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Former CMS, FDA chief McClellan helps frame timeline for real health reform

BY Alaric DeArment

DENVER – Pharmacy is in a state of deep transformation, but it could take some time for the trend to gain traction.

That was one of the messages behind a keynote speech delivered Monday morning at the National Association of Chain Drug Stores’ Pharmacy & Technology Conference in Denver on the dynamics, challenges and opportunities of healthcare reform. The speaker, Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institute, also said that regardless of the outcome of the 2012 elections, the retail pharmacy industry will be called to step up. “The trend toward more personalized care outside traditional institutions will continue,” McClellan said.

In addition, regardless of the elections, there will be a continued trend toward limited Medicaid and employer health coverage, a tighter Medicaid financing environment. “It’s going to be a much tougher environment for health care at the federal and state levels than we’ve ever faced before,” the former head of CMS and FDA  told NACDS attendees.

Still, according to McClellan, the overriding goal of healthcare reform remains the same: improving care while reducing costs; but lowering prices and expanding insurance wouldn’t be enough. The risk is that efforts to lower costs can lower quality as well. “The payment rates go down, and the quality of care is squeezed,” McClellan said. Meanwhile, allowing healthcare costs to rise risks squeezing out funding for other services like infrastructure, research and development and education, he said. This created a need to get out of the “vicious circle” of holding healthcare costs down while not improving quality and outcomes.

In the meantime, he said, pharmacy would have a significant role to play in the drive to achieve better outcomes, including helping in the management of disease states like diabetes and cardiovascular disease through services like improving medication adherence. “Those are treatable chronic diseases – lots of opportunities to improve quality and reduce costs there,” McClellan said. “There are opportunities to build on pharmacy leadership.”

Other opportunities included preventive services and partnerships with other providers like hospitals and physicians.
 

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Amid uncertainty of elections, health reform, community pharmacy ‘must adjust sails,’ Anderson charges

BY Alaric DeArment

DENVER — The 2012 elections mean a lot of things to a lot of people, communities and industries, and retail pharmacy is no exception.

In his speech Monday morning during the second business program at the National Association of Chain Drug Stores’ 2012 Pharmacy and Technology Conference in Denver, NACDS president and CEO Steve Anderson talked about the November presidential and congressional elections and what the industry his organization represents has in store as it prepares to mark its 80th anniversary next year. “Amid all of this, one bet seems pretty solid: Things are going to get even more nasty as we head down to the wire and into next year,” Anderson said. “I saw one report that the new Congress could be one of the least-experienced in decades, with about 155 members with less than four years’ experience, with stronger partisanship and less willingness to compromise.”

The elections were just one of the external forces and dynamics that will affect the industry. Another was whether states would accept the Medicaid expansion that is part of the Patient Protection and Affordable Care Act, a key provision of which, the individual mandate to have health coverage, the Supreme Court recently upheld as constitutional. “Some think that even the governors who say they won’t participate are really going to have to think twice,” Anderson said.

The next external force was the so-called “fiscal cliff,” which Anderson called a “witches’ brew” of hundreds of billions of dollars in spending cuts and tax increases that will go into effect unless action is taken in Congress due to the expiration of the Bush administration’s tax cuts and the failure of the congressional super committee to reduce spending last year. Cuts to Medicare are capped at 2% and will reach $123 billion over nine years, while Medicaid is exempt from cuts, though Medicaid spending is expected to decrease by $325 billion over the same period.

“But all of this – from the election to healthcare reform to the economy – creates the operating environment for pharmacy and for every industry,” Anderson said. “Even with factors beyond our control, success still relies on true leadership. We can’t change the wind, but we must adjust the sails.”

This, he said, would mean NACDS advocating that the government pursue policies favorable to patients and pharmacies, and promoting the value of pharmacy. “This focus and tenacity are necessary in the face of massive instability in our country,” Anderson said. “We face a pivotal election. We will see many new members of Congress who need to be educated on the value of pharmacy and on our crucial issues that impact their constituents and your patients.”

Anderson also touted the organization’s outreach to members of Congress and the public. These have included RxImpact, which brings together retail pharmacy leadership teams to meet one-on-one with members of Congress, and RxImpact Votes, designed to encourage people in the industry to volunteer on campaigns, register to vote and turn out on election day. In addition, retail pharmacies have sought the attention of members of Congress by offering tours of drug stores that include introductions to medication therapy management and other services around medication adherence and synchronization and answering questions on drug importation, government purchasing of medications and healthcare reform. So far, 48 such events have occurred this year, Anderson said. Anderson encouraged NACDS Pharmacy and Technology Conference attendees to continue look for opportunities to host more of these types of store visits with policy makers and congressional members.

Meanwhile, NACDS Foundation president Kathleen Jaeger has created the Pharmacy Care and Patient Advocacy Department, and has appeared in numerous newspaper op-eds and on TV news programs to advocate for pharmacy, since joining NACDS in November. “We pitch her to the media as a plain-spoken pharmacist, advocate and mom who can explain complex issues,” Anderson said, noting that Jaeger lately had been raising awareness about whooping cough vaccinations.

“The people of pharmacy save lives and reduce costs,” Anderson said. “They educate the nation on how much more pharmacy care can do. And the response, from patients to policy-makers, has been extraordinary.”


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Community Specialty Pharmacy Network joins Pharmacist Society

BY Alaric DeArment

NEW YORK — The whole purpose of Pharmacist Society is to bring together the myriad stakeholders in the field, so it’s only natural that specialty pharmacy also should have a place.

The Community Specialty Pharmacy Network recently joined the network and launched its first page devoted to specialty pharmacy to coincide with the National Association of Chain Drug Stores’ 2012 Pharmacy & Technology Conference, currently under way in Denver.

“It becomes a forum devoted to the exchange of ideas directly related to the practice of specialty pharmacy,” CSPN VP industry relations Nick Calla told Drug Store News.

The idea is to reach out to stakeholders in specialty such as managed-care organizations, employer groups and manufacturers and give them a way to see what’s being done in community specialty pharmacies.

”We are excited to have CSPN join us on Pharmacist Society, where they will take the conversation about the growing role of specialty pharmacy in the community practice setting to the next level,” Drug Store News publisher Wayne Bennett said. “By having CSPN participate in this online pharmacy community, they will help provide connectivity, engagement and conversation between all stakeholders including payers, distributors, wholesalers , suppliers, pharmacy retailers and all other players in the specialty pharmacy supply chain.”

If you are a pharmacist and would like to join Pharmacist Society, click here.


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