Practice Transformation
Only 31% of hospital and health system executives surveyed said their organizations use EHR capabilities to conduct telehealth visits, according to a recent Sage Growth Partners report. However, 48% said they use third-party software such as Skype. Overall, only 11% expect to return to their pre-pandemic rates of virtual care within 24 months. When asked what tech solutions are critical to their organizations, 85% said virtual care, 52% said hospital communication and 43% said supply chain automation. (Becker’s Hospital Review; Sage announcement)
As COVID-19 continues to threaten the viability of primary care practices, capitation may be a solution. In an opinion piece, David Nash, MD, MBA, says the severity of the threat will be related to payment mechanisms. Practices operating on a fee-for-service basis “are taking a particularly harsh financial beating,” but ACOs are also feeling the pinch. His recommendation: Give capitation another chance. “Capitated managed care contracts offer financial incentives that are aligned with prevention in addition to ensuring a stable monthly income for care providers. For providers with capitated care contracts, it can be business as usual despite COVID-19.” (MedPage Today)
Evidence & Innovation
CVS Health may launch its own group purchasing organization, Zinc, for its pharmacy benefit management business, according to a Nephron Research report. Details are vague, according to Healthcare Dive, but it appears to be similar to Ascent Health Services, a GPO launched by PBM Express Scripts. Ascent does rebate negotiations for Cigna-owned Express Scripts along with Kroger Prescription Plans, a PBM owned by the grocer, and Prime Therapeutics, a Blues- and Walgreens-affiliated PBM. (Healthcare Dive; Drug Channels)
After consulting with health IT leaders in hospitals and health systems, Becker’s health IT team identified the 10 most significant advancements in health care technology over the past four months. Precision medicine made the list. Organizations without a focus on precision medicine “leave caretakers to use a standard approach for all patients, potentially wasting PPE, ventilators and other resources for mild cases while not acting quick enough for those at highest risk.” Other advancements include predictive analytics, telehealth and 5G expansions and AI chat bots. (Becker’s Hospital Review)
Policy Solutions
The American Hospital Association is calling on CMS to keep the coronavirus-driven flexibilities around several issues, including telehealth, quality and compliance measures, scope of practice and bed capacity. In a letter to CMS, the AHA said such a move will help physicians and hospitals be more efficient. Earlier this month, the American College of Physicians urged CMS to extend its current waivers for telehealth reimbursement, Healthcare Dive reports. (Healthcare Dive; AHA letter)
PhRMA (Pharmaceutical Research and Manufacturers of America) has sued Minnesota over a new law requiring drugmakers to provide insulin supplies to those who can’t afford them. The cost of insulin has more than tripled in recent years, and some patients have been rationing their insulin. PhRMA is asking the court to declare the law, which took effect July 1, unconstitutional and issue a permanent injunction against enforcement. (Modern Healthcare; STAT News)
In Case You Missed It!
GTMRx workgroup update: Pharmacogenomics Payment and Policy Taskforce
Jane Gilbert, CPA, director of Retiree Health Care for the Teacher’s Retirement System of the State of Kentucky (TRS) spoke to the Pharmacogenomics Payment and Policy Taskforce on Tuesday, July 7. Gilbert discussed the following topics: the successes, improvement areas and challenges of TRS’s PGx service deployments, key people/roles for program buy-in and the metrics collected on patients receiving PGx-guided MAPs.
GTMRx workgroup update: HIT and AI to Support Optimized Medication Use
Tom Wilson, co-lead of the HIT and AI to Support Optimized Medication Use Workgroup and chief technology innovation officer, Tabula Rasa HealthCare, spoke to both the HIT and AI to Support Optimized Medication Use Workgroup and the Precision Medicine Enablement via Advanced Diagnostics Workgroup. Tom spoke to the new ONC rule,”21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program,” and how it will affect electronic health record interoperability in the future. In addition, areas of cross-pollination between the two workgroups were identified.
GTMRx Employer Toolkit Taskforce update
Steve Chen, Pharm.D., FASHP, FCSHP, FNAP, founder and executive director of the California Right Meds Collaborative (CRMC); associate professor, USC School of Pharmacy; and GTMRx distinguished fellow, spoke to the Employer Toolkit Taskforce on Thursday, July 9. Dr. Chen spoke to roles and functions of the care team during the CMM process. In addition, Dr. Chen answered the employer coalition group participant’s questions that were created from a meeting in January on the pharmaceutical care process and how it relates to CMM; the impact, benefits, and/or outcomes related to CMM; the employer perspective regarding CMM (financial cost and working with healthplans/PBMs); and studies measuring the impact of CMM to employee presenteeism or productivity.
By Susan Dentzer, senior policy fellow, Duke-Margolis Center for Health Policy
Add to the long list of reasons to “get the medications right” the COVID-19 pandemic. It’s clear that the fight against the SARS-CoV-2 virus will include an arsenal of therapies to combat the virus and its devastating effects on the body. This reality affords a clear rationale for comprehensive medication management, perhaps as never before to the same degree.
Read this excerpt from our upcoming Blueprint for Change here.
Register for our upcoming webinar!
Wednesday, July 22, 2020 | 1- 2 p.m. EDT
Optimal patient care cannot happen without a systematic approach to medication use and that will require significant structural changes. This webinar will give insight into making the case for medication management reform and focus primarily on practice and care delivery to outline how providers can enhance the patient experience, improve population health, reduce costs and bring back the joy in practicing.
Join our speakers as they offer an overview of actions that providers can take in their practice in order to assist in the implementation of comprehensive medication management.
- Paul Grundy, M.D., MPH, FACOEM, FACPM, chief transformation officer of Innovaccer and president of the GTMRx Institute;
- Todd Sorensen, Pharm.D., FAPhA, FCCP, associate dean for strategic initiatives and innovations, Department of Pharmaceutical Care and Health Systems at the University of Minnesota; and
- Kylee Funk, Pharm.D., BCPS, associate professor, University of Minnesota College of Pharmacy,
Hosted by the GTMRx Institute’s executive director and co-founder, Katherine H. Capps, Voices of Change features leaders who have knowledge, experience and ideas to solve this urgent need to get the medications right. The most recent episode features Amanda Brummel, PharmD, BCACP, vice president, Clinical Ambulatory Pharmacy Services Fairview Pharmacy Services. Past guests include Orsula V. Knowlton, PharmD, MBA, president and chief marketing & new business development officer of Tabula Rasa HealthCare, Inc., Anand Parekh, MD, chief medical advisor, Bipartisan Policy Center and GTMRx President Paul Grundy, MD, chief transformation officer, Innovaccer. Listen here.