The New York Times website has a flow chart and other charts that simplify and bring some semblance of understanding to the various plans that were considered and what the upcoming stages are in the budget discussions. What happens over the next few months is extremely important to pharmacy because of our efforts around medication therapy management and potential cuts to Medicare and Medicaid that are embedded in the fine print. Please continue to monitor our APhA Legislative and Regulatory Updates on pharmacist.com and stay in touch with your Members of Congress.
Archive for the ‘Policy & Advocacy’ Category
The debt deal made simple
Thursday, August 11th, 2011Pharmacy e-HIT Collaborative call for action
Tuesday, August 9th, 2011The Pharmacy e-Health Information Technology (HIT) Collaborative was formed by nine national pharmacy organizations and has grown to include others. We continue the work of getting pharmacists access to and “functional use” of electronic health records (EHR).
The most important thing practicing pharmacists can do is to look for ways to adopt the EHR into their pharmacy management systems without delay. Pharmacists should participate in vendor user groups and push for greater access to EHR functionality and connectivity. Write, call, and otherwise bug your system vendors. Work with physicians, hospitals, other health care providers, and health information exchanges in your area to understand their systems’ functions so you can be specific in your requests to them.
There are activities going on in your community about which you may not be aware. Call your hospitals and physician practices to ask how you might support their efforts. Let us know how we can help.
AMA adopts resolution to evaluate expanding scope of pharmacists’ practice
Wednesday, July 6th, 2011As discussed at a recent Board of Trustees meeting, the American Medical Association (AMA) House of Delegates met last month in Chicago and passed a resolution aimed at evaluating pharmacists’ scope of practice issues. APhA spearheaded a joint comment letter that nine other pharmacy organizations cosigned. I do believe that our efforts to draft the comment letter, our efforts to offer other pharmacy organizations the opportunity to cosign, and our presence and testimony at the AMA meeting helped to soften the tone of the resolution. We can use this opportunity to continue our ongoing collaboration with AMA staff as they consider next steps to implement the policy and provide information back to their AMA House of Delegates.
Our pharmacist.com news article does a good job of further discussing the resolution. Thanks again to APhA staff Anne Burns, Brian Gallagher, Ben Bluml, Mitch Rothholz, and Marcie Bough for their efforts to work with me on this important issue. I also appreciate that our Margaret Tomecki could be at the meeting to support Marcie as she testified.
Health care reform: Court rules, APhA maintains focus on pharmacists’ services
Wednesday, June 29th, 2011Politico and other news outlets are reporting that judges for the 6th Circuit Court of Appeals, which has jurisdiction over districts in Kentucky, Michigan, Ohio, and Tennessee, have ruled in favor of the “personal mandate” contained in the Affordable Care Act. That mandate is considered to be a fundamental linchpin in the successful funding of the Act.
This ruling is the first time a federal Court of Appeals has ruled on the constitutionality of the health care reform law. The final decision seems destined for the U.S. Supreme Court.
At APhA, we will continue to monitor developments in the continuing battle over health care reform and most importantly, to fight for the common-sense provisions in ACA that support the provision of pharmacists’ services.
Pharmacy e-HIT Collaborative Council meets
Friday, June 17th, 2011On 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.
National plan to reduce prescription drug abuse includes opioid REMS
Tuesday, April 26th, 2011Last week, the White House Office of National Drug Control Policy (ONDCP), U.S. Department of Health and Human Services, FDA, and DEA released the Obama administration’s comprehensive action plan to address the national prescription drug abuse epidemic, “Epidemic: Responding to America’s Prescription Drug Abuse Crisis.” The plan provides a national framework for reducing prescription drug diversion and abuse by focusing on education, prescription drug monitoring programs, medication disposal, and enforcement on pill mills and doctor shopping.
Marcie Bough, our Senior Director of Government Affairs, attended the press conference on April 19 during which ONCDP also announced efforts to pursue legislation to amend the Controlled Substances Act by requiring prescriber education upon DEA registration and reregistration. We should expect to see such legislation introduced in a month or so.
As part of this coordinated intergovernmental effort, FDA also announced the final Risk Evaluation and Mitigation Strategies (REMS) for long-acting and extended-release opioid medications as one step in addressing prescription drug abuse and better ensuring safe use of opioids. FDA expects the REMS to become effective in 2012.
The opioid REMS will require manufacturer-developed prescriber education that addresses proper pain management, patient selection and education, and information on proper storage and disposal; Medication Guides for patients; and assessment of prescriber education and patient access. The prescriber education component will be voluntary at this time. A future mandatory hook is tied to DEA registration.
FDA had reached out to us in advance of the announcement to provide us with some background. I was pleased to join Marcie on that call with FDA Center for Drug Evaluation and Research (CDER) Deputy Director Doug Throckmorton, MD. He focused on how REMS fits into the overall action plan, which we support. He specifically expressed FDA’s appreciation for all the work that APhA has done on the REMS issue and in helping FDA better understand the impact of REMS on pharmacy. Marcie does a nice job of managing this relationship.
On a final note, FDA also held a stakeholder call to further discuss the REMS. When asked by a caller about the REMS not requiring pharmacist education, Marcie reports that CDER Director Janet Woodcock, MD, said that at FDA they already think that pharmacists are the most educated on these medications and that this program is focused on the prescribers. Then she said that FDA fully supports the role of pharmacists in counseling patients and in discussing proper storage and disposal of all medications. This was a good plug for pharmacists!
Annual Meeting testimonial
Thursday, April 21st, 2011It is one thing for me to say that I think staff did an outstanding job of planning and executing the 2011 APhA Annual Meeting & Exposition (see my earlier blog post), with all its many orbits. But I think comments from our attendees carry greater weight. So I’m sharing some feedback I’ve received about APhA2011:
Tom,
The recent APhA Annual Conference exceeded my expectations. Here are three reasons why …
Brian Gallagher/health care reform—Brian Gallagher’s health care reform presentation was outstanding. It was clear, concise, and relevant. We need to expand the audience.
Clayton Christensen—Very thought provoking. Clayton was an excellent selection as a keynote speaker.
FDA and HRSA [Health Resources and Services Administration] attendees—I appreciated the opportunity to meet and hear the FDA and HRSA attendees. Washington, DC, is driving health care change.
Please extend my appreciation to all the APhA employees who made this year’s meeting a success. Thank you.
[An APhA corporate partner]
Made my day!
Wednesday, April 20th, 2011I was in the middle of a 2-week odyssey that started right after the 2011 APhA Annual Meeting & Exposition in Seattle, and has taken me from coast to coast, to Canada, and to New Jersey and New York.
Then, I received the message below:
APhA Membership Committee:
I just renewed my membership for 2011–12 today with a contribution to APhA–PAC [Political Action Committee]. Thank you for all you do for the profession of pharmacy and its future practice!
I have to tell you, it made my day! Thanks to this member, and to all the others who support us every day with your membership as well as your support of our advocacy work. I assure you that Team APhA is doing everything we know to do to protect and defend our profession.
Every day is not like that. Here’s my response to an old friend who shared some negative comments about how poorly the profession was faring:
Nice to hear from you … I don’t dispute that the folks you quote feel the way they do. They have a right to their feelings and beliefs. Yet, I see thousands of folks who ARE getting it done, and who ARE enthusiastic about their present AND our profession’s future. I’m not discouraged by the concerns below. They just make me more determined to make a difference …
We’re doing our best at APhA to support pharmacists and their provision of services. We won’t always be appreciated by those who want us to do it faster or differently. That’s OK. I still listen carefully to them. If they participated with us, things might change to their liking. We’re a VERY inclusive organization. We don’t have nearly enough members, given the 300,000 practicing pharmacists in America! Yet I’m proud that we amplify the membership dollars we do get with complimentary work that both serves the profession and garners additional dollars to support our advocacy. Every penny that comes in goes back out to support pharmacists and our profession, whether these folks know it, or support us or participate.
I would enjoy having a conversation with any one of these folks. I’m guessing we would both learn something, and that’s a good thing.
Three-breakfast mornings
Thursday, March 31st, 2011I’m sitting in my office a couple of days after our 2011 APhA Annual Meeting & Exposition in Seattle. Several staff are already working on APhA2012 in New Orleans so we can capture all our learnings from this year and make 2012 even better. Meanwhile, I’m processing what just happened in the various “orbits” that attract pharmacists and technicians in the first place.
On the front end of the meeting, our Board of Trustees met, as did the APhA Foundation board to conduct the business of the Association. We said thanks to several retiring board members, including Ed Hamilton, Valerie Prince, Kelly Goode, Dan Kennedy, and Steven Zona, and we bestowed Honorary Membership on Roger Browning, my retiring Chief Financial Officer. On Thursday, APhA and the American Society of Health-System Pharmacists (ASHP) also conducted a sellout exam prep course for pharmacists interested in sitting for the Board of Pharmacy Specialties (BPS) Ambulatory Care exam this fall. It was exciting to see over 250 very smart-looking folks as they finished the day. We’re off to a very good start with this new specialty. The next exam prep courses are at the American College of Clinical Pharmacy meeting in April and at the ASHP meeting in June.
Unfortunately, I only got 1 credit hour for continuing education (CE), so I didn’t capture a lot of firsthand insight into the 80-plus hours of educational programming conducted, but I did hear from hundreds of pharmacists, including my Israeli friends Ilan and Sami, who thought the sessions they attended were the best ever.
In my humble opinion, the General Sessions were awesome! Clayton Christensen, author of The Innovator’s Prescription (a “must read”) did a marvelous job describing opportunities for pharmacists as disruptive innovators in health care. He and his wife were kind enough to visit with a group of us before and after his Opening General Session presentation. From that interaction, I’m sure he “gets” the upside of pharmacists’ inclusion in any medication-use discussion. We’re just beginning our relationship with this well-respected thought leader, but it promises to be a productive one. Likewise, Carolyn Clancy’s presentation at our Second General Session was equally thought provoking, and described a very supportive attitude about roles in primary care for pharmacists. As head of the Agency for Healthcare Research and Quality, Clancy is a visible and influential policy maker, so her alignment with our goals is critical. She acknowledged something I’ve been saying for 2 years—that we have a “medication-use crisis” in this country right now as the system throws millions of meds at patients with precious little help to optimize their use. Pharmacists have a role to play in any reformed health care system.
The APhA Academy of Student Pharmacists (APhA–ASP) had a major set of orbits going as well. The APhA–ASP General Opening Session, awards presentations, and the student House of Delegates were all highly productive. Our profession is in good hands with the new generation of leaders and practitioners.
In addition to the business and CE orbits at our Annual Meeting, the policy-making machine was working well too. At our final House of Delegates session on Monday, we swore in our new leaders, including Marialice Bennett as President, Jenelle Sobotka as President-elect, Brad Tice as Speaker of the House, Michael Hogue, Academy of Pharmacy Practice & Management President, Sara McElroy as ASP President, and Jonathan Marquess, Trustee. The House voted to support APhA’s leadership in the development of practice standards. We’ve been looking at this prospect for over 3 years, so it was good to see the House so engaged. While the policy passed, there were those who weren’t sure we needed standards. We’ll be sure that as the process unfolds, all voices will be heard and considered carefully.
The social and recognition (awards) orbits were in full swing. We attended dozens of receptions where I was able to reconnect with hundreds of old friends. The Remington Medal Honoree was Paul Lofholm from California, a pharmacist leader for decades who broke important ground on several fronts, including CE for pharmacists and compounding. Our Honorary President this year is Hazel Pipkin from Texas, who blazed her own trail for women in pharmacy as a pharmacy owner who became a professor so she could preach what she practiced in a way that inspired many to assume leadership roles not only in Texas but throughout the United States. You can read about all the honorees by going to www.pharmacist.com/awards.
Finally, and perhaps most importantly, the political action orbit was outstanding! Each of the advocacy presentations the Government Affairs staff and policy makers conducted throughout the program was well attended by enthusiastic crowds. And the Political Leadership Breakfast was sold out with more than 400 attendees. We honored stellar leaders of our advocacy efforts—all exemplary pharmacists who not only make their own voices heard, but inspire others to get involved as well.
You might gather from this blog post that I thought we had a good meeting, and you would be right. Even after the multiple late-night receptions each night, the weeklong succession of “three-breakfast mornings” was invigorating! I’m so pleased with our staff and leadership, who all worked flawlessly as a team to execute a year’s worth of planning. We came back with dozens, if not hundreds, of follow-up action items and a better sense of where our profession is going. Judging by the way thousands have embraced the provision of pharmacists’ services as the practice model of the future, I think we’re on the right trajectory. If you weren’t there this year, you missed a good one!
Let’s play through.
Monday, February 28th, 2011You can waste a lot of good golfing weather waiting for it to rain. Instead, carry a rain suit and umbrella.
What does this sports analogy have to do with pharmacy?
Today, we are pursuing projects to build recognition of and support for pharmacists’ services within Medicare, Medicaid, and evolving team-based integrated care and transitions of care models driven by implementation of the Affordable Care Act (ACA). As you have likely seen, however, there is a lot of media attention around congressional and court activity to potentially defund or repeal ACA.
Yes, we know that ACA’s Patient-Centered Outcomes Research Institute was funded by the American Recovery and Reinvestment Act (the 2009 stimulus package). We know that the CMS Center for Medicare and Medicaid Innovation, which already has funds, may be in jeopardy of being defunded (it might rain). But doing nothing because it might rain is not an option.
Be assured that we are assessing the full picture. We do not have all our advocacy efforts focused on Medicare and the role that pharmacists can play in implementing ACA’s provisions and the continued improvements to Medicare Part D medication therapy management (MTM). Rather, we are also doing everything possible to stimulate the growth of MTM within Medicaid programs, private and commercial insurers, managed care, entrepreneurs, community practice, and other entities looking to improve patients’ medication use, address drug-related problems, and reduce overall health care costs. As evidence, check out the new MTM Digest soon to be published and released at the 2011 APhA Annual Meeting & Exposition in Seattle.
Yes, we know it could rain. But let’s play through.