Despite the shifting winds of health care reform in politics and the courts, the pharmacist's role will keep expanding, says Bruce Stuart, PhD, professor at the University of Maryland School of Pharmacy.
Pharmacists are currently on the cusp of new opportunities in integrated care partnerships involving providers, patients, employers, and insurers, says Stuart, who is director of the School's Peter Lamy Center on Drug Therapy and Aging.
The federal health care reform legislation that President Barack Obama signed into law earlier this year, the Accountable Care Act (ACA), has numerous provisions designed to increase care coordination through interdisciplinary health teams, says Stuart.
The ACA provides a key delivery system reform promoting Accountable Care Organizations (ACOs). Scheduled to go into effect on Jan. 1, 2011, ACOs will "facilitate coordination and cooperation among providers to improve the quality of care for Medicare beneficiaries and reduce unnecessary costs," the law states. The concept of ACOs has been discussed for many years prior to the current health care debate, but this will be the first true test of the concept.
"The ACO is a new kind of fee-for-service organization centered on primary care with responsibility for coordinating all specialty services," Stuart told the School's faculty and students gathered for his take on "Health Reform: What is really in it for Pharmacy?"
"What distinguishes ACOs from traditional fee for service is that the organizations can earn bonuses by meeting cost and quality targets. Developing an effective system for care coordination is key to ACO success. And having good medication management procedures is a key to effective care coordination. This is where pharmacists can play a major role," Stuart said.
One of the health reform law's elements most dear to the hearts of pharmacists is a provision offering grants to community pharmacists to develop medication therapy management (MTM) services. "However, the law does not appropriate funding for MTMs--that all depends on the mood and shape of the Congress next year," said Stuart. "There are other reasons for growth in MTMs no matter who controls Congress."
Stuart, an economist, urged pharmacists to identify successful examples of interdisciplinary care coordination involving pharmacists, and then to work with local ACOs and medical homes to help assure that they adopt such practices.
Magaly Rodriguez de Bittner, PharmD, BCPS, CDE, professor and chairperson of the School's Department of Pharmacy Practice and Science, said, "At this time it is important for the pharmacists to actively participate at the table with entities such as ACOs concerning the opportunities and benefits that integrated medication management services could have for them. It is critical that pharmacists become proactive and do not wait to be invited to participate in benefits design. We can't afford to miss the opportunities that health care reform brings for the profession"