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Practice Transformation

The nation’s largest commercial health plan will start covering genetic testing for providers to choose the best medications to treat mental health issues. UnitedHealthcare said it will cover evidence-based genetic testing to support treatment decisions for psychiatric disorders starting October 1. However, the coverage only kicks in after the patient has failed at least one prior medication to treat the condition. (Clincalomics)
Opioid overuse has overshadowed a parallel growth in the overuse of benzodiazepine sedatives, which resulted in 11,500 overdose deaths in 2017. Drugs like Xanax and Valium intensify symptoms of chronic diseases and also raise the risk of injury and dementia symptoms like drowsiness and memory problems. Policy reform around limiting long-duration prescribing and provider accountability could be in the works. (Axios)

Evidence & Innovation

Clinical pharmacy practice in the community pharmacy setting is, in many ways, a new frontier. The American College of Clinical Pharmacy dedicated its July issue to the evolution and evidence for patient-centered care delivery in this setting. Barriers to overcome include access to patient-specific data, physical barriers like private counseling space, and lack of a payment structure that rewards value over volume of prescriptions process. (JACCP)
If 15 minutes sounds like a short amount of time to allocate for a doctor to examine and take care of a patient, how does eight minutes sound? Research shows that doctors spend only 52.9% of the typical office visit on actual patient care and 37% of that time on paperwork. Forbes senior contributor, Bruce Y. Lee, explains how we got to this point and makes the case that it’s time to re-evaluate the length of doctors’ visits — and the reimbursement that comes with them. (Forbes)

Policy Solutions

Former VA Secretary David Shulkin says he’s an advocate of bringing health care delivery up to speed with new technology, specifically “bringing precision medicine to the bedside” in his new role with Sanford Health. Data and technology are tools to help reduce the cost of care, improve accuracy of diagnosis and treatment, but those resources have yet to be fully harnessed in the health care space. To reap the rewards of more targeted approaches to care—and accompanying cost and quality improvements—stakeholders will need to leverage these tools. (First Report Managed Care)
The Centers for Medicare & Medicaid Services announced it will cover CAR-T therapies—gene therapy that leverages an individual’s immune cells to fight cancer—when provided within the Food and Drug Administration’s safety rules. CAR-T will even be covered for treating conditions that aren’t FDA approved. This is a major step to extend the life-saving therapy to more patients, who will be able to access the treatment in hospitals and oncology clinics. The CMS rules around CAR-T don’t require the data collection and outcomes reporting facilities feared would be attached to delivering the therapy. (STAT News; Modern Healthcare)
Coming soon: Focus On calls for members
The GTMRx Institute is now more than 410 members strong! Our Work Groups are forming, education opportunities are growing and we’re raising awareness with key stakeholders. Stay tuned for more information about joining brief, weekly “Focus On” membership calls designed to keep you up to date on our activities.
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