Updated Pharmacists’ Patient Care Process released
The Joint Commission of Pharmacy Practitioners released the 2025 Pharmacists’ Patient Care Process. The Commission took into consideration a number of issues, including person-centered language, emphasis on health equity and social determinants, expanded pharmacist scope of practice, new care delivery modes, and team-based collaboration with patients and healthcare professionals. The update incorporates insights from the Comprehensive Medication Management in Primary Care study that validated the PPCP steps. (2025 Pharmacists’ Patient Care Process; ApHA announcement)
New rule: Docs can access drug pricing in real time
HHS announced prescription drug reforms designed to give physicians real-time access to drug costs. The final rule, which takes effect Oct. 1, requires healthcare providers using certified health IT systems to electronically submit prior authorizations, select drugs consistent with patients’ insurance coverage, and exchange prescription information with pharmacies and insurers. Issued as part of CMS’s Inpatient and Long-Term Care Hospital Payment Systems, the rule—according to HHS–expands interoperability and ensures providers can check drug prices during appointments, reducing administrative burdens and improving patient access.(Becker’s Hospital Review; HHS press release)
Practice Transformation
OIG: Hospitals failing to report “harm events”
Hospitals are failing to meet federal and state harm reporting requirements the HHS Office of Inspector General found. Nearly half of hospitals surveyed failed to identify “harm events” among hospitalized Medicare patients. Even fewer of those occurrences were investigated, the OIG found. Hospitals told the OIG that they didn’t identify some harm events because staff didn’t consider them to be harmful, that it was not standard practice to capture them, and that it was difficult to distinguish harm from patients’ underlying medical conditions. (Modern Healthcare)
Blood cancer patients get inadequate palliative care
Blood cancer patients, including those with leukemia and lymphoma, don’t get the palliative care services they need, according to research published in BMC Palliative Care. Researchers identified three barriers: misconceptions about palliative care’s role, unpredictable disease trajectories, and physicians’ focus on curative treatments. About half the patients surveyed prefer comfort-focused care over life-extending treatment, yet 37% report receiving unwanted aggressive interventions. Two-year survival rates showed no significant difference between preferred comfort care and unwanted life-extending treatments. (Oncology Nurse Advisor ; BMC Palliative Care)
Evidence & Innovation
Medicare to launch controversial prior authorization pilot
Traditional Medicare enrollees in six states will face prior authorization when CMS launches its “Wasteful and Inappropriate Service Reduction (WISeR)” pilot January 1, bringing prior authorization to traditional Medicare for the first time. The 6-year pilot affects beneficiaries in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington State. Private companies using AI will review select procedures, including spine surgeries, pain management injections and some steroid injections. These companies will receive payment shares from denied claims. Critics argue this imports Medicare Advantage’s most unpopular features into traditional Medicare. (The New York Times; CMS)
Policy Solutions
New digital tool for medication transparency
Blue Shield of California has introduced a new tool, Price Check My Rx, that notifies members when their clinician begins an e-prescription and allows them to compare lower-cost alternatives. Members can see their out-of-pocket price for new or renewed prescription medications ordered by their doctor. They can also review alternative medications that may cost less, see other in-network pharmacies and check for discounts. The clinicians prescribing the medications also receive the same information on lower-cost alternatives when they’re e-prescribing. (MedCityNews)
