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Payment and Policy Solutions Workgroup

  • Identify foundational elements of policy solutions necessary to overcome barriers to the adoption of CMM and optimization of medication and gene therapies.
  • Identify successful use cases for utilization in advocacy and coalition building.
  • Identify payment solutions and policy and payment strategies that reward the value of CMM services in terms of cost, quality and patient outcomes.
  • Design an approach to educate and engage policymakers about CMM.
Workgroup Leads

Workgroup
Co-Lead

Kathy Pham headshot

Co-Lead: Kathy Pham, Pharm.D., BCPPS Director, Policy and Professional Affairs, ACCP

Workgroup
Co-Lead

John McGlew headshot

Co-Lead: John McGlew, MA, Director of Government Affairs, ACCP

Workgroup
Co-Lead

Co-Lead: Brad Cannon, Pharm.D., Director of Experiential Education, Assistant Professor, Department of Pharmacy Practice, Rosalind Franklin University

Workgroup
Co-Lead

Co-Lead: Tom Kraus, JD, MHS, VP, Office of Government Relations, ASHP

 

Payment Methodologies Subgroup Co-Leads:

Subgroup
Co-Lead

Co-Lead: Bayli Larson, PharmD, MS, BCPS, Strategic Intiative Associate, Office of the Chief Operatinf Officer, ASHP

Subgroup
Co-Lead

Co-Lead: Larry LaMotte, Principal, Advocacy Option LLC

Telehealth Delivery Subgroup Leads:

Subgroup Lead

Co-Lead: Mary Ann Kliethermes, BPharm, PharmD, FAPhA, FCIOM, Director, Medication Safety and Quality, ASHP

Workgroup Participants

  • Sarah Amering, Pharm.D., BCACP, Clinical Pharmacy Specialist, University of Rochester Medical Center
  • Amy Baker, Pharm.D., FAAMFM, ABAAHP, Director of Pharmacy, Rogue Community Health
  • Craig Beavers, Pharm.D., FACC, FAHA, FCCP, BCCP, BCPS (AQ-Cardiology), CACP, Cardiovascular Clinical Pharmacy Specialist, University of Kentucky Healthcare
  • Amanda Bektas, Pharm.D., Pharmacist in Charge & Central Clinical Medication Management Team Lead, Consana, LLC.
  • Amanda Brummel, Pharm.D., BCACP, Vice President, Clinical Pharmacy Services, Fairview Pharmacy Services
  • Starlin Haydon-Greatting, MS-MPH, BSPharm, CDM, FAPhA, Director, Clinical Programs, IPhA-PSMP
  • Robin Kahn, Director, Health and Benefits, Willis Towers Watson
  • Shirley Reitz, Pharm.D., RPh, Pharmacy Services Manager, Clinical Pharmacy Client Services, Regence
  • Amy Schwartz, Pharm.D., BCPS, Associate Dean and Professor, University of South Florida
  • Marie Smith, Pharm.D., FNAP, Henry A. Palmer Professor of Pharmacy Practice, Assistant Dean, Practice and Public Policy Partnerships, UConn School of Pharmacy
  • Karmen Stephens, Pharm.D., BCGP, Vice President, Clinical, Consana, LLC
  • David Zgarrick, Ph.D., FAPhA, Professor, Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Bouvé College of Health Sciences, Northeastern University
  • Polly Webster, JD, MPH, Counsel, Government Relations, Kaiser Permanente
  • Michael Blumberg, MD, JD, MHA, Clinical Professor of Pediatrics, Virginia Commonwealth University Health
  • Rebecca Cupp, RPh, Vice President, Pharmacy Controls, Kaiser Permanente
  • Jon Easter, BPharm, Professor of Practice and Director, Center for Medication Optimization, UNC Eshelman School of Pharmacy
  • Patricia Fabel, Pharm.D, BCPS, Professor, Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Bouvé College of Health Sciences, Northeastern University
  • Brooke Griffin, Pharm.D., BCACP, Pharmacist and Professor, Midwestern University
  • Tony King, RPh, Director, Pharmacy Programs, Mountain-Pacific Quality Health
  • Mary Mulrooney, Pharm.D., MBA, Assistant Research Professor, Pharmacy Practice, School of Pharmacy, University of Connecticut
  • Christopher Pitts, Pharm.D., Pharmacist, IU Health
  • Chris Syverson, Chief Executive Officer, Nevada Business Group on Health/Nevada Health Partners

Areas of Further Work

Create a Value Framework

  • Identify evidence, promising payment frameworks, use case examples and tools for advocacy to promote the value of optimized medication use to consumers, providers, public & private sector payors

Evaluate Barriers to Adoption of New Payment Models

  • Evaluate and establish a plan to overcome policy and payment barriers that currently exist in the market preventing a scalable, sustainable rational system to optimize medication use and gene therapies.

Determine Key Policy Elements

  • Identify successful use cases (commercial, public, private) for use in advocacy and coalition building in support of and to advance the mission and vision of GTMRx.
  • Specifically define characteristics and foundational elements that will inform a policy  platform designed to overcome barriers to broad and sustainable adoption of team-based care activities designed to optimize the use of medication and gene therapies.

Identify Payment Solutions

  • Identify payment structure solutions (and possible framework) necessary to overcome barriers to adoption of CMM and optimized use of medications and gene therapies.

Design an approach to educate and engage policymakers about these solutions

  • Identify partners, develop tools, guidance and a dissemination plan (practice leaders, physicians/their agents, consultants, care teams and payors) to increase awareness, build demand for, and ensure adoption and use of a successful strategies and standardized implementation processes for CMM integration.

Standing Date:

  • Every other Tuesday from 2:00-3:00 pm EST
  • 2019: 9/5, 9/17, 10/1, 10/15, 10/29, 11/12, 12/3, 12/10
  • 2020: 1/14, 1/22, 2/25, 3/24, 4/7, 4/21, 5/5, 5/19, 6/2, 6/16, 6/30, 7/14, 7/28

If interested in learning more about the Workgroup, contact:

We need your help now more than ever!

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