Coster joins independent Rx team to spearhead government affairs, policy
ALEXANDRIA, Va. Retail pharmacy and policy veteran John Coster has joined the National Community Pharmacists Association as SVP government affairs, succeeding Charlie Sewell. His appointment to the independent pharmacy organization is effective immediately.
Coster, a licensed pharmacist and vocal advocate for the profession, is well known to pharmacy stakeholders and to policymaking staffs on Capitol Hill. He last served as VP federal affairs and public policy for Rite Aid Corp., and prior to that was the high-profile VP policy and programs for the National Association of Chain Drug Stores.
Coster has also worked for former Senator David Pryor, D-Ark., and on the staff of the U.S. Senate Special Committee on Aging and within the Congressional Office of Technology Assessment. He also served on the Task Force on Health Care Reform during the Clinton Administration.
NCPA EVP and CEO Bruce Roberts praised Coster as a well-respected expert in pharmacy and public policy. “As a pharmacist himself, with extensive legislative and policy experience, John will be an outstanding addition to the NCPA team. We are pleased that a pharmacist will be a strong voice for community pharmacy on Capitol Hill and in the regulatory agencies,” said Roberts.
Added NCPA president Holly Henry, “I look forward to having John Coster represent community pharmacy for NCPA in Washington, D.C. John’s expertise will give community pharmacy the competitive advantage it needs to be part of the overall health care dialogue.”
Coster, who earned a degree in pharmacy from St. John’s University in New York, and his Masters and Ph.D. in Policy Sciences with a concentration in health from the University of Maryland Graduate School, remains a licensed pharmacist in New York, Maryland and Virginia.
Rushing HIT legislation could increase healthcare costs
While Drug Store News has been, and continues to be, a staunch supporter for the widespread adoption of healthcare information technology — as it is the most logical first step toward a working healthcare system where providers communicate, patients get better, and payers get their money’s worth — rushing HIT legislation through in the name of economic stimulus is the wrong idea. And, not because HIT adoption won’t create jobs and stimulate the economy, either.
Building the infrastructure, making sure that all systems can talk to each other and then maintaining those systems will no doubt require countless manpower hours, and create tens, and maybe even hundreds of thousands of new jobs in health care. That’s a good thing. But all the extra privacy provisions that have been tacked on to the House bill would not only add exorbitant and unnecessary cost to implement — and particularly to pharmacy operators, who by and large, have already invested considerably in healthcare technology systems in contrast to other provider groups — but it has the potential to set patient care back considerably in this country.
For instance, the “accounting of disclosures” provision being considered would mean that every time a pharmacy submitted a claim for reimbursement — which, of course, requires the disclosure of the health information of the patient in question, between the pharmacy and the insurance company — it would have to keep a record of that action for at least three years. Forgetting the cost to store that kind of transaction data, which would number in the billions, most if not all pharmacies would have to junk their existing pharmacy systems and buy entirely new ones, as the original systems were not designed to that requirement.
In addition, under the proposed “marketing issues” provision, pharmacies would be required to get a specific patient authorization form, for each specific case in which the patient’s health information might be used to generate a communication to that patient. No single patient authorization can be used for more than one purpose; each must have a specific expiration date, and patients can decide to revoke their authorization at any time.
So, basically, if a pharmacy wants to send a patient a refill reminder, they will need the patient’s prior authorization; if that same pharmacy wanted to send that same patient information about a disease state management program that could help manage the condition for which the prescription was written in the first place, that requires a separate authorization. Want to tell them about a flu shot? That’s another patient authorization. Last year non-compliance cost $177 billion in unnecessary healthcare costs; how does this help reduce those costs? Moreover, how does this provision help prevent the negative health outcomes that drove those costs?
Simply, it doesn’t.
And that’s not all, but it’s at least two good reasons why Drug Store News believes healthcare IT should not be part of the current stimulus bill. It’s bad for pharmacy, and it’s even worse for patients in the long run. The only thing it will stimulate is a lot of unnecessary cost in the name of patient privacy.
DMEPOS accreditation represents a significant pharmacy hurdle
DMEPOS accreditation requirements threaten the availability across several durable medical equipment categories at the pharmacy level, including canes, walkers, wheelchairs, portable commodes, compression hose, mastectomy prosthetics, neck and body orthotics and wound care, among other products and services.
That’s because securing DMEPOS accreditation represents a significant hurdle that grows exponentially in conjunction with the store base. Accreditation fees, training and implementation costs are projected to total at least $5,000 to $7,000 per store over three years, according to the National Community Pharmacists Association. And even though larger chains will be able to spread those costs across their store bases, it’s still going to push a lot of operators crunching the return-on-investment numbers to ask the question, “Why are we even in this business?”
Sales of DMEPOS products comprise between 6% and 8% of an average independent pharmacy’s annual sales — or anywhere from $216,000 to $288,000 per store — NCPA noted, which suggests that many independents and small chains may be more inclined to shutter their doors altogether.
For consumers, the DMEPOS accreditation requirements for pharmacy operators threaten convenient access to those needed supplies, especially in rural areas.
According to a study conducted by HealthPolicy R&D, retail pharmacies are the largest providers of DMEPOS services to Medicare patients.