Practice Transformation
Sustained team-based approach reduces burnout
A team-based approach to primary care reduces clinician burnout, according to research published in the Annals of Family Medicine. In 2016, Stanford Health Care’s primary care clinic in Santa Clara launched Primary Care 2.0, a team-based model. It has proven beneficial for patients and physicians —but only when the model is sustained. “The Primary Care 2.0 model of enhanced team-based primary care demonstrates team development is a plausible key to protect against burnout, but is not sufficient alone. […] Transformation to team-based care cannot be a 1-time effort and institutional commitment is integral.” (Annals of Family Medicine; Stanford News)
Pharmacists play key collaborative role with MDs in PGx
As pharmacogenetic (PGx) testing becomes more common, pharmacists will play a key role, Pharmacy Today reports. It’s a collaborative process: Physicians authorize the test, and pharmacists provide clinical guidance on interpreting and applying results. Olivia Santoso Bentley, PharmD, codeveloped a PGx program at Rx Clinic Pharmacy. Through collaborative practice agreements, she has strong relationships with area physicians who refer patients for testing. Patients can log into an online portal to view their lab report which is also sent to their physician. She works with a lab that “agreed with the vision we had for this to be an important screening tool at the community level — not to have to wait until patients have some acute condition and need it right away.” (Pharmacy Today)
GTMRx Published Article: Legal issues around failure to implement PGx
Integration of pharmacogenomic (PGx) testing into clinical practice has become more common, according to a paper published in The Journal of Precision Medicine. “What was once thought to be a novelty has now become a standard part of the patient care experience today.” As PGx testing becomes a standard of care, failure to implement it could lead to instances where care may not be optimized, raising legal issues. “If so, there could well be a significant increase in the potential liability of physicians and to a lesser degree the pharmacist,” the authors conclude. (The Journal of Precision Medicine)
Evidence & Innovation
ACOs, medical homes grew during pandemic
Physician participation in ACOs and medical homes continued to grow during the pandemic, according to an AMA report. Nearly 43% of physicians were in practices that participated in a commercial ACO in 2020, up from 32% in 2016. Meanwhile, nearly 30% of physicians were in practices that took part in a Medicaid ACO, up from 21% in 2016. And the share of physicians in practices involved in Medicare ACOs has risen from 29% in 2014 to 37% in 2020, though it dipped from a high of 38% in 2018. In addition nearly one-third of doctors worked in practices participating in medical homes in 2020, up from 23.7% in 2014. (AMA announcement; AMA Policy Research Perspectives)
Policy Solutions
“Most favored” officially out of favor
With a Dec. 29 final rule, CMS officially abandoned a Trump-era policy that would have prevented Medicare from paying more for certain outpatient drugs than the lowest price paid by other wealthy countries. While CMS’ final decision is a major win for the pharmaceutical industry, provider groups are also sure to be happy, according to Fierce Healthcare. Several groups said in comments to CMS that the rule would hurt reimbursement for providers. Among the concerns: The model didn’t specify whether drugmakers would have to decrease prices for providers, meaning providers may have had to offer drugs at a financial loss. (Fierce Healthcare; Modern Healthcare*)
Study: Costs influence use of telehealth
Most Americans (53%) prefer to receive care in person but are generally willing to continue using telehealth services, according to research published in JAMA Network Open. Nearly 30% preferred a telehealth. But patients who preferred telehealth would be less interested if the out-of-pocket cost was higher than for in-person care. Patient “willingness to use telehealth is very sensitive to costs. Patients may not perceive video visits to have the same value as in-person healthcare,” RAND’s Zachary S. Predmore, PhD, the lead author, said in a prepared statement. (mHealth Intelligence; JAMA Network Open; RAND announcement)
**There will be no new edition of the news brief next Tuesday, Dec. 28, 2021 or Tuesday Jan. 4, 2022. The next release will be January 11, 2022.
Note: sources that have an asterisk require login to view the article.
In Case You Missed It!
GTMRx Workgroup Updates | Speakers
January 11 from 2:00-3:00 pm EST
- Speaker: Co-lead of the GTMRx Payment/Policy Workgroup – Kathy Pham, Pharm.D., BCPPS, Director of Policy and Professional Affairs, ACCP
- Topic: CMMI’s white paper, “Innovation Center Strategy Refresh”, which discusses the work CMMI will do for the next decade (e.g. driving accountable care, partnering to achieve system transformation, advancing health equity, supporting care innovations, and improving access by addressing affordability).
Want to join? Contact [email protected]
January 10 from 3:00-4:00 pm EST
- Speakers: Ryan Altman, Legislative Assistant in the office of Congressman Tom Emmer (R-MN and co-chair of the Personalized Medicine Caucus) and Sarah Shapiro, Legislative Director in the office of Congressman Rep. Eric Swalwell (D-CA and co-chair of the Personalized Medicine Caucus)
- Topic: Update on the Right Drug Dose Now Act — draft legislation underway on the implementation of PGx testing
GTMRx sponsoring Health Care Value Week
January 24 – 28, 2022
Health Care Value Week will feature opportunities for interested stakeholders to participate in meaningful dialogue with health care executives and policymakers in the Administration and Congress through virtual events and social media.
GTMRx will host a panel on Value-based Strategies: A Better Way to Manage Medications with speakers Katherine H. Capps, GTMRx executive director, Steven Chen, PharmD, MHS, GTMRx distinguished fellow, associate dean for clinical affairs at USC School of Pharmacy, and Michael Hochman, MD, MPH, CEO of Healthcare in Action,
SCAN Group. This session will take place on January 24, 2021 from 3:00pm -3:30pm EST as part of Monday’s Special Edition of the Virtual Value-Based Payment Summit event.
More information and registration for Health Care Value Week can be found here.
You can register for the Virtual Value-Based Payments Summit: Update on CMS/CMMI Payment Reform Initiatives here.
GTMRx Institute Blog | A sparkling solution:
CMM is the innovation we need. Stop stalling.
In a season of hope, I’m feeling a just little frustrated about the current health care system’s resistance to change. Specifically, of course, I’m talking about giving patients access to comprehensive medication management through team-based, person-centered care. The potential of CMM is undisputed, yet we still lack buy-in from the very stakeholders who could bring it to scale.
Two questions from a recent survey of health care leaders that we conducted illustrate the promise and predicament of CMM…
SEE THE EVIDENCE | The Outcomes of Implementing and Integrating Comprehensive Medication Management in Team-Based Care: A Review of the Evidence on Quality, Access and Costs
Learn about the peer-reviewed evidence showcasing the value of CMM, through improvements in access to care, provider work life, outcomes and patient satisfaction as well as a reduction in costs. These findings, updated in December 2021, outline the CMM team-based care process that can be implemented in a variety of health care systems to ensure positive patient outcomes.
SEE THE GUIDANCE | The Integration of Telehealth Delivery within a Comprehensive Medication Management Practice
Considering the advantages of telehealth and the future direction of health care, it is no longer a question of if telehealth needs to be implemented into practice; rather, it is a question of how to integrate telehealth and CMM services. Core to a plan is a patient care team that works together to achieve a goal of enhancing patient-centered care and medication optimization. Outlined are essential steps to integrating telehealth services and CMM practice: define what telehealth means for your practice, secure stakeholders, develop a team, equipment and software needs; assess costs and financial stability, educate staff, patients and caregivers, develop a workflow, measure health care outcomes and meet with your team regularly.
SEE THE GUIDANCE | Value Framework for Providing CMM in Telehealth
The escalation of telehealth has shed light on the opportunities that exist to increase patient access to care through virtual visits that extend beyond the traditional in-office visit. Included as an opportunity for telehealth is comprehensive medication management (CMM). This value framework, intended for health care team members, payers for health care services and health care policy makers, proposes a guide for providing CMM services via telehealth. Although obstacles to telehealth delivery of CMM exist, the benefits to providers, patients and payers outweigh the barriers. For sustainability of telehealth and CMM provided via telehealth, effort from multiple stakeholders is needed to address the challenges that exist.
Join us to be part of meaningful change
Irma, like many others, struggles as a result of our current trial-and-error approach to medication. That is why we advocate for a new, comprehensive approach to medication use and prescribing. As a non-profit 501(c)(3) and 501(c)(4) organization, the GTMRx Institute and Foundation relies on funding from our supporting members. We ask that you consider becoming a Supporting Signing Member so we can continue to provide relevant, timely resources to get the medications right!
If you’re interested in supporting the Institute or Foundation at a higher level, please contact us. Your dollars will bring about meaningful change for people like Irma.
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Adding the foundation on AmazonSmile will help us continue to provide no cost educational webinars, issue briefs, weekly news briefs and promote the need for transformation of our current system of medication use through social media campaigns.
