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Practice Transformation

Algorithms are not new in health care, but newer emerging algorithms are increasingly complex and require oversight and quality control, according to the authors of “The Case for Algorithmic Stewardship for Artificial Intelligence and Machine Learning Technologies.” When used appropriately algorithms can improve the diagnosis and management of disease, but they also have the potential to “exacerbate existing systems of structural inequality.” They identify several key considerations for emerging algorithmic stewardship programs. (JAMA Viewpoint)
As telehealth use surged, so did cyberattacks on telehealth providers, according to cybersecurity ratings firm SecurityScorecard and DarkOwl, dark web research company. Telehealth providers have experienced an “almost exponential surge” in targeted cyberattacks, Healthcare Dive reports. The research also shows an increase in mentions of major health care and telehealth companies across the dark web since February 2020. The good news: The report also found that health care companies generally improved security in 2019, moving to ninth place out of 18 industries, up from 10th the previous year. (Healthcare Diveannouncement)

Evidence & Innovation

Gene therapy costs can be managed, but it requires preparation. For example, long before receiving its first request about covering a prescription gene therapy, Blue Cross and Blue Shield of Kansas had been prepared. They worked with their pharmacy benefit manager, Prime Therapeutics, to seek out value-based outcome contract opportunities and make the terms more favorable. There are various approaches to managing gene therapy costs, explains Brett Sahli, PharmD, the senior director of value and health outcomes for Prime: annuities that spread payments out two or more years; milestone-based contracting (an annuity payment contingent on a positive outcome or a rebate based on performance or failure) and risk pooling (paying into a pool so plans won’t have to bear the full cost). (Specialty Pharmacy Continuum)
A better patient/provider relationship can improve patient functional health status, according to research published in the Annals of Family Medicine. That aspect wasn’t so surprising. However, when patient-provider relationships improved, functional health status also improved. When patient-provider relationships deteriorated, so did functional health status. The researchers conclude that a longitudinal analysis of the data “suggests that the quality of the physician-patient relationship is positively associated with functional health. These findings might inform health care strategies and health policy aimed at improving patient-centered health outcomes.” (Annals of Family MedicinePatientEngagement HIT)
Most Americans responding to a new Pew survey support efforts to improve how their medical information is shared among clinicians. They also they want greater access to their own health data. For example, 81% indicated they would support allowing health care providers to share patient information between their EHR systems when caring for the same patient. In addition, 61% of adults said they would want to be able to download their records to applications on mobile devices to help them manage their own health. (Pew)

Policy Solutions

Both CMS and providers are using COVID-19 as an excuse to cut back on value-based experiments, warns Modern Healthcare editor Emeritus Merrill Goozner. “Most providers still have both feet firmly planted on the fee-for-service dock. Their ACOs remain little more than experiments—toy sailboats adrift in what now has become a turbulent sea,” he writes. He offers some suggestions to re-invigorate value-based programs. For example, he says, CMS could offer transition grants to primary-care practices that take on full financial risk. “Failing to act will not end existing value-based reimbursement programs. But it will ensure they never become anything more than curiosities in a largely fee-for-service world.” (Modern Healthcare*)
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In Case You Missed It!

At the GTMRx Institute, we recognize that we cannot achieve our goals for medication management reform without a team-based approach which must include a viable primary care foundation—supported by payment reform that rewards inter-professional teams, utilizes effective and smart use of health IT at the point of care and is personalized through the use of companion and complementary diagnostics.
The virtual event will bring in speakers to illuminate the crisis we face with
  • a crumbling primary care infrastructure,
  • the importance of payment and policy change to achieve value,
  • the way forward in practice transformation and
  • the need for point-of-care access to information enabled by health IT (companion and complementary diagnostic test results, clinical information needed to evaluate therapy effectiveness and/or changes in needed therapy) available for use by all team members.
Featuring Susan Dentzer, MPH; Mark McClellan, MD, Ph.D.; Mary R. McClurg, Pharm.D.; Mark Loafman, MD, MPH; Ann Greiner and Annette Dubard, MD, MPH.
This is a by invitation only event. Find more information here.
CMM offers reduced costs, improves access to care, provides better care and enhances provider work life. These results are outlined in “The Outcomes of Implementing and Integrating Comprehensive Medication Management in Team-Based Care: A Review of the Evidence on Quality, Access and Costs,” updated in June 2020. The evidence document was prepared by GTMRx workgroup members, M. Shawn McFarland, PharmD, FCCP, BCACP, national clinical pharmacy practice program manager, clinical practice integration and model advancement, clinical pharmacy practice office, pharmacy benefits management services, Veterans Health Administration; and Marcia Buck, PharmD, FCCP, FPPAG, BCPPS, director, clinical practice advancement, American College of Clinical Pharmacy. (GTMRx Institute)
Hosted by the GTMRx Institute’s executive director and co-founder, Katherine H. Capps, Voices of Change features leaders who have knowledge, experience and ideas to solve this urgent need to get the medications right. Did you miss the most recent episode?
Episodes feature:
  • Liz Fowler, JD, Ph.D., executive vice president for programs, The Commonwealth Fund
  • Amy Gutierrez, Pharm.D.,senior vice president and chief pharmacy officer, Kaiser Permanente
  • Amanda Brummel, PharmD, BCACP, vice president, Clinical Ambulatory Pharmacy Services, Fairview Pharmacy Services
  • Orsula V. Knowlton, PharmD, MBA, president and chief marketing & new business development officer, Tabula Rasa HealthCare
  • Anand Parekh, MD, chief medical advisor, Bipartisan Policy Center
  • Paul Grundy, MD, president, GTMRx; chief transformation officer, Innovaccer
AmazonSmile is an easy way for 0.5% of your qualified purchases go to the GTMRx Foundation at no cost to you. And signing up is simple—go to smile.amazon.com and select “Get the Medications Right Foundation” as your charity of choice. If you prefer to directly donate instead, you can do so here.
Adding the foundation on AmazonSmile will help us continue to provide no cost educational webinars, issue briefs, weekly news briefs and promote the need for transformation of our current system of medication use through social media campaigns.
The GTMRx Institute is supported by our Founding Funders, Executive Members and Strategic Partners.
  See past issues of our weekly news brief here

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