Tuesday, October 23, 2012

Affordable Care Act...coming to a community pharmacy near you?

After sitting through several meetings last week, some of which included discussion of the value-based purchasing and readmission reduction programs that are included in the Affordable Care Act, I wonder how long it will take for the government (through Medicare-D plans) to implement similar programs that impact the world of community pharmacy.

You see, as pharmacy attempts to move forward and take a more proactive role in patient care we are going to be held accountable for results.  Since individual pharmacists have not been granted provider status, the accountability will be passed to the actual pharmacy.  This could be a good thing for the professional practice of pharmacy.

Now I have no knowledge of anything like what I am going to write about being in the works, but after hearing the presentation last week it seems entirely possible.  And probably likely in the near future.  Actually, I've wondered for quite a while about how long it would be until community pharmacies would be reimbursed based on performance.  As the Affordable Care Act develops over the next several years, I can see similar programs being rolled out to the retail pharmacy.

Some of the measuring sticks for the hospital world under the value-based purchasing aspects of the ACA center on clinical outcomes, patient satisfaction scores, clinical outcomes, and efficiency in delivering medical care.  This could very easily be translated to the community pharmacy setting.  Can you imagine the change that would occur in the community pharmacy world if reimbursements were tied to things like time spent counseling patients, patient satisfaction scores, medication in-stock rates?

Imagine walking into a retail pharmacy and actually having a pharmacist be able to counsel a patient without worrying about falling behind by a dozen prescriptions.  Imagine working at a pharmacy that has adequate pharmacist-staffing to allow for the patient interaction.

Of course this would have to be implemented in a manner similar to what is being done to hospitals.  A certain percentage of reimbursements from government plans would be withheld, with pharmacies who achieve the goals receiving that money at the end of the year.  This type of incentive would make some of the chain pharmacies focus less on the volume of prescriptions and more on the quality of care delivered to our patients.

Maybe extra reimbursements would be distributed to pharmacies that offer community education programs and show results.  The few studies that have focused on the impact of pharmacist care on patient outcomes might actually be able to be implemented on a large scale.

What would happen if reimbursements were tied to the patient's perception of the care they receive at the pharmacy?  If your patients believe that you are providing quality care and surveys back that up, you get an extra 4 or 5-percent on your reimbursements.  I think the chains might react if better reimbursements are tied to the satisfaction scores.

The national pharmacy organizations have been pushing for inclusion of the pharmacist in the different health care models that are being debated.  If we are included, we are going to need to show results.  Be prepared to make the necessary changes and show your results.

Monday, October 8, 2012

Election day is on its way

I've found that as I get older, I have a greater appreciation for what the United States of America is.  I have a tremendous amount of respect for the men and women who serve in our armed forces, preserving the freedoms that we have.

At the present time, I'm honored to have my children attend a school district where our veterans are honored.  Our district has one of the top football programs in the state.  The fans get jacked for our home games.

But at each home game, the crowd falls silent, rises to their feet, and honors our servicemen as an honor guard marches with the flag from one goal-line to the other.  he crowd noise doesn't go down in volume a little bit.  It is silent.  You can hear a baby crying on the other side of the stadium.  The amount of respect that is shown to our military by the crowd at the games is amazing.  As soon as the honor guard comes to a halt, the band takes the field and the crowd gets back to its' pre-game craziness.

You don't see that in too many places anymore.

As we head into the election season, I encourage you to deliberate on what the United States of America is, and to vote for the candidates that represent the ideals of the United States.

 One a side note... a local radio host has been playing this version of the Star-Spangled Banner over the airways quite a bit recently.  After visiting the Smithsonian's American History museum a couple times over the last year or so and seeing the actual flag that the Star-Spangled Banner is written about, I have a greater appreciation for the words of the Star-Spangled Banner.  Watch this video, reflect on the lyrics, and remember what the United States of America represents.