Practice Transformation
CMMI should support flexible primary care, not FFS
To increase the likelihood that models achieve overall cost savings and/or quality improvement, CMMI should test approaches that add flexibility and significantly increase the share of total health care spending devoted to primary care, according to a new Commonwealth Fund report. Replacing Medicare fee-for-service with alternative payment arrangements could improve the effectiveness of future primary care models. The report calls on CMMI to go big: “Models that adjust small details while retaining many of the features of the existing fee-for-service approach are not likely to achieve success.” Place greater value on primary care and give PCPs greater flexibility to care for people outside of a fee-for-service system. (Commonwealth Fund)
Despite FDA efforts, clinical trials lack diversity
Black patients have long been underrepresented in clinical trials, and an FDA initiative launched in 2015 didn’t change things, according to a paper in Health Affairs. “Black patients remained inadequately represented in clinical trials for drugs […], and fewer than 20 percent of drugs had data regarding treatment benefits or side effects reported for Black patients.” The FDA program changed neither of those metrics, according to the authors. (Health Affairs)
Marry interoperability to VBC
“You’d think that a hospital or medical practice’s ability to provide the best possible care at the lowest possible cost to a patient would depend on the provider getting a complete medical picture of a patient by accessing the patient’s health information from other sources, including other providers. If you do, you think wrong like I did,” Dave Burda recently wrote, commenting on study that found “no observable evidence that hospital APM participation was associated with interoperability engagement.” Value-based care and interoperability make a good pairing, he argues, but it won’t happen “unless we make interoperability a condition in a VBC model or make VBC payments — rewards and penalties — dependent on interoperability.” (4Sight Health; JAMA Health Forum)
Evidence & Innovation
Are AI-based algorithms undermining patient safety?
An investigation by STAT and MIT found that shifts in data fed into popular health care algorithms — algorithms used to warn caregivers of impending medical crises — can cause their accuracy to plunge over time. “Instead of transforming care, the algorithms withered in the face of fast-moving clinical conditions — unable to keep up with the pace of change. “Their frailty exposes gaping holes in the governance of products whose quiet deterioration in hospitals around the country threatens to mislead doctors and undermine patient safety,” STAT reports. (STAT)
US comes up short on primary care, thanks to underinvestment
From access to coordination of care, the US primary care system lags far behind those of other wealthy countries, according to a new Commonwealth Fund report. U.S. adults are the least likely to have a regular physician or place of care, or a longstanding relationship with a primary care provider. They are also least likely to have access to home visits or after-hours care. The authors note that the US primary care system has been weakened by decades of chronic underinvestment and that policymakers must strengthen the system; this includes including by narrowing the wage gap between generalists and specialists. (Commonwealth Fund; AHealthcareZ)
Policy Solutions
New intelligence brief | CMMI Announces Revisions, Rebranding, and Relaunch of GPDC: Analyzing the new ACO REACH Model
On February 24, the CMS Innovation Center announced a redesign of the Global and Professional Direct Contracting Model and the launch of a replacement initiative, the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model. The ACO REACH Model represents an important practical opportunity for organizations to engage in an attractive advanced alternative payment model (APM), it also represents a powerful momentum builder for the broader value movement. The brief (1) offers a short background on the model’s history and recent controversies leading up to the announcement, (2) summarizes the major provisions of the new ACO REACH Model, outlining the key changes from the GPDC design and (3) considers potential implications for the 99 Direct Contracting Entities (DCEs) currently participating in the model as well as the broader value movement. This brief is open access courtesy of our sponsor, Lumeris. (Accountable Care Learning Collaborative)
In Case You Missed It!
GTMRx Workgroup Updates
- The GTMRx Health IT to Support Optimized Medication Use Workgroup had a presentation on March 15, 2022 from 11:30-12:30pm EST with Farah Madhat, Pharm.D., MA, Chief Product Officer, Tabula Rasa HealthCare about the role that community pharmacies can play in comprehensive medication management (CMM). She discussed topics such as how community pharmacies use their available data to engage patients, ways they schedule CMM appointments with their patients, how they form their clinical relationships, and barriers (both pre and post pandemic) to implement CMM.
- The GTMRx Payment and Policy Solutions Workgroup had a presentation on March 8, 2022 from Todd Sorensen, Pharm.D., professor and senior executive associate dean for strategic initiatives and faculty affairs, distinguished teaching professor, College of Pharmacy, University of Minnesota; Daniel Rehrauer, Pharm.D., senior manager, Medication Therapy Management Program, HealthPartners; and Joel Farley, PhD, BPharm, professor and associate head, Department of Pharmaceutical Care & Health Systems, University of Minnesota. Together, these speakers discussed building payer-provider partnerships to produce value and also gave feedback on the subgroup’s payment methodology discussion document and insight into dissemination strategies.
GTMRx Experts Reveal Health Care Must-Haves for 2022 and Beyond
Leading Institute for Comprehensive Medication Management Shares Strategies for Improving Inefficiencies in Health Care and Reforming Medication Management
“Collaborative practice agreements, using clinical pharmacists, who are right there in the community and know the patients. And specifically with homeless patients, I think there does need to be a little more outreach, the clinical pharmacist going out, through collaborative practice agreements, and seeing patients, and helping us manage their complex needs.. And because it is of course, a little challenging to expect homeless patients to visit clinics. But I’ll say this, they’re much more likely to respond if you meet them in the community rather than a traditional medical office practice.” – Michael Hochman, MD primary care physician and CEO of Healthcare in Action, SCAN’s Homeless Medical Group
Read more in our press release.
GTMRx in the News
While the health care industry reevaluates processes and care from the fallout of the COVID-19 pandemic, patient experience optimization has arguably never been more of a priority for the health community at-large. A big part of optimizing the experience includes paying attention to and changing how medications are selected, managed and monitored to avoid misuse, overuse or underuse.
Read more from GTMRx Executive Director, Katie Capps, in Healthcare Business Today.
The Right Drug Dose Now Act Introduced Feb. 28, 2022
On February 28, 2022, the GTMRx Institute issued a letter of support for the Right Drug Dose Now Act which was introduced on the same day. (See the press release from Congressman Swalwell here.)
GTMRx’s Precision Medicine Enablement via Advanced Diagnostics Workgroup invited congressional staff from the Personalized Medicine Caucus to present on draft PGx legislation underway on two occasions. The Personalized Medicine Caucus, co-chaired by Representatives Tom Emmer (R-MN) and Eric Swalwell (D-CA), engages members in a constructive dialogue about legislative and regulatory policies that can help realize the full potential of personalized medicine. The recommendations that came out of these discussions were put into our Letter to the Personalized Medicine Caucus Co-Chairs—Representatives Tom Emmer (R-MN) and Eric Swalwell (D-CA)—on the Right Drug Dose Now Act.
Some of the GTMRx recommendations to the Caucus included:
- Incorporating comprehensive medication management definition and language.
- Combining PGx testing with the CMM process of care.
- Expanding implementation of EHR guidelines, education awareness campaigns, and reporting.
- Clarifying the definition of adverse drug events.
New Podcast Episode: Jessica Lea, PharmD
Host Katherine H. Capps talks to Tria Health CEO, Jessica Lea. As a trained pharmacist, she brings 20 years of knowledge and expertise in managed care and pharmacy benefits and is an advocate for the pharmacists’ role in improving outcomes. Her background in academia and numerous pharmacy achievements continue to fuel her passion of providing patient-centered care that results in optimal health outcomes.
In the episode, she offers guidance to employers as health plan sponsors to develop a “Buy Right Strategy”—an educational outreach program to educate employers about a new process of care to ensure medication are safe, effective and appropriate for their employees.
A Comprehensive Overview of the Institute, It’s Vision, Mission and Leadership
The Get the Medications Right Institute is working to decrease misuse, overuse and underuse of medications and avoid waste by advancing comprehensive medication management to ensure appropriate and personalized use of medications and gene therapies. Learn more in this brochure.
Interested in supporting our work?
Please contact Jeff Hanson (e: [email protected])
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.
