Are you innovative? Do you influence the care patients receive in a health system through quality initiatives? You’re invited!

A new initiative announced by the CMS Center for Medicare and Medicaid Innovation is accepting applications for the Innovation Advisors Program from providers in health systems and any professional employed by a public health or health care facility, institution, or department.

The idea is to engage folks to refine, apply, and sustain the managerial and technical skills necessary to drive delivery system reform. Medicare, Medicaid, and Children’s Health Insurance Program beneficiaries want your help. The program will allow skilled individuals in the health care system to deepen key skill sets, including health care economics and finance, population health, systems analysis, and operations research.

The selection criteria for applicants include career achievements; their pre-existing skill set and its relevance to transforming the health care system for these beneficiaries; the quality of a proposed innovation project in their home organization; their organization’s explicit commitment to their work; and management experience.

As many as 200 Innovation Advisors around the country will be selected and developed in the program’s first year, and their home organization or group will be eligible to receive a stipend of up to $20,000 to support their activities, including travel.

The first group of Innovation Advisors will start a 6-month intensive orientation and applied research period in December 2011. During the initial 6-month period, advisors will commit up to 10 hours per week, with similar or less involvement thereafter. They’ll meet together at the regional level each quarter and at CMS in Baltimore once each year. Advisors will not be employees of CMS or the government.

The deadline to apply is November 15. Innovation Advisors will be notified of their selection by mid-December 2011.

It’s critically important that pharmacists from a variety of practice settings apply for this program. APhA encourages pharmacists to participate. Please let us know at iqi@aphanet.org if you intend to submit an application!

On June 3, I chaired the Pharmacy e-Health Information Technology (HIT) Collaborative meeting at the National Community Pharmacists Association headquarters in Alexandria, VA. The meeting brought together the founding members of the collaborative plus new Associate Members (National Council for Prescription Drug Programs, RelayHealth, Surescripts, and Medco Health Solutions).

One action item was to incorporate management of the Pharmacist Services Technical Advisory Coalition into the collaborative. Collaborative members unanimously voted to approve a budget for the collaborative through December 2012, and the contract of Shelly Spiro, Director of the Pharmacy e-HIT Collaborative, was extended to the end of the budget term.

The collaborative has made significant progress on moving the electronic health record forward for pharmacy practice while addressing the coding needs for pharmacist-provided patient care services, and increasing the profession’s presence at the table of current HIT discussions.

The next scheduled meeting of the Pharmacy e-HIT Collaborative Council will be on August 24, 2011. Questions on the Pharmacy e-HIT Collaborative can be addressed to Jim Owen at jowen@aphanet.org.

Yesterday, a federal judge in Florida ruled in favor of 26 states that sued the federal government to overturn the new health care reform law—the Affordable Care Act (ACA). The judge ruled that the law is unconstitutional because it requires individuals to buy insurance or face tax penalties. Further, and unlike the earlier ruling in Virginia, the Florida judge chose to rule not solely on the so-called individual mandate portion of the law, but rather on the entire ACA. In the judge’s ruling, he said ACA is so dependent upon the mandate that the entire law is unconstitutional since the law would not work without it. Notably, the courts in two other states earlier ruled in favor of ACA’s constitutionality.

Judge Roger Vinson in the Florida case yesterday said it would be a “radical departure” from existing law to give Congress power to order people to buy something, as opposed to merely regulating activity once someone has entered the economic stream, reported CBS News legal analyst Jan Crawford.

The judge’s ruling that the entire 2,000-plus–page law is unconstitutional was unexpected as well. Typically, in determining the constitutionality of a law, judges employ a concept called “severability” and make as narrow a ruling as possible. So, even if they rule that part of a law is unconstitutional, they sever that piece out and leave the other parts in place. Broader rulings than simply excising the unconstitutional portions are often decried as judicial activism. As reported on CBS News, Vinson concluded he couldn’t sever the unconstitutional individual mandate provision from the broader law, and so as a result the entire law must fall. In my observation, and for practical purposes, without the individual mandate, the law won’t work. There must be universal coverage to finance other provisions, like coverage for pre-existing conditions.

Joining the coalition in the Florida case were: Iowa, Kansas, Maine, Ohio, Wisconsin, and Wyoming, in addition to Alabama, Alaska, Arizona, Colorado, Georgia, Indiana, Idaho, Louisiana, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah, and Washington.

From here, the case ruled on yesterday will likely be appealed to the U.S. Supreme Court, where some pundits suggest it may be fast-tracked to get a ruling as early as this fall. The only thing that is clear is a significant split in the federal decisions.

When all of this shakes out, it could be a real mess. If some parts are constitutional and others aren’t, it will cause significant problems because so much is interrelated. If it is all struck down, many will be upset who worked to get it passed, while others will be pleased that the courts sided with their opposing view. Many on both sides agree there are significant good elements in ACA, such as the elimination of pre-existing conditions and the ability for parents to keep their kids on the parents’ insurance to age 26 years. While APhA remained neutral on the bill, we also feel that the many pharmacy-friendly provisions have the ability to help a lot of people, and don’t want them struck down. The political debate will likely escalate over the next few months, so your participation and support are more important than ever. We will stay focused on ensuring Congress understands and values the services pharmacists have to offer the American people.

Tonight, in the words of Politico, President Obama outlined an agenda to grow the American economy and called on Americans to heed the message from the shootings in Tucson that we need to work together.

The president also vowed to veto all bills containing earmarks — specific projects funded at the request of individual lawmakers — and proposed a freeze in discretionary government spending for 5 years, with an eye toward reducing the massive federal deficit.

Later in his speech, the President referenced the health care reform law when he said, “Anything can be improved.” He suggested changes in one provision that would impose a huge reporting burden on small businesses by requiring the reporting of any purchase over $600. “We can start right now by correcting a flaw in the legislation that has placed an unnecessary bookkeeping burden on small businesses,” he said. That’s good news — and something we at APhA have lobbied for.

Obama spoke out against repeal of the Affordable Care Act, while opening the door to good ideas. He wants to protect exclusions due to pre-existing conditions and protect small businesses from “paying $5,000 more to cover employees.” He applauded the decreased cost of prescription drugs for seniors and the continuation of coverage for young persons on their parents’ insurance. He added, “Let’s fix what needs fixing and move forward.”

At APhA, we are making sure the good ideas in the Affordable Care Act are protected as well-intentioned leaders from both parties engage in a re-analysis of that law. Based on the White House perspective provided tonight by the President, the door is open for us to advocate for retention of important common-sense provisions — ones that provide more Americans with the pharmacists’ services they need so much.