Former HHS secretary calls for forced e-prescribing by insurers
SAN FRANCISCO According to former Health and Human Services secretary Tommy Thompson, health insurers should force physicians through reimbursement policies to adopt electronic prescribing technology, as stated at the America’s Health Insurance Plans’ Institute 2008.
Electronic prescriptions can significantly increase the quality, safety and efficiency of care, Thompson noted, but only 8 percent of doctors e-prescribe. Insurers, however, can compel widespread adoption by paying more to e-prescribers and less to those who still rely on paper, he said. “You, as the controller of who gets paid and how they get paid, can force e-prescribing.”
Tying e-prescribing to payment will really change physician practice behavior, said former Sen. John Breaux, D-La. in a roundtable debate with Thompson and former Senate Majority Leader William Frist, R-Tenn.
Widespread e-prescribing will help to some degree to start bending down the rising curve of health care costs, Breaux said, but so will using information technology to give consumers information they need on pricing and the quality of care.
Breaux and Thompson told attendees that major, systematic change in the health care system is right around the corner, and both predicted congressional passage of a reform bill next year. “2009 will be the biggest year in health care transformation that we’ve ever seen,” Thompson said.
Frist, however, is not so optimistic. The gulf between different philosophies, he noted, remains too large.
NACDS recognizes pro-pharmacy Republican Senators
ALEXANDRIA, Va. The National Association of Chain Drug Stores has joined with the 18 Republican Senators who are urging Sen. Charles Grassley, R-Iowa, Ranking Member of the Senate Finance Committee, to include provisions in the pending Medicare reform legislation concerning the importance of delaying Medicaid reimbursement cuts and ensuring prompt payment under Medicare Part D.
One provision under consideration would delay the implementation of a new Medicaid reimbursement benchmark, Average Manufacturer Price, which would drastically reduce payments to pharmacies. The other provision would ensure that pharmacies are reimbursed within fourteen days for Medicare Part D claims filed electronically.
These provisions were originally included in legislation sponsored by Senate Finance Committee Chairman Max Baucus, D-Mont., as part of a package of Medicare and Medicaid improvements. Sens. Baucus and Grassley are expected to negotiate a similar bipartisan bill that needs to be enacted by July 1.
“We applaud these 18 senators for their strong support of pro-pharmacy legislation,” said NACDS president and chief executive officer Steven C. Anderson. “It is crucial that these provisions be enacted, and we thank Chairman Baucus, Senator Grassley, and Senator Wicker for their leadership on behalf of patients and pharmacies.”
The 18 senators who signed the letter are: Roger Wicker, R-Mo., John Barrasso, R-Wyo., Sam Brownback, R-Kan., Kit Bond, R-Mo., Richard Burr, R-N.C., Saxby Chambliss, R-Ga., Thad Cochran, R-Miss., Susan Collins, R-Maine, Norm Coleman, R-Minn., Bob Corker, R-Tenn., Larry Craig, R- Ind, Elizabeth Dole, R-N.C., Mike Enzi, R-Wyo., Chuck Hagel, R-Neb., Johnny Isakson, R-Ga., Pat Robert, R-Kan., Arlen Specter, R-Pa. and George Voinovich, R-Ohio.
CVS Caremark hosts panel discussion on health plan strategies
WOONSOCKET, R.I. CVS Caremark is hosting a panel discussion this week at America’s Health Insurance Plans Institute 2008, addressing ways in which health plans can take a proactive approach to consumer health in order to deliver the lowest overall cost and drive positive health outcomes.
The AHIP Institute 2008 is being held June 18 to 20 in San Francisco. The panel discussion, entitled “Improving the Value of Health Care by Redefining the Consumer Experience,” is being held June 19.
Panel participants include Bari Harlam, vice president of marketing for CVS Caremark; Asif Ally, R.Ph., vice president of market strategy for CVS Caremark; Julie Slezak, vice president of analytics and outcomes for CVS Caremark; and Mitch Betses, R.Ph., vice president of health services at CVS Caremark.
Looking to improve patient compliance and adherence, CVS Caremark has created the Proactive Pharmacy Care model. CVS Caremark research has shown that as many as 30 percent of people who fill a ‘new to therapy’ maintenance prescription will decide to discontinue taking that medication before their first refill is due. In addition, more than half of patients taking a maintenance medication will stop taking their prescription within their first year of treatment.
“We are redefining the pharmacy continuum of care,” stated Betses. “As a combined retail pharmacy and PBM, we can serve as a true pharmacy home to complement and support the medical home. Proactive Pharmacy Care enables us to inform and engage consumers in ways that are personalized, convenient and accessible so that we can positively impact health outcomes.”
As an integrated health care provider, CVS Caremark is positioned to engage consumers at more than 6,300 pharmacy locations and 500 MinuteClinics, as well as through mail, telephone and online. In order to most effectively leverage these multiple touch points and reduce overall costs, CVS Caremark has created the Proactive Pharmacy Care model.
The first phase of the Proactive Pharmacy care model, recently implemented in all 6,300 pharmacy locations, has a number of elements aimed at improving patient engagement in how they manage their prescription therapies, including:
- First Fill Counseling: Targeted counseling for new-to-therapy patients to encourage known reasons for medication non-adherence.
- Adherence Outreach: Outreach calls from the pharmacy to encourage patients who have stopped their drug therapy to restart therapy.
- IVR Refill: Automated call reminders to patients to refill upcoming prescriptions.
The company is also addressing the issue of rising costs and is piloting a variety of cost-savings initiatives, including Maintenance Choice and ExtraCare Health.
Under Maintenance Choice, plan sponsors and their beneficiaries may be able to enjoy cost savings usually available only at mail order, with customers on maintenance medications having the option of paying lower mail rates/co-pays for their 90-day medication supply at any one of the CVS locations.
Under ExtraCare Health, CVS Caremark members will receive a special ExtraCare Health card offering an additional 20 percent discount on FSA-eligible CVS branded items and the opportunity to earn special offers and discounts tailored to their health care needs.