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Practice Transformation

Why mental health carveouts are so bad
The current push for primary care physicians to provide mental health care has tremendous support; it could enhance whole-person care and address the shortage of mental health providers. But, as Kaiser Health News points out, there’s one problem: Many insurers have “carved out” behavioral health benefits. Patients typically don’t even know whether their insurance plan has a carve-out until they end up with an unexpected bill. “It’s the patients who end up with the short end of the stick,” says Jennifer Snow of the National Alliance on Mental Illness. (KHN)
Donigan: The future of the pharmacy is a phone
“During covid everyone understood the power of pharmacies,” Rite Aid President and CEO Heyward Donigan tells the Washington Post in a recent profile. “That really accelerated the world view of what a pharmacist can do.” She plans to broaden that even more. “The pharmacy of the future to me is always going to start with your phone. […] Nobody knows more about prescription drugs than a pharmacist, and I would like [my doctor] to talk to my pharmacist on [the] phone about which prescriptions I should be on. The evolution of this business is how to make the pharmacist transportable.” (Washington Post)
Investigation: MLM schemes and the provider/patient relationship
Multi-level marketing companies are convincing health care providers, including physicians, into selling their products, according to a MedPage Today investigation. This may be legal, but it raises ethical questions about whether physicians should be selling to their patients. Robert FitzPatrick, an MLM expert and author Ponzinomics, tells MedPage Today he gets many calls and emails about this. “Many doctors are involved in these schemes. … Oh my god. I mean, I’ve seen it over and over and over again.” (MedPage Today)

Evidence & Innovation

BMJ: Sponsorship bias in cost effectiveness analysis
Public and private payers increasingly rely on cost-effectiveness analyses (CEA) to justify drug coverage. But research published in The BMJ finds that such studies sponsored by drug companies were often biased in favor of setting higher prices for their medicines. A third of the cost-effectiveness analyses conducted by drugmakers reached more favorable conclusions than independently conducted analyses. “Our analyses showed a significant sponsorship bias in CEAs that is systemic and exists across a range of diseases and study designs,” the researchers conclude. (Stat NewsBMJ)
Making clinical trials a therapeutic option
According to study results from the BECOME Research Project, Black women with metastatic breast cancer don’t get enrolled into clinical trials. Only 40% of Black respondents said they were even offered a trial, “but over 80% would consider joining a trial if they had known about one,” Stephanie Walker, an RN and patient advocate with the Metastatic Breast Cancer Alliance, told the American Society of Clinical Oncology. (Stat NewsBECOME Research Project)

Policy Solutions

Finding non-opioid options for chronic pain
Non-opioid pain medication prescribing increased after the CDC published guidelines on opioids for chronic pain in 2016, according to research published in JAMA Network Open. “It is important to consider a precision medicine approach to pain management. Such an approach identifies and delivers the right combination of treatments to the right patient at the right time to maximize benefits, minimize adverse effects and adverse events, and align with patient treatment goals and preferences,” Stephanie A. Eucker, MD, PhD, and colleagues wrote in an accompanying commentary. (MedPage Todaycommentarystudy)

In Case You Missed It!

GTMRx is a proud sponsor of the Virtual National Primary Care Transformation Summit, which will take place July 26-29, 2022. The event will feature in-depth conversations and discussions with leaders from CMS/CMMI, VillageMD, Aetna/CVS, Humana, United/Optum, Boeing, Google, Walgreens and others involved in primary care transformation. As a sponsor of the event, we have arranged free registration for a number of clinicians to include NPs, PAs, clinical pharmacists, and primary care physicians (regularly an up-to $1,095 value).
If you qualify, you may register using our special link here:
Don’t Miss! After registering, be sure to catch our virtual panel discussion on Friday, July 29, 2022 from 11:15am – 11:00am ET. GTMRx Mini Summit 28: Integrating Pharmacists into Advanced Primary Care: A Better Way to Manage Medications
  • Katherine H. Capps, Co-Founder, Executive Director, GTMRx
  • Julie Ceno-England, MD, Chief Medical Officer, OneOme
  • Steven W. Chen, PharmD, FASHP, FCSHP, FNAP, Associate Professor, Associate Dean for Clinical Affairs and Heeres Chair in Community Pharmacy, USC School of Pharmacy
  • Michael Hochman, MD, MPH, Chief Executive Officer, Scan’s Homeless Medical Group; Inaugural Director, USC Gehr Center for Health Systems Science & Innovation
  • Mitchell A. Kaminski, MD, MBA, Program Director, Population Health, Jefferson College of Population Health
New Episode of Voices of Change Out Now | Alliance for Medication Management: Work in Washington State
An innovative care coordination system is emerging in eastern Washington State. Empire Health Foundation is providing funding to develop and implement a care coordination system that brings pharmacists and care coordinators together to simultaneously address medication related problems and the associated social determinants of health that are impacting the patient’s ability to achieve the intended benefits from their medications. The program is designed to support and supplement the primary care provider’s care plan and identify potential medication related problems, social barriers and behaviors that reduce medication effectiveness.
The program is called Medication Care Coordination or MCC and has been developed as a collaboration between Empire Health Foundation, Aging and Long-Term Care of Eastern Washington (ALTCEW), Rural Resources Community Action (RRCA) and Medication Review, Inc (MRI).
The Washington State University School of Pharmacy is providing academic resources in support of the program and has generated several articles on the findings from early pilots. The Alliance for Integrated Medication Management (AIMM) is providing strategic program design, management development and implementation support to program partners.
Host Katherine (Katie) Capps talks to Jeri Rathbun, Empire Health Foundation; Dr. Bob Crittenden, Health Policy Advisor; and Dr. Candace Anderson, Pharmacists, Medication Review, Inc. Take a listen.
GTMRx Workgroup Update
On June 23, the GTMRx Physician Advisory Group had their fourth meeting featuring a briefing with GTMRx’s ERIC strategic partner James Gelfand, JD, co-president, ERIC (ERISA Industry Committee). GTMRx has formed a consultative/strategic partnership to drive advocacy to support GTMRx initiatives and goals focused on enhancing GTMRx opportunities on the demand side (employers as health plan sponsors/ consumer groups).
During the meeting, the group also heard from GTMRx executive physician advisor Michael Barr, MD, MBA, MACP, FRCP, president, MEDIS, about the themes seen across the results from the GTMRx physician survey and how the results support an action-oriented agenda.
GTMRx Webinar: Building, Managing and Sustaining Your CMM Practice June 22
Where is CMM available? What quality measures are being used to evaluate the value of CMM? What do CMM staffing models look like? How mature are CMM practices and what are the various needs based on stages of maturity?
Hear from, M. Shawn McFarland, PharmD, FCCP, BCACP, Veterans Health Administration, on early findings from the GTMRx National Registry of CMM Practices.
Learn from organizations at various lengths of maturity shedding light on the benefits of a more widely adoption of CMM and the challenges of getting there:
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.

Become a Supporting Member Today

AmazonSmile is an easy way for 0.5% of your qualified purchases go to the GTMRx Foundation at no cost to you. And signing up is simple—go to and select “Get the Medications Right Foundation” as your charity of choice. If you prefer to directly donate instead, you can do so here.
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.
The GTMRx Institute is supported by our Founding Funders, Executive Members and Strategic Partners.
  See past issues of our weekly news brief here

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