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News brief | April 21, 2020
Practice Transformation Some pharmacists to be paid to manage chronic disease UnitedHealthcare plans to pay pharmacists in Ohio to deliver primary care to Medicaid patients—in particular, to help patients better manage chronic conditions such as diabetes and high blood pressure. Keeping these populations healthy could lower health care costs and could free up hospital beds during the COVID-19 pandemic. Ohio enacted a law in January 2019 that allows insurers to pay pharmacists as medical providers, but the state’s Department of…
News brief | April 14, 2020
Practice Transformation Delivering on the promise of personalized medicine The latest edition of the Personalized Medicine Coalition's Personalized Medicine in Brief includes a reprint of remarks from the GTMRx / Bipartisan Policy Center Feb 6 keynote address by Gregory Downing, D.O., PhD, (page 10-13) "Get the Medications Right: Innovations in Team-Based Care." He left listeners with the question, “Will we look back 10 years from now and say that we did the best we could to optimize the benefits of science for our patients?” That…
News brief | April 7, 2020
Practice Transformation Putting the pharmacist in pharmacogenomics By 2030, pharmacists will likely have little to do with dispensing and much more to do with clinical outcomes. One implication of this transformation is that pharmacists will need to take a very involved pharmacogenomics role with patients and providers, says Jaclyn Boyle, Pharm.D., MS, PhD, associate professor of pharmacy practice at Northeast Ohio Medical University. “Pharmacogenomics data can help inform decisions about whether a patient should try a medication, stay on it,…
News brief | March 31, 2020
Practice Transformation AMA offers guidance on supporting the care team The AMA has developed a list of practical strategies for health system leadership to consider as they try to support their care teams during COVID-19. The areas range from child and pet care to food delivery. Several relate to workforce distribution leveraging the skills of the entire team. For example: “Allow medical assistants and nurses to make contributions according to their ability, with physician or APP oversight and discretion.” (AMA)…
News brief | March 24, 2020
Practice Transformation Putting the pharmacist in pharmacogenomics By 2030, pharmacists will likely have little to do with dispensing and much more to do with clinical outcomes. One implication of this transformation is that pharmacists will need to take a very involved pharmacogenomics role with patients and providers, says Jaclyn Boyle, PharmD, MS, PhD, associate professor of pharmacy practice at Northeast Ohio Medical University. “Pharmacogenomics data can help inform decisions about whether a patient should try a medication, stay on it,…
News Brief | March 17, 2020
Practice Transformation Florida expands pharmacist scope of practice as coronavirus response escalates Florida Gov. Ron DeSantis signed legislation that expands roles pharmacists and some nurses, allowing them to perform certain functions without physician supervision. HB 607 allows certain advanced practice nurses to provide primary care and practice independently of doctors. HB 389 allows pharmacists to test and treat patients for the flu and strep throat as well as treat chronic medical conditions. It also requires them to recommend patients follow-up with a…
News Brief | March 10, 2020
Practice Transformation Beyond MTM: de-prescribing More needs to be done to optimize medications for older patients, say representatives from the Lown Institute and Kaiser Permanente. They describe a “medication checkup” that focuses on de-prescribing. It has been shown to improve quality of life, reduce inappropriate medication use and reduce the risk of medication-related falls. But it takes work. “Making sure that clinicians—especially pharmacist—can bill for their time discussing medications with patients is key. Improving the usability and accuracy of [EHRs] and…
News Brief | March 3, 2020
Practice Transformation Another insurer caps certain drug costs Oscar Health is the latest insurer to cap some plan members’ out-of-pocket costs for life-saving insulin and other medications, a move several insurance companies have made in the last year amid pressure to reduce prescription drug costs. It announced its individual insurance plan members will pay $3 for a month’s supply of 100 commonly used drugs. In addition to diabetes, the list includes drugs to treat migraines, nausea, allergies and hypertension, among…
News Brief | February 25, 2020
Practice Transformation BCBS Tennessee mail-order plan draws ire A proposed BlueCross BlueShield of Tennessee policy change could hurt patient access to critical drugs, eight medical societies warn in a letter to the insurer. The change would require physicians to use mail-order pharmacies to order drugs administered in-office, instead of allowing physician offices to bulk-order the drugs and keep them in-house. This, the societies say, could delay patient care, reduce access to much-needed drugs, inflate out-of-pocket costs and increase drug waste.…
News Brief | February 18, 2020
Practice Transformation Commentary: Let pharmacists do what they are trained to do Pharmacists have the training and expertise to help solve the overmedication problem, but reimbursement models work against them, say Don Downing of the Institute for Innovative Pharmacy Practice and Judith Garber of the Lown Institute. “This negative incentive to provide appropriate medication therapy drives up prescription costs and overuse of medication, putting patients at increased risk for harm.” In contrast, when Washington state required commercial insurers to recognize pharmacists as health…
News Brief | February 11, 2020
Practice Transformation Lown releases Medication Overload action plan Over the next decade, expect more than 4.5 million hospitalizations of older adults due to serious medication side effects, warns The Lown Institute. In response, it released Eliminating Medication Overload: A National Action Plan. A group of 22 experts, including patient advocates, physicians, nurses, pharmacists and researchers, developed the plan. It recommends five high-level action areas: implement prescription checkups; raise awareness among clinicians, policymakers and the public; improve information at the point of care; educate and…
News brief | February 4, 2020
Practice Transformation AI: The new stethoscope? Bertalan Meskó, MD, PhD, of the Medical Futurist Institute, sees no contradiction between artificial intelligence and the art of medicine. In the Journal of Medical Internet Research, he writes, “While digital health technologies might be considered a threat to the art of medicine, I argue that advanced technologies, such as artificial intelligence, will initiate the real era of the art of medicine. …I believe that AI is going to be the stethoscope of the 21st…
News brief | January 28, 2020
Practice Transformation CDC: Five 2019 studies with direct impact on clinical practice In a recent paper, The Genomic Medicine Working Group of the National Advisory Council for Human Genome Research of the National Human Genome Research Institute identified the most significant advances in genomic medicine. Of the top 10 papers identified by the working group, the CDC selected those with immediate or near-term impact on clinical practice and public health. Among them: Most BRCA1 and BRCA2 variant carriers are not detected in the population,…
News brief | January 21, 2020
Practice Transformation A CMM primer for docs Last month’s Minnesota Physician offered a primer on comprehensive medication management, summarizing some of the evidence and explaining how CMM expands the primary care interprofessional team. Pharmacists have long been core members of interprofessional teams in hospital settings; now, they are also moving to ambulatory care settings. The article notes that in Minnesota, more than 150 clinics have pharmacists integrated into the care team. The authors discuss the benefits to patient care as well physician wellbeing. (Minnesota…
News brief | January 14, 2020
Practice Transformation VA: A model for drug policy? The VA pharmacy benefit provides a model for reform to address the crisis in prescription drug affordability, according to a paper published in Health Affairs. The VA model involves a combination of regulation, negotiation and a national formulary; this makes it possible for veterans to obtain medicines with low or no copayment. Those who obtain prescription medications from the VA are less likely than other insured Americans to skip doses or delay filling prescriptions…
News brief | January 7, 2020
Practice Transformation New BCBS policy could change how infusions are delivered Effective Jan. 1, BCBS of Tennessee will no longer reimburse providers for some specialty infusion drugs. Instead, it requires providers to get the drugs through a specialty pharmacy in BCBS’ preferred network. According to BCBS, the policy aims to slow the growing cost of specialty drugs. However, some providers say it could cause them to end their infusion services and force patients to find other sites. They say they…
News brief | December 24, 2019
Practice Transformation Clinical pharmacists improve patient satisfaction Patients who received focused attention from pharmacists during hospital stays were more satisfied, according to research presented at the American Society of Health-System Pharmacists Clinical Meeting. “Our findings add to growing literature demonstrating that pharmacist involvement in hospital discharge improves outcomes and safety,” Katherine L. March, PharmD, BCPS, of Methodist University Hospital in Memphis, said in a prepared statement. “Pharmacists play a multitude of vital roles for patients during a hospital stay, including…
News brief | December 17, 2019
Practice Transformation Increased integration of medical and pharmacy benefits Historically, medical and pharmacy benefits have been siloed. When employers and other organizations design benefit plans, they typically use one company for medical benefits and a different one for pharmacy benefits. As separate entities, they don’t share data or information—creating a disconnect. “As a result, plan sponsors are challenged to ensure that members receive coordinated care and understand the true cost of care,” says Jerry Buller, DPh, MMHC, chief pharmacy officer…
News brief | December 10, 2019
Practice Transformation AI transforming health care Artificial intelligence has started to transform U.S. health care. In hospitals and health systems, AI is already creating operational efficiencies, but it’s relatively simple AI. The potential is so much greater, Healthcare Finance News reports. AI can help improve precision medicine and reduce administrative complexity, lowering the cost of doing business. In this regard, the AI landscape is still evolving. The sophisticated techniques used in cognitive computing are the next frontier for AI in health care.…
News Brief | December 3, 2019
Practice Transformation Humana pushes interoperability, built on FHIR Humana is highlighting its efforts to support data sharing with provider organizations. Humana President and CEO Bruce Broussard told analysts that interoperability is at the core of its corporate strategy. That strategy is built on HL7’s Fast Healthcare Interoperability Resources (FHIR) standard. The FHIR standard enables real-time exchange of data using the latest web standards. It’s part of a larger effort: Humana is looking for ways to better leverage data as the…
