APhA and other stakeholders are working to secure opportunities for pharmacists that were created with the passage of the Affordable Care Act. Some initiatives to be supported by the Center for Medicare and Medicaid Innovation were announced November 16. Most of the dollars allocated will go to integrating and coordinating care. We understand from our sources that there will be opportunities for pharmacists in the health home and medical home concepts. There will also be a great opportunity to work with states that will be eligible for grants to design care coordination programs for dually eligible (Medicaid and Medicare) patients.

Earlier this week, a group of APhA management team members sat in on a Health Affairs briefing on “Moving Forward on Health Reform.”

The first thing that struck me about this briefing if the continued variation in terminology with regard to the Affordable Care Act. We continue to hear about “health care reform,”  “health insurance reform,” and “health reform” as people discuss the new law.

Of course, it’s not just one law. ACA refers to two laws. The HCR bill signed by President Obama on March 23 was the Patient Protection and Affordable Care Act (Pub. L. 111-148). It was then amended by section 1101 of the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152), signed a week later. Since neither bill title alone is accurate, the Obama administration is using “Affordable Care Act,” or ACA, to refer to these bills collectively, and APhA is using that acronym to describe the new law.

In any case, it was clear from the Health Affairs panelists that we’re going to get significant insurance reform, and almost certainly reforms in health information technology (HIT) and integrated care delivery systems. Even though there are hundreds of deadlines in the ACA, some at the conference suggested the government should not be too harsh on enforcing them. I might suggest that it’s easy to predict the future, but it’s hard to predict “when.”

Despite terminology ambivalence, it is clear that the world of health insurance will be very different (and larger) as companies grapple with loss ratio and exclusion policy changes, individual mandates and coverage policies, and a host of other insurance reforms required to implement ACA.  If you’re interested, this issue of Health Affairs will be great reading.

Meanwhile, pharmacy continues to focus on the reforms that we can influence and that will improve the lives of our patients. For example, APhA recently pulled together a 22-page list of the panels, committees, and commissions formed by ACA. We are sorting out which ones are most critical in our quest to promote patient access to pharmacists’ services. We’re working with other associations and groups to “divide and conquer” by supporting their nominees and asking them to support ours as we figure out our priorities.

We’re also working outside the Beltway to integrate care, as promoted by ACA, with our colleagues in medicine, nursing, and other health care disciplines. My attitude is that health care is a team sport, so we’ve got to reach out to our teammates if we want to optimize our respective contributions to care. On June 23, APhA will lead a contingent of pharmacy representatives in a meeting at AMA where we will discuss collaborative drug therapy management and MTM, adherence and immunizations, medical homes, HIT, FDA’s Risk Evaluation and Mitigation Strategies, and educational challenges with physicians and pharmacists. This will primarily be a door opener but promises to set the stage for significant collaboration between organized medicine and pharmacy. I’ll report more on the meeting and follow up later.

Closer to home, I’m happy to report that Bonnie and I watched our nephson’s (it’s a made-up word, but you get it) 8th grade graduation last night. It’s an important event for us, as it was just 2 years ago when he suffered a major health setback, which he weathered like a hero.

And right outside my window, it’s a glorious weather day. I never get used to the feeling of good fortune that we have in occupying this space on the National Mall. I am grateful for the opportunity to serve our members as we all strive to improve medication use and advance patient care—together!