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Practice Transformation

Researchers estimate that U.S. primary care practices are projected to lose more than $15 billion as a result of missed consultations and services during the pandemic. That’s more than $67,000 of lost revenue this year for each full-time U.S. primary care physician, according to research published in Health Affairs. Overall, the researchers “anticipate large, meaningful reductions in revenue for primary care practices” that could “threaten practice viability should practices be unable to secure sufficient funding through either fee-for-service or capitated payment mechanisms,” researchers conclude. (Health Affairs)
By 2033, the shortfall of physicians could be as high as 139,000, according to a new report commissioned by the Association of American Medical Colleges (AAMC). It’s expected to be greatest among primary care physicians, with the 2033 shortfall ranging from 21,400 to 55,200. Last year, the AAMC projected the shortfall of physicians at as many as 122,000 by 2032. (HealthLeaders Media)

Evidence & Innovation

Pharmacist-led pharmacogenomics services added to the traditional medication review significantly reduce costs, according to a study published in Pharmacogenomics. From a sample of 200 pharmacogenomics consultations, 165 participants had at least one actionable drug-gene pair totaling 429 drug-gene pairs. Of those, 158 were clinically actionable. Most (70.5%) pharmacists’ recommendations were accepted. Estimated cost avoidance was $233,945 when all recommendations were included but, conservatively, $162,031 based on acceptance rates. The overall mean cost avoidance per actionable drug-gene pair was $1,063, or $1,983 per participant. (Pharmacogenomics)
Don’t call them retail clinics. Walmart Health’s four clinics offer an array of services, including primary care, labs, behavioral health, dental care, even X-rays. That’s just the beginning, MedCity News reports. Walmart wants to create “supercenters” with comprehensive health care services. “There’s a big difference between offering healthcare services to drive more people to your store and offering healthcare services because you’re in the healthcare business,” Walmart President of Health and Wellness Sean Slovenski said during an American Telemedicine Association event. “We’re in healthcare. We’re not in retail healthcare.” (MedCity News)
EHR provider Epic and Blue Cross and Blue Shield plans in five states are rolling out a new, two-way information exchange, according to Health Care Service, which operates BCBS plans in Illinois, Montana, New Mexico, Oklahoma and Texas. This secure “Payer Platform” will allow the plans and the providers who use Epic to review patient data; streamline administrative processes (e.g., prior authorizations); and “facilitate a care management strategy and identify gaps in care, helping patients make smart care choices that will help reduce personal health care costs.” This will “create a secure, interconnected and efficient health system and information exchange between insurers, providers, and patients.” (Forbesannouncement)

Policy Solutions

Despite joining the lawsuit to overturn the Affordable Care Act, the Trump administration probably won’t offer a replacement plan until after the Supreme Court rules on the legality of the ACA, according to Health and Human Services Secretary Alex Azar. “We’ll work with Congress on a plan if the ACA is struck down,” he told NBC’s “Meet the Press.” “We’ll see what the Supreme Court rules.” SCOTUS will likely hear the case around the time of the election, but a ruling could take months. (Bloomberg Law)

In Case You Missed It!

Dr. Ron Kline, MD, chief medical officer and Dr. Dele Solaru, Pharm.D., MBA, chief pharmacy officer both from the Office of Personnel Management (OPM) spoke to the Payment and Policy Solutions Workgroup on June 30. Kline and Solaru spoke on the process to develop the FEHB Program Carrier Letter and how it may help the agency better understand how medication optimization can contribute to achieving many of these goals, opportunities to support a similar care delivery transformation for federal employees that could build on the success stories from the Department of Veteran Affairs and how the workgroup can support the important work of the Medicare Innovation Center.
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,

Register here.

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.
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