Keynote session discussed healthcare reform and implications for managed care pharmacy.
In the first of two keynote sessions at AMCP’s 23rd Annual Meeting and Showcase, Susan Dentzer, Editor-in-Chief of Health Affairs, illuminated the current and changing landscape of healthcare reform. Ms. Dentzer’s talk focused on the Affordable Care Act (ACA), initiatives under the new law, political consideration, and implications for managed care pharmacy.
Although there are several facets of the new law already taking effect, such as coverage for those with pre-existing conditions, business tax credits, etc., much more of the law has yet to be rolled out. After explaining the three-part aim strategy which forms the backbone of the ACA (better health, better healthcare, and greater value for dollars spent), Ms. Dentzer discussed a few new initiatives set to achieve these aims under the new legislation, beginning with the National Quality Strategy.
Mandated under the ACA, the National Quality Strategy was released on March 21, 2011, and builds on the triple aim with government-led goals and programs. Firstly, the Office of Health and Human Services (HHS) is slated to create agency-specific plans to implement, and engage the private sector as much as possible. In addition, the National Quality Strategy calls for the release of the “Leading Causes of Mortality” initiative. This initiative will focus on prevention of the top causes of death in the United States, beginning with cardiovascular disease, which accounts for 1 in 3 deaths and annual costs of over $500 billion. Finally, the National Quality Strategy will seek to create a “Partnership for Patients” initiative, with the goal of bringing together public and private sectors to achieve prevention of injury and illness (as reported in a Health Affairs-cited study, substantial adverse events are reported in 1 of 3 US hospital admissions, and are most often medication errors or other preventable incidents).
Ms. Dentzer also touched on the services to be offered through the Center for Medicare & Medicaid (CMS), speaking to the hot-button issues of accountable care organizations (ACOs), medical homes, and value-based purchasing. Addressing the audience of managed care pharmacy professionals, Ms. Dentzer emphasized that the role of such professionals in the new landscape of healthcare reform would be a large and important one, pointing out that the pharmacist is “often underused” in the current reform models of ACOs and medical homes. Pointing out that only 33% to 50% of patients are adherent to medication regimens and that 32% of adverse events are attributed to medications, Ms. Dentzer stressed that the role of the pharmacist in the new age of healthcare reform will be critical for the successful improvement and success of quality patient care goals.
After addressing the implications of the ACA for managed care pharmacy, Ms. Dentzer concluded by reminding the audience that this issue is more than a medical one, and that the new legislation is largely contingent on the changing and unpredictable political landscape.