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GTMRx News Brief

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25May 21

News Brief | May 25, 2021 | Key concern: Lack of provider/pharmacist communication

Practice Transformation Key concern: Lack of provider/pharmacist communication In terms of managing medications, what’s the biggest issue? Surprisingly, it’s not cost. In a GTMRx survey of health care leaders, 50.3% of respondents chose lack of communication between prescribers and pharmacists. Medication costs came in second (36%). The survey found almost unanimous (96%) agreement about the need for a more comprehensive and integrated way to manage medications. However, 44% said that comprehensive medication management is not well understood or not understood…

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18May 21

News Brief | May 18, 2021 | Hospital Price Transparency: You’ve been warned

Practice Transformation Include pharmacy in whole-person VBC Conversations about patient-centered and value-based care typically leave out the pharmacy aspect, writes Karthik Ganesh, CEO at EmpiRx Health, a value-based PBM. “If we ever hope to improve patient outcomes and lower unsustainable costs, pharmacy must feel empowered to join the groundswell toward whole-person VBC.” Pharmacy must be represented at the “value-based table” and become a key contributor to interdisciplinary care teams. “When every facet of health care is incentivized to do better instead of more, we will…

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11May 21

News Brief | May 11, 2021 | NAM: Move away from FFS, support team-based primary care

Practice Transformation NAM: Move away from FFS, support team-based primary care A new report from the National Academy of Medicine calls for interprofessional teams that coordinate care across the continuum, meaningfully engaging the full range of primary care professions. It describes opportunities for integration between primary care and various areas, including pharmacy. The report also calls on payers to move away from fee-for-service in favor of models that better support independent practices, enable team-based care, and address the social determinants. CMS,…

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04May 21

News Brief | May 4, 2021 |Medication risk score correlates with mortality risk

Practice Transformation Medication risk score correlates with mortality risk New research confirms that higher medication risk scores (MRS) are correlated with a higher risk of death. The study published in the Journal of Patient Safety, used EHR data from over 427,000 patients to calculate medication risk scores, using Tabula Rasa HealthCare’s MedWise technology. Researchers concluded that MRS was independently associated with death even after adjusting for other factors that increase the risk of death. “Our results suggest that pharmacist-directed interventions targeted…

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27Apr 21

News Brief | April 27, 2021 |CMM requires health technology innovation

Practice Transformation GTMRx CMM Evidence Review published The evidence review,  Assessing the Impact of Comprehensive Medication Management on Achievement of the Quadruple Aim, authored by GTMRx workgroup experts, explains the differences between CMM and traditional Medicare Part D MTM services and provides the evidence of the CMM process of care and highlights recent research on the value of CMM in achieving better quality of care, reduced health care expenditures, an improved patient experience and greater provider well-being. More than 20 studies were included in the…

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20Apr 21

News Brief | April 20, 2021 | CMM supports primary care fundamentals

Practice Transformation MGMA chief: Address provider burnout now Provider burnout has grown to “potentially catastrophic” levels, writes MGMA President and CEO Dr. Halee Fischer-Wright. Worklife happiness has dropped from 69% pre-pandemic to 49%, according to Medscape's National Physician Burnout & Suicide Report 2021; the repercussions will be felt for decades, she warns. “We recognized years ago that relying on burned out providers makes it impossible to achieve cost-effective, high-quality, satisfying care. To avoid blows to accessibility, patient trust and engagement, and…

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13Apr 21

News Brief | April 13, 2021 | Through vaccinations, pharmacies gaining access to patient data / C-SPAN covers BPC & GTMRx event

Practice Transformation Are you ready to share your notes? As of April 5, health care organizations must provide patients with free, full and immediate electronic access to their doctors’ clinical notes as well as test results and pathology and imaging reports. Organizations must provide access via patient portals to the following types of notes: consultations, discharge summaries, histories, physical examination findings, imaging narratives, laboratory and pathology report narratives and procedure and progress notes. Noncompliant organizations will eventually face fines for…

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06Apr 21

News Brief | April 6, 2021 | GTMRx Report released: Background and Resources to Build Vaccine Confidence in the Medical Neighborhood

Practice Transformation Commentary: Build back better with primary care As Congress and the administration work to “build back better,” they need to focus on primary care, write Ann C. Greiner, president and CEO of the Primary Care Collaborative, and Elizabeth Mitchel, president and CEO of the Purchaser Business Group on Health. They offer several concrete recommendations, including behavioral health integration and a move away from fee-for-service. “As we build back better and extend the coverage gains made by the Affordable…

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30Mar 21

News Brief | March 30, 2021 | Amazon enters the care delivery business

Practice Transformation Amazon enters the care delivery business Amazon will take its telehealth services nationwide. It will immediately expand its Amazon Care telemedicine program to interested employers in Washington and, this summer, will expand to all Amazon workers and to private employers in the US. Currently available to Amazon employees in Washington, the Amazon Care app connects users virtually with doctors, nurse practitioners and nurses who can provide services and treatment telephonically 24/7. In the Seattle area, it also includes…

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23Mar 21

News Brief |March 23, 2021 | Commentary: Controlling the costs of biologics

Practice Transformation Health Affairs: Team-based care is better Team-based care is superior to solo care, according to an aptly titled paper in Health Affairs, “Provider Teams Outperform Solo Providers in Managing Chronic Diseases and Could Improve the Value of Care.” Looking at patients with type 2 diabetes, hyperlipidemia and hypertension, researcher found that, regardless of team composition, provider teams outperformed solo providers. They also found that among solo providers, care management and outcome differ little between physicians and nonphysicians. “As policy…

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16Mar 21

News Brief | March 16, 2021 | Put diagnosis on the prescription

Practice Transformation Put diagnosis on the prescription Prescriptions for outpatient drugs should include diagnoses. That information should also be captured in claims data, write Christi A. Grimm and Julie K. Taitsman of the HHS Office of the Inspector General. “As medical care becomes more team based, physicians, pharmacists, patients, and caregivers need better information to collaborate to achieve better health outcomes.” It also allows pharmacists to apply their expertise. “Sometimes, pharmacists know what medications a patient actually takes better than…

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09Mar 21

News Brief | March 9, 2021 | Data sharing, privacy and COVID

Practice Transformation Testimony: Include PCPs in the vaccination process Want to reduce COVID-19 vaccine hesitancy? Let people talk to their primary care physician about it. That was the message public health experts delivered to the House Ways & Means Health Subcommittee. Vaccine efficacy is complex, Ashish Jha, MD, dean of Brown University School of Public Health, told the panel. "It would be ideal if people would sit down with their physician and have this conversation; the issues are complicated and…

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02Mar 21

News Brief | March 2, 2021 | PCPs ready to administer vaccines; are they being ignored?

Practice Transformation Collaboration improves diabetes, hypertension outcomes Interprofessional collaborative practice (ICP) among providers in the primary care setting leads to markedly better patient outcomes for those with hypertension and diabetes, according to analysis published in JAMA Network Open. The authors also point out that the approach can help overwhelmed practices: “Concurrently, aging populations with chronic conditions may overwhelm primary care systems. ICP appears to be a plausible option for areas with limited access to care and in patients with poorer diabetes…

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23Feb 21

News Brief | February 23, 2021 | More patients using apps to price shop meds

Practice Transformation A key factor in vaccination access: car keys Transportation and social support are emerging as a critical barrier as older adults try to access COVID-19 vaccines. Seniors without family or friends to help them land vaccine appointments are at a disadvantage. Elders who can’t drive and don’t have anyone to take them to the vaccine site are also missing out. “The question is ‘Who’s going to actually get vaccines?’—older adults who are tech-savvy, with financial resources and family…

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16Feb 21

News Brief | February 15, 2021 | Ambiguous gene testing results: Fear, confusion

Practice Transformation Ambiguous gene testing results: Fear, confusion Doctors are increasingly using genetic testing to identify hereditary cancer risks so they can recommend treatments or preventive measures. However, many genetic findings are ambiguous. An inconclusive result—variant of uncertain significance (VUS)—may be a harmless variation in a gene—or one linked to cancer. From 20%-40% of patients learn they have a VUS after multiple-gene panel testing. Although expert consensus is to not make medical decisions based on a VUS, doctors who lack…

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09Feb 21

News Brief | February 9, 2021 | Testing implications of asymptomatic COVID-19

Practice Transformation HIT training, optimization can reduce burnout Health IT and EHR optimization can mitigate clinician burnout, EHR training and care team expansion, according to a study in the Journal of the American Medical Informatics Association. “Arguably, the primary drivers of burnout for physicians have been related to electronic health records and overwhelming inefficiencies in clinical practice that significantly and negatively impact workflow and patient care,” the authors write. “Physicians experience high fatigue with short, continuous periods of EHR use, which…

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02Feb 21

News Brief | February 2, 2021 | HIT training, optimization can reduce burnout

Practice Transformation Analysis: Hospitals dramatically marking up prices Hospitals mark up prices on medicines by an average of 250%—and some as much as 533%, according to Bernstein analyst Ronny Gal. For example, Neulesta, a drug given to chemotherapy patients, was marked up 364% percent on average. Hospitals also charge different prices for the same drug: The average variation is about 36%. To use the Neulesta example again, some hospitals charge $5,000 per treatment, while others charge $20,000. Such markups incentivize…

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26Jan 21

News Brief | January 26, 2021 | YouTube wants to be reliable source of health info

Practice Transformation Commentary: The case against prior authorization In an opinion piece for STAT News, Brian Barnett, MD, of the Cleveland Clinic and Case Western Reserve University School of Medicine, makes a case against prior authorization. It puts patients in the crossfire between pharmaceutical companies, PBMs and insurers, he argues. “Being regularly compelled by insurers to reconsider and justify treatment decisions we have made in our patients’ best interests, providers are increasingly wondering who’s actually doing the prescribing — us…

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19Jan 21

News Brief | January 19, 2021 | CMS rule to streamline prior authorization

Practice Transformation Trend: Blurred lines between payer, provider Expect the continued rise of “payviders” this year. These are insurers that have bought or partnered with medical groups and other providers. “The line between providers and payers is getting blurrier and blurrier over the course of time with major payers taking significant positions in the provider space,” David Morlock, a managing director in Cain Brothers’ Health Systems M&A group, tells Modern Healthcare. Such arrangements typically involve global budgets—that means keeping patients out…

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12Jan 21

News Brief | January 12, 2021 | Drug overdose deaths highest ever May 2019-May 2020

Practice Transformation Wholesale drug price hikes affect payers, patients Drug wholesale list price increases in 2010-2016 led to a rise in payer spending and out-of-pocket costs for patients, according to a study published in JAMA Network Open. Adjusting for inflation, median patient out-of-pocket costs for specialty medications rose by 85%; non-specialty medications rose by 42%. “This finding suggests that, although discounts and rebates significantly reduce the amount paid for drugs and have increased over the past several years, they have not…

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