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GTMRx Institute joins business and health leaders to call for PBM reform
On November 8 the GTMRx Institute joined a coalition of employers, health care providers and patient advocates in urging Congress to support strong PBM reforms this year. In a letter to Senate leadership, the coalition outlines several needed reforms, including commonsense changes to hold PBMs accountable to fair market practices when partnering with employers, the largest customers of PBMs. “PBM transparency alone is NOT enough, but it is vital that Congress require complete and unrestricted transparency into the PBM ‘black box,” the letter states. (letter to Senate leadership)

Innovation Center to focus on care transformation

Over the past decade, the CMS Innovation Center has tested over 50 payment models aimed at improving healthcare delivery. Past evaluations have focused on cost reduction, with less focus on care delivery transformation. But a recent retrospective review indicated demonstrable evidence of enhanced care delivery in several areas, including care coordination, team-based care, and data utilization to stratify patients. Successful efforts shared three key themes: common care coordination strategies, adapting care to local needs, and extending care delivery innovation beyond the Innovation Center models. These findings are guiding the development of a new framework to expedite care transformation. (NEJM Catalyst)

Practice Transformation

Leapfrog: Communication about medicine worsening

The Leapfrog Group’s fall 2023 Hospital Safety Grades report finds that patient experience continues to worsen. Patient experience reports show the most significant declines in the categories of “communication about medicines” and “responsiveness of hospital staff,” both of which correlate with preventable medical errors. On the positive side, the latest grades show hospitals reducing health care-acquired infections post-pandemic, after significant increases during the COVID-19 pandemic. (Hospital Safety Grade)

Expanding pharmacy deserts threaten most vulnerable

After decades of expansion, large drugstore chains are closing hundreds of stores turning many already-vulnerable communities into pharmacy deserts. Over the past two years, Rite Aid, CVS and Walgreens have signaled plans to close more than 1,500 stores, and public health experts say there’s already been fallout, noting that the first neighborhoods to lose their pharmacies are often predominantly Black, Latinx and low-income. Experts tell The Washington Post that research shows that pharmacy access directly affects how closely people adhere to medication regimes set out by their doctors. (Washington Post)

Evidence & Innovation

The patient care pipeline is dwindling

About a quarter of US medical students say they are considering quitting their studies, with many citing mental health and study/life balance issues, according to a new report from Elsevier. Globally, 12% of medical students said they were considering quitting their studies. Among U.S. students, that jumped to 25%. US students were more likely to cite cost as an issue than are their global counterparts. Perhaps more alarming, 58% of medical and nursing students said they viewed their current studies as a stepping stone to careers in health care that don’t involve treating patients. (The Hillreport)

It may be confusion, not hesitancy

In recent years, the number of vaccinations adults are being asked to get has expanded substantially. Keeping track of which vaccines are recommended, when to get them, where to get them and how to get insurance coverage for the various shots, has grown increasingly convoluted, STAT reports.  Even Alison Buttenheim, a professor of nursing at the University of Pennsylvania who studies vaccine acceptance and hesitancy, has questions; she ended up paying $160 out of pocket for her latest Covid booster. (STAT News)

Policy Solutions

Infographic: Understanding pharmacoequity

Pharmacoequity is an essential component of achieving health equity, the fifth aim in the Quintuple Aim of healthcare. It ensures that all patients regardless of race, ethnicity, socioeconomic status, or availability of resources are treated with the optimal medication regimen, have access to their medications, and can use their medications to manage their health conditions. The Get the Medications Right Institute has created an infographic to illustrate the importance of pharmacoequity. (GTMRx Infographic)

HHS outlines provider penalties for information blocking

Health care providers that block information to impede appropriate access to patient information in EHRs would be subject to significant penalties under a proposed rule HHS published Monday. Disincentives include lower reimbursements. Enforcement would begin once the proposed rule is finalized. For example, physicians and hospitals would lose Meaningful Use status, which would cut reimbursements. (Modern Healthcare)

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