ASCP Reports
A New Opportunity for Pharmacists: Accountable Care Organizations Accountable care organizations (ACOs)—one of the emerging models of care fostered by the Affordable Care Act—offer pharmacists the opportunity to show how their talents, expertise, and communication skills can improve patient care and reign in costs. A day-long seminar on ACOs, the first in a series sponsored by ASCP on key issues in pharmacy practice, was held June 26, 2014, in Alexandria, Virginia. More than 85 individuals from across the country attended the meeting. ACOs comprise a network of physicians and facilities that have financial incentives to work together to meet specific quality standards and ensure consistent care across settings while keeping down costs. “Providers across settings share risk, as well as rewards,” said Brad Kile, PhD, president of The Dumbarton Group, Tallahassee, Florida. “Government is tying payment to quality.” ACOs are seen as an innovative model for delivering services to manage the health care needs of Medicare beneficiaries. Currently, there are 360 Medicare-Medicaid ACOs serving more than 5.3 million Medicare beneficiaries as well as more than 280 commercial ACOs. Payments are bundled, with a single payment following a patient across settings. The role of the pharmacist will be to work as part of the health care team in each facility. Two key areas where pharmacists have an opportunity to get involved are medication reconciliation and transition of care. “The important piece for pharmacists is to show your value as part of the medication reconciliation process. You’ll need to demonstrate that you have the right processes and protocols in place,” said Michelle Templin, MBA, vice president, strategic business development, Managed Health Care Associates, Inc. “You need to show that you can help reduce preventable hospital admissions and readmissions.” Joe Moose, PharmD, co-owner of Moose Pharmacy, Concord, North Carolina, agreed. “The real value of pharmacy within an ACO is the effect we can have on readmission rates,” he said. “Pharmacists who can do face-to-face coaching with patients and then give this
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information back to physicians will prove their value. This will be where we get the biggest bang for our buck.” Speakers agreed that pharmacists have an opportunity to become an integral part of ACOs and other new models of care, but they need to take the initiative and demonstrate that they are part of the team and will add value. Emerging models of care present challenges, but the faculty cautioned that this shouldn’t stop pharmacists from tackling these head-on. “If I’m going to take financial risks, I certainly need to collaborate with other members of the health care team,” noted Troy Trygstad, PhD, PharmD, MBA, vice president, pharmacy programs, Community Care of North Carolina, Raleigh, North Carolina. “Our value just hasn’t been recognized under the current payment system,” he said. Pharmacists need to let other health care professionals know that consultant pharmacists long have focused on improving outcomes and providing top-notch medication therapy, Trygstad said. “We are the poster child for teambased care.” Pharmacists have the knowledge and skills, as well as the processes and protocols in place, that will benefit these new organizations, said Frank Grosso, RPh, newly named ASCP executive director and CEO, and former vice president, pharmacy services, Genesis HealthCare LLC, Kennett Square, Pennsylvania, “Pharmacists need to take the opportunity to show that their involvement will improve care and keep down costs.” For example, he said, if an expensive drug can keep a patient out of the hospital, it will benefit both the patient and the facility. “You can’t just look at the cost of the drug,” he said. “There are 40 million people over the age of 65, and we are only taking care of 1.3 million,” Grosso said. “It’s incredibly rare in our industry to have an opportunity like this.” n Doi:10.4140/TCP.n.2014.570.
ASCP intends to stay on top of this issue and anticipates offering future programming on pharmacists’ involvement in emerging models of care.
The Consultant Pharmacist SEPTEMBER 2014 Vol. 29, No. 9
A New Opportunity for Pharmacists: Accountable Care Organizations Accountable care organizations (ACOs)—one of the emerging models of care fostered by the Affordable Care Act—offer pharmacists the opportunity to show how their talents, expertise, and communication skills can improve patient care and reign in costs. A day-long seminar on ACOs, the first in a series sponsored by ASCP on key issues in pharmacy practice, was held June 26, 2014, in Alexandria, Virginia. More than 85 individuals from across the country attended the meeting. ACOs comprise a network of physicians and facilities that have financial incentives to work together to meet specific quality standards and ensure consistent care across settings while keeping down costs. “Providers across settings share risk, as well as rewards,” said Brad Kile, PhD, president of The Dumbarton Group, Tallahassee, Florida. “Government is tying payment to quality.” ACOs are seen as an innovative model for delivering services to manage the health care needs of Medicare beneficiaries. Currently, there are 360 Medicare-Medicaid ACOs serving more than 5.3 million Medicare beneficiaries as well as more than 280 commercial ACOs. Payments are bundled, with a single payment following a patient across settings. The role of the pharmacist will be to work as part of the health care team in each facility. Two key areas where pharmacists have an opportunity to get involved are medication reconciliation and transition of care. “The important piece for pharmacists is to show your value as part of the medication reconciliation process. You’ll need to demonstrate that you have the right processes and protocols in place,” said Michelle Templin, MBA, vice president, strategic business development, Managed Health Care Associates, Inc. “You need to show that you can help reduce preventable hospital admissions and readmissions.” Joe Moose, PharmD, co-owner of Moose Pharmacy, Concord, North Carolina, agreed. “The real value of pharmacy within an ACO is the effect we can have on readmission rates,” he said. “Pharmacists who can do face-to-face coaching with patients and then give this
570
information back to physicians will prove their value. This will be where we get the biggest bang for our buck.” Speakers agreed that pharmacists have an opportunity to become an integral part of ACOs and other new models of care, but they need to take the initiative and demonstrate that they are part of the team and will add value. Emerging models of care present challenges, but the faculty cautioned that this shouldn’t stop pharmacists from tackling these head-on. “If I’m going to take financial risks, I certainly need to collaborate with other members of the health care team,” noted Troy Trygstad, PhD, PharmD, MBA, vice president, pharmacy programs, Community Care of North Carolina, Raleigh, North Carolina. “Our value just hasn’t been recognized under the current payment system,” he said. Pharmacists need to let other health care professionals know that consultant pharmacists long have focused on improving outcomes and providing top-notch medication therapy, Trygstad said. “We are the poster child for teambased care.” Pharmacists have the knowledge and skills, as well as the processes and protocols in place, that will benefit these new organizations, said Frank Grosso, RPh, newly named ASCP executive director and CEO, and former vice president, pharmacy services, Genesis HealthCare LLC, Kennett Square, Pennsylvania, “Pharmacists need to take the opportunity to show that their involvement will improve care and keep down costs.” For example, he said, if an expensive drug can keep a patient out of the hospital, it will benefit both the patient and the facility. “You can’t just look at the cost of the drug,” he said. “There are 40 million people over the age of 65, and we are only taking care of 1.3 million,” Grosso said. “It’s incredibly rare in our industry to have an opportunity like this.” n Doi:10.4140/TCP.n.2014.570.
ASCP intends to stay on top of this issue and anticipates offering future programming on pharmacists’ involvement in emerging models of care.
The Consultant Pharmacist SEPTEMBER 2014 Vol. 29, No. 9
