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GTMRx News Brief

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13Sep 22

News Brief | September 13, 2022 | Underappreciated CMM is the missing ingredient to value-based models

Practice Transformation Underappreciated CMM is the missing ingredient to value-based models Comprehensive medication management is the missing ingredient in value-based models, but despite evidence supporting its effectiveness and value, it remains underappreciated and underused, a group of GTMRx leaders write in Health Affairs Forefront. They highlight the evidence for CMM, including how it supports all five elements of the Quintuple Aim—including the newest aim, equity. Their a call to action: Align on the standardized definition of CMM “to promote well-defined CMM…

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02Sep 22

Press Release | GTMRx to CMS: MA needs to support team-based, interprofessional care that includes CMM

GTMRx to CMS: MA needs to support team-based, interprofessional care that includes CMM Coalition submits comments to enhance Medicare Advantage Tysons Corner, VA — Sept. 1, 2022: Wednesday, the Get the Medications Right™ (GTMRx) Institute submitted comments urging the Centers for Medicare & Medicaid Services to support value-based payment models that incentivize team-based, interprofessional care that includes comprehensive medication management (CMM) services provided by clinical pharmacists working in collaboration with clinicians. The GTMRx Institute is a non-profit coalition of 1,700 members focused on ensuring optimal use…

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30Aug 22

News Brief | August 30, 2022 | PBMs concern “even free-marketeers”

Practice Transformation Amazon to shutter Amazon Care Say “goodbye” to Amazon Care. The virtual and in-home health service, initially created for Amazon employees will be gone by the end of 2022. Amazon Care currently has six corporate customers including Hilton, Silicon Labs and Amazon-owned Whole Foods. Workers were told the service was shutting down because those customers did not see the value in the service, the Washington Post reports. Modern Healthcare notes that the decision comes just weeks after the company said it would…

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16Aug 22

News Brief | August 16, 2022 | Drug reform passage is just the beginning

Practice Transformation To improve population health, invest in primary care Investing in primary care is the key to improving population health and reducing disparities, according to the authors of a Health Affairs Forefront post. ”Strengthening primary care benefits everyone by improving overall health and lowering health care costs. By improving how the health care system connects with patients, generalists and specialists can support the patients who need them most, when they need them the most. This will make our health care system…

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02Aug 22

News Brief | August 2, 2022 | GTMRx provides insights to HHS to strengthen primary care

Practice Transformation Texas NAMI head: End nonmedical switching Health insurers and PBMs are making the current mental health crisis through “nonmedical switching”—moving stable patients from their current medication to one that may not work as well for them, writes Greg Hansch, LMSW, of the National Alliance on Mental Illness of Texas. “As a result, a patient with a mental health disorder who was stable on his or her current medication may be forced to switch to a different medication regardless of…

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19Jul 22

News Brief | July 19, 2022 | Fendrick: Rethink prior authorization

Practice Transformation Safety-net providers worry about loss of 340B discounts Hospitals and clinics that serve low-income patients say drug manufacturers have threatened their financial stability by dramatically cutting back participation in the 340B federal discount program. “They are killing health centers,” said Jangus Whitner, who runs the pharmacy program for PrimaryOne Health, a multisite community health center. PhRMA spokesperson Nicole Longo disagrees: “There is very little to no evidence that 340B is helping patients access medicines, and that’s a big…

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12Jul 22

News Brief | July 12, 2022 | NYC to offer Paxlovid, bypassing pharmacies

Practice Transformation NYC to offer Paxlovid, bypassing pharmacies New York City plans to start offering Paxlovid at "mobile test-to-treat sites" across the city, bypassing pharmacies; which is the fist of its kind, Bloomberg reports. Currently, people who test positive for COVID-19 and are eligible for Paxlovid can fill their prescriptions at the nearest pharmacy. Mayor Eric Adams said the service targets inequity in getting Paxlovid, according to Bloomberg. A recent study found that the drug is inaccessible to more than 26 million people…

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05Jul 22

News Brief | July 5, 2022 | Finding non-opioid options for chronic pain

Practice Transformation Why mental health carveouts are so bad The current push for primary care physicians to provide mental health care has tremendous support; it could enhance whole-person care and address the shortage of mental health providers. But, as Kaiser Health News points out, there’s one problem: Many insurers have “carved out” behavioral health benefits. Patients typically don’t even know whether their insurance plan has a carve-out until they end up with an unexpected bill. “It’s the patients who end up with…

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28Jun 22

News Brief | June 28, 2022 | CVS hiding the generics?

Practice Transformation CVS hiding the generics? A recently unsealed whistleblower suit claims that CVS Health subsidiaries coordinated to prevent members from accessing generic drugs, according to Stat News. The whistleblower, Alexandra Miller, says that when she reported the behavior to a superior, she was told that the company had decided the benefits of the alleged scheme outweighed the likelihood of being caught. Specifically, she claims that the SilverScripts Part D subsidiary, the Caremark PBM and the retail pharmacies worked together to…

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21Jun 22

News Brief | June 21, 2022 | Colorado to hospitals: No transparency? Then no debt collections

Practice Transformation Can Oracle create a national EHR database? Just after closing the deal to acquire Cerner, Oracle—or more specifically, board chair and chief technology officer Larry Ellison–said the company would create a national health records database. “We’re building a system where all American citizens’ health records not only exist at the hospital level, but they also are in a unified national health records database.” Health IT experts have been expressing doubts, however, pointing out that for decades, public and private…

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14Jun 22

News Brief | June 14, 2022 | JMCP: Sustaining CMM in the pharmacy setting

Practice Transformation JMCP: Sustaining CMM in the pharmacy setting What is needed to sustain CMM in the community pharmacy setting? HealthPartners shared its insights, based on decades of experience. Among other things, the authors stressed the importance of differentiating CMM from other services and providing support for pharmacies doing CMM. They also discussed the influence payment models have on sustainability. “CMM in community pharmacies shows promise for being a sustainable practice model. However, increased reach and performance of networks, as…

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07Jun 22

News Brief | June 7, 2022 | AMA won’t support opioid training legislation

Practice Transformation Telehealth boom opened the door to hybrid models Telehealth is increasingly incorporated in hospitals’ digital roadmaps, according to speakers at the annual HIMSS health care conference. That’s good news for proponents of hybrid care models, who cite the value of meeting patients. The use of hybrid models aligns with the shift to value-based care, Healthcare Dive reports. If providers have a certain amount of funds to take care of a specific population, instead of being paid on a per-visit basis,…

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31May 22

News Brief | May 31, 2022 | Employers lack transparency into specialty drug outcomes

Practice Transformation Employers lack transparency into specialty drug outcomes A Pharmaceutical Strategies Group report finds that specialty drugs continue to be a top focus for plan sponsors, at least in part because of costs. And as it stands, sponsors don’t have much insight into the impact of such drugs. “More than 80% of plan sponsors have access to reporting on their total healthcare costs,” PSG’s Tracy Spencer said in a prepared statement. “However, clinical outcomes of adherence, persistency and clinical…

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24May 22

News Brief | May 24, 2022 | Hospitals harm seniors; medication problems top cause

Practice Transformation Hospitals harm seniors; medication problems top cause One in four older Americans covered by Medicare experienced some sort of harm during hospital stays in October 2018, according to a report from the HHS Office of Inspector General. About half those cases involved adverse events that led to longer stays and sometimes permanent harm or death. By far, the most common type of harm event was related to medication (43%), followed by patient care (23%), procedures and surgeries (22%)…

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17May 22

News Brief | May 17, 2022 | Tailored CMM: Different models, same process

Practice Transformation Tailored CMM: Different models, same process Pharmacists are well positioned to collaborate with primary care providers to conduct comprehensive medication management, but different PCP practices require different CMM practice approaches, according to the authors of an Annals of Pharmacotherapy commentary. The authors consider two models — Expanded Care Team Pharmacist Model and Population Health Team Pharmacist Model — and explore how the CMM process works in each. “By tailoring the CMM process to their practice model, pharmacists can follow consistent…

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10May 22

News Brief | May 10, 2022 | DOJ launches investigation into Cerebral

Practice Transformation Tots likely to get COVID vax from docs Most states prohibit pharmacists from vaccinating children under 3. Even where it’s permitted, pharmacies are wrestling with whether to do so. That means physicians — especially pediatricians — will play a large role in the in this phase of the country’s largest-ever vaccination campaign, the Washington Post reports. It notes that across party lines, pediatricians are the most trusted source of vaccine information for parents, which could help overcome vaccine hesitancy. (Washington Post) Study…

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03May 22

News Brief | May 3, 2022 | Opinion: Make policy changes to prevent medication harm

Practice Transformation Diabetes care needs to be team-based A multidisciplinary team of health care professionals including physicians, nurses, dietitians and pharmacists can provide comprehensive diabetes care and management for patients, writes Susan Cornell, PharmD, of the Chicago College of Pharmacy at Midwestern University. “Working as a team allows each practitioner to work to the highest level of their license and provides more reward in what they have achieved. The key to success and efficacy of workflow is knowing what each…

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26Apr 22

News Brief | April 26, 2022 | GTMRx: Think beyond the pill, and support primary care

Practice Transformation Increased use of generics, biosimilars help control costs Biosimilars and generic drugs may slow drug cost growth in 2022, Modern Healthcare reports. Drug prices only increased 1.9% in 2021, partly due to new biosimilars and generics, according to an American Society of Health-System Pharmacists report. “Biosimilars really took off this year,” Eric Tichy, PharmD, MBA, division chair, supply chain management, at Mayo Clinic, said in a release. “A couple of years ago there was a lot of consternation about the…

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19Apr 22

News Brief | April 19, 2022 | Community pharmacists, collaboration and CMM

Practice Transformation Before prescribing, plan on deprescribing opioids Before prescribing opioids, physicians should—in collaboration with the patient--develop a deprescribing plan, argues Jason Doctor, PhD, of the USC Schaeffer Center for Health Policy & Economics. It would lay out a specific path for reducing, and then eliminating, opioid use. “Properly structured, the plan will give the patient confidence that an opioid prescription may help relieve pain in the short run but will not lead to dependence or addiction in the long…

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12Apr 22

News Brief | April 12, 2022 | Physicians lack time, support to address SDOH

Practice Transformation Physicians lack time, support to address SDOH Most (61%) of physicians say they have little or no time to address their patient’s social determinants of health (SDOH), according to a new survey from The Physicians Foundation. Yet, roughly 80% believe the U.S. cannot improve health outcomes or reduce health care costs without addressing those factors. In addition, 63% report they often have feelings of burnout when trying to address their patients’ SDOH. (Physicians Foundation; RISE) To free up pharmacists, Walgreens…

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