10/1/ OBRA Doctor of Pharmacy as entry-level degree Medication Therapy Management (MTM) 2010-ACA signed into law

Transcription

1 Jody Smotherman, Pharm.D. Hospitalist Program Director White River Health System There are no relevant financial relationships to disclose. (Although the speaker does prefer Coca-Cola over Pepsi products). 1

2 10. A reference to any president or political party. 9. Anything related to, or that could be related to, pharmacokinetics or pharmacology! (we will especially avoid words like drug of choice, MIC, loading dose, half-life, and therapeutic substitution. ) 8. Anything about pharmacist-to-tech ratios, or pharmacist-to-anything ratios. 7. Actual pharmacy information because both Jody and Jeremy haven t really been pharmacists for a while. 6. A reference to, or joke about, the iphone 6, with the exception of how much easier it is to butt-dial it. 5. The reason why the NCAA switched from the BCS to a year-end playoff system (hint: conspiracy against the SEC). 4. The Henderson-Hasselbach equation. 3. A reference to the Breaking Bad series (many other CE talks have worn that out over the past couple of years). 2. Poor analogies, metaphors, or illustrations (we guarantee that any allegories will contain 100% high-grade sarcasm). 1. The term AWP minus OBRA Doctor of Pharmacy as entry-level degree 2003 Medication Therapy Management (MTM) 2010-ACA signed into law What do these four things have in common? They are all common sense. 2

3 The Patient Protection and Affordable Care Act (ACA) was signed into law on March 23, The steps of implementation: 2010 Patient s Bill of Rights and young adults allowed to stay on parents insurance until age MCR reduction in donut hole medications and key MCR preventative/wellness services become free of charge Initiation of ACOs, Value-Based Purchasing, and goal of reducing paperwork and administrative costs Open enrollment in HIE (Health Insurance Exchange) Marketplace begins; payment bundling begins All Americans required to have insurance Medicaid expansions No annual limits on coverage Reduction of Medicare payments for Hospital-Acquired Infections. 3

4 Readmission reduction (3% penalty for MCR) Hospital Value-Based Purchasing (1.75% penalty for MCR) Hospital-Acquired Conditions (1% penalty for MCR) Medication Reconciliation (past MCD IQI performance measure and could become a CMS performance measure) Prevention/Wellness (Bundled payments and PCMH) The unique skill set of pharmacists aligns with what is desperately needed in hospitals today Clinically-oriented Safety conscious Process mindset and problem solvers Financial acumen Technologically savvy We are Nerdy nuff said Study after study shows that when pharmacists are involved that quality, safety, and outcomes improve and costs are reduced. Average Length of Stay (ALOS) a measure that CMS loves. Case Mix Index (CMI) a measure that CMS developed, and loves. Expected scores will be come more important. Data is becoming less reflective and more predictive. Learn the ins-and-outs of Pay-for-Performance measures and what drives them. 4

5 Proactively participate in teams Forsake non-valued added activity to participate in valueadded activity Get out of the pharmacy! Be involved in or help initiate Multi-Disciplinary rounding Develop relational equity with physicians Amundsen s Axiom: Victory awaits those who have everything in order. People mistakenly call this luck. Know what you don t know, and figure it out. Carmichael s Law: for every human reaction there is an over-reaction. It s not about how talented you are, it s about how team-oriented you are. Clement s Premise: Assumption and presumption are the parents of all foul-ups! General Truth: Administration is always trying to fine tune the solution before it defines the problem! Antimicrobial Stewardship leadership! Navigation of Transition of Care and Collaboration of Care Accountable Care Organizations a network or group of providers and hospitals that collaborate to provide care and share responsibility (i.e. risk) for cost and quality of care. PCMHs!!! 5

6 Product-based role. Service-based role. Influence-based role 6

7 Contact info: Care-Reform-Reportsm2010.aspx Douglas Kay Symposium: The Affordable Care Act: Key Points for Pharmacists, Smith, June 11, /HealthCareReform# 7