GTMRx News Brief Archive

Practice Transformation Maybe it’s not comorbidities Patients with cardiovascular disease who had worse composite scores for six social determinants of health—including education, 30-day food security and health insurance—were less likely to adhere to all the measures recommended to lower their risk of contracting and spreading COVID-19, according to research published in Circulation: Cardiovascular Quality and Outcomes. “Identifying and prioritizing individuals whose medical vulnerability is compounded by social adversity may optimize emerging preventive efforts, including vaccination guidelines,” the researchers conclude. (Circulation: Cardiovascular…

Practice Transformation Integrating drug, medical benefits saves money, improves outcomes Highmark group customers with integrated medical and pharmacy benefits saved an average of $150-$230 per member per year compared to those with carved-out pharmacy benefits, according to independent analysis by HealthScape Advisors. The savings were driven by shorter episodes of care, enhanced chronic care management and increased member engagement. The analysis is based on three years of claims data, from 2017 to 2019. Group clients who offered integrated benefits saw…

Practice Transformation The elephant in the room: appropriate use of medications The most pressing issues related to managing medications isn’t cost; it’s the lack of communication between prescribers and pharmacists, according to a recent Get the Medications Right (GTMRx) Institute survey of health leaders. That by itself is significant, but it points to a larger issue, says GTMRx Executive Director, Katherine Capps: appropriate use of medications. Outside of the opioid crisis, “the tragedy of medication misadventures” is rarely discussed, much…

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…

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…

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,…

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…

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…

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…

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…

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…

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…

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…

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…

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…

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…

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…