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Practice Transformation

Team-based care is superior to solo care, according to an aptly titled paper in Health Affairs, “Provider Teams Outperform Solo Providers in Managing Chronic Diseases and Could Improve the Value of Care.” Looking at patients with type 2 diabetes, hyperlipidemia and hypertension, researcher found that, regardless of team composition, provider teams outperformed solo providers. They also found that among solo providers, care management and outcome differ little between physicians and nonphysicians. “As policy makers contemplate scope-of-practice changes, they should consider the effects of not only provider type but also team-based care on outcomes.” (HealthDayHealth Affairs)
Health information exchange is used in less than half of referrals, according to research in the Journal of the American Medical Informatics Association, and primary care physicians are less likely than specialists to use HIE. Overall, researchers found HIE use in 49% of referrals. Primary care providers had a 42.7% HIE use level compared to 57% among non-PCPs. Providers who treat older patients and those with greater proportions of patients with diabetes used HIE for more referrals. (JAMIAEHR Intelligence)
Evidence & Innovation
A combination pharmacogenetic test is a better predictor of medication blood level and patient outcomes than single-gene testing alone, in patients with major depressive disorder, according to research published in Psychiatry Research. “This evaluation of clinical validity shows that only the combinational pharmacogenomic test was significantly associated with improved patient outcomes. In addition, the combinatorial pharmacogenomic test was a superior predictor of medication blood levels across a larger group of medications,” the researcher wrote. (Psychiatric TimesPsychiatry Research)
Biosimilars were supposed to save the health care system billions. But today, dozens of older, costly biologic drugs still have market exclusivity, contributing greatly to the current drug pricing crisis, Dr. Peter Bach of Memorial Sloan Kettering and Mark Trusheim of MIT write in the New York Times. Prices for biologic drugs are not falling as fast as they should or as much as they could. “Billions in excess drug costs are shouldered by employers, taxpayers and patients as a result.” Lawmakers can step in where biosimilars have failed: Enact a law “that ensures that at the appropriate time their prices fall fast, and they fall far.” The general idea has bipartisan support, they say. (New York Times)

Policy Solutions

Attorney General Dave Yost sued Centene earlier this month alleging it used a “web of subcontractors” to, among other things, overcharge Ohio’s Medicaid program for millions of dollars in pharmacy benefits, Modern Healthcare reports. He alleges that Centene filed reimbursement requests for amounts already paid by third parties, artificially inflated drug dispensing fees and didn’t accurately disclose the true cost of its pharmacy services. Centene said the state reviewed and pre-approved the pharmacy contracts before it went into effect and calls the attorney general’s claims unfounded. (Modern Healthcare*)
Clinicians and health care experts alike dramatically underestimated the degree of clinician burnout that would result from passage of the HITECH Act in 2009 and the subsequent increase in EHR adoption. At the same time, they overestimated the concern over patient privacy and fraud, according to a study published in the Journal of the American Medical Informatics Association. But they were warned: Back in 2009, experts made several recommendations that may have helped to mitigate some of that burnout. Few were implemented. (JAMIAEHR Intelligence)
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In Case You Missed It!

The GTMRx Best Practices and Innovative Solutions (BPIS) Subgroup of the Practice and Care Delivery Transformation Workgroupis working on a comprehensive medication management (CMM) FAQ tool for physicians. The group recently hosted several physician focus groups to inform their work—which will be a part of a larger physician stakeholder package.
Allan Goroll, MD, professor of medicine at the Harvard Medical School and of Massachusetts General Hospital, spoke to the GTMRx Payment and Policy Solutions Workgroup. The following are the key subjects that were addressed:
  • Overview of the steps taken to develop payment models, including components and activities that should be considered
  • Examples of existing and evolving payment models the workgroup should consider as they look for developing payment models that will allow for reimbursement of CMM in practice
  • The 3 essentials characteristics of a successful prospective payment-reform:
  • net investment in primary care,
  • collaboration between payers and practices, and
  • participation of all principal payers
REGISTER NOW: Building Vaccine Confidence During COVID-19:The Role of the Medical Neighborhood | GTMRx Institute & Bipartisan Policy Center (BPC) April 6 Virtual Event
Vaccinating Americans is critical to preventing severe illness or death from COVID-19 and ultimately stopping the pandemic. It is also essential in getting people back to work, to play and to living. To achieve widespread vaccination, engagement of the medical neighborhood is fundamental when implementing community programs designed to effectively build vaccine confidence. While we have seen encouraging vaccination rates, urgent action is necessary to reach herd immunity which experts estimate would require anywhere from 70% to 90% of the U.S. population be fully vaccinated. The reasons people are skeptical about taking the coronavirus vaccine are complex. Building vaccine confidence requires proactive and thoughtful public awareness, education and engagement of a variety of local stakeholders including community members.
Hear opening remarks from:
  • Donald M. Berwick, MD, MPP · President Emeritus and Senior Fellow, Institute for Healthcare Improvement
  • Senator William H. Frist, MD · Former U.S. Senate Majority Leader
  • Anand Parekh, MD · Chief Medical Advisor, Bipartisan Policy Center
  • Katherine H. Capps · Executive Director and Co-Founder, GTMRx Institute (Announcing the GTMRx National Task Force: Building Vaccine Confidence in the Medical Neighborhood)
Hear from the CDC’s Deputy Incident Manager for CDC’s COVID-19 Response:
  • Karen Remley, MD · Director, CDC’s National Center on Birth Defects and Developmental Disabilities
Medical Neighborhood Panel discussion moderated by Susan Dentzer, Senior Policy Fellow, Robert J. Margolis Center for Health Policy at Duke University, to include:
  • Sree Chaguturu, MD · Chief Medical Officer, CVS Caremark
  • Lisa Fitzpatrick, MD, MPH, MPA · Founder and CEO, Grapevine Health
  • Bruce Gellin, MD, MPH · President, Global Immunization, Sabin Vaccine Institute
Join BPC & GTMRx April 6, 2021 from 10:30 am – 12:00 noon ET. Register Here.
What do health plans, providers, employers, patients and other health care stakeholders value within CMM? Optimizing medication use through CMM in practice improves value and enhances provider work life, patient satisfaction, access and quality of care while avoiding unnecessary costs and saving money for the overall health system. Learn how these outcomes are paralleled with the values of key players in the health care arena: patients and advocacy organizations, employers, providers and professional organizations, health systems, health care insurers, government agencies and medication manufacturers. Developed by the Payment Methodologies Subgroup of the Payment and Policy Solutions Workgroup.
Read the document here.
Listen 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. Did you miss the most recent episode?

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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.
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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