texas Health Clinical Practice Group includes four pharmacists and 48 physicians who collaborate to provide primary and specialty care. Their collaborative practice agreement is believed to be the most expansive one in Texas. (Annals of Family Medicine; announcement)
Physician burnout and work satisfaction improved from 2014 to 2017, according to research published in Mayo Clinic Proceedings. However, it remains a significant problem, the authors warn. “Despite this improvement, symptoms of burnout among physicians continue to be prevalent and markedly higher than seen in the general US working population. Given the evidence that burnout impacts patient satisfaction, access, quality of care and costs, continued efforts to make progress are needed.” (Mayo Clinic Proceedings)

Policy Solutions

Health and Human Services announced proposed reforms to self-referral (Stark Law) and anti-kickback rules. The much-anticipated move addresses longstanding concerns that the two hinder coordinated care. The changes would allow more flexibility for innovation, reports Healthcare Finance News. It’s part of a larger HHS initiative: the Regulatory Sprint to Coordinated Care. But industry experts and executives point out that Stark and the anti-kickback rule are only two of the many hurdles to value-based care, Modern Healthcare reports. The biggest hurdle, they say, is the lack of incentive to move from fee-for-service medicine. (Modern Healthcare; Healthcare Finance News)
Increased transparency isn’t enough. Consider: Learning about payments from pharma companies to doctors diminished Americans’ trust in the physician profession, regardless of whether their own doctor took industry money, according to research published in JAMA Open. “The issue isn’t transparency itself; the issue is the noisiness of the information that is being conveyed,” lead author Genevieve Kanter, PhD, tells Healthcare Dive. “What we need is not just transparency, but more directed, more targeted, more informative transparency about payments to particular physicians.” (Healthcare Dive; JAMA Open)
The human and dollar costs associated with sub-optimal medication use—when medicines are wrong, skipped or make you sick—is staggering with an estimated 250,000 lives lost and $528 billion in wasteful spending annually. Launched in April of this year, the GTMRx Institute reports on collaboration for system-wide transformation among those who pay for, those who deliver and those who receive care. (Press Release)
Join us for our next webinar! Interoperability Forecast: Opportunities & Solutions for Comprehensive Medication Management 
October 29 at 1 p.m. eastern
The empowered consumer has personalized data that is meaningful to them at every point in their health care journey. Nearly three years after the signing of The 21st Century Cures Act, multiple government and industry-led initiatives are underway to deliver on that vision—at scale.
Join us for a webinar to make sense of where we are and where we’re going with our ability to get the right data at the right time to help patients and their care teams get the medications right.
Presented by:
  • Deb Gage, MBA, President and CEO at Medecision, GTMRx Institute Board Member
  • Ryan Howells, M.H.A., PMP, Principal at Leavitt Partners, Lead at the CARIN Alliance
  • Lisa Bari, MBA, MPH, Consultant, former Health IT and Interoperability lead at the Centers for Medicare and Medicaid Services’ (CMS) Innovation Center
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