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NACDS: Pharmacists can help improve care in Medicare, Medicaid
March 1st, 2013
ARLINGTON, Va. – The National Association of Chain Drug Stores has urged Senate leaders to advance policies aimed at improving care for Medicare and Medicaid beneficiaries.
NACDS said Friday that it submitted comments for a Feb. 28 Senate Finance Committee hearing titled "Delivery System Reform: Progress Report from CMS." CMS is the Center for Medicare & Medicaid Services, the federal agency overseeing those public health benefits programs.
In its statement, NACDS highlighted the breadth of health services that community pharmacies and pharmacists provide, such as immunizations, medication counseling, medication therapy management (MTM) and disease screenings.
"Through personal interactions with patients, face-to-face consultations and convenient access to preventive care services, local pharmacists are helping to shape the health care delivery system of tomorrow — in partnership with doctors, nurses and others," NACDS stated.
In particular, NACDS pointed to pharmacists' expanded role in immunizations. For the 2010-11 flu season, 18.4% of adults nationwide got their flu vaccine at a community pharmacy, second only to a doctor's office. The association also noted that the Centers for Disease Control and Prevent (CDC) cites pharmacists as pivotal to increasing the U.S. vaccination rate.
Both patients and the nation's health care system, too, realize cost savings from expanding pharmacists' vaccination authority, NACDS said in its statement.
"As noted by the Department of Defense in a 2011 final rule, significant savings were achieved under the Tricare program when the program was first implemented to allow beneficiaries to obtain flu and pneumococcal vaccines at retail pharmacies," NACDS stated. The association explained that for the first six months that Tricare beneficiaries could get their vaccines at retail pharmacies, 18,361 vaccines for H1N1, flu and pneumococcal were administered at a cost of about $300,000 in a community pharmacy. Had those vaccines been administered under the medical benefit, instead of the pharmacy benefit, the cost to Tricare would have been $1.8 million.
Meanwhile, policymakers have begun to recognize the key role that pharmacists can play in improving medication adherence and how MTM can help lower health care costs in Medicare Part D, according to NACDS. In its Senate committee statement, NACDS cited a Congressional Budget Office (CBO) report revising its methodology for scoring proposals related to Medicare Part D. CBO found that for each 1% increase in the number of prescriptions filled by beneficiaries, there is a decrease in overall Medicare medical spending.
In addition, NACDS said, a recent report by CMS found that Part D beneficiaries with congestive heart failure and COPD who were newly enrolled in the Part D MTM program experienced higher medication adherence and discontinuation of high-risk medications. Specifically, monthly prescription drug costs for these Part D beneficiaries were lowered by about $4 to $6 per month and that they had nearly $400 to $500 lower overall hospitalization costs than those who didn't participate in the Part D MTM program.
NACDS also made its case to lawmakers for expanding the role of pharmacists in patient-centered health care models, such as accountable care organizations (ACOs), medical homes and community-based transitions of care programs.
"Permitting pharmacists to practice to their maximum capabilities within these new delivery models would help increase medication adherence and coordination between health care settings, result in higher rates of vaccinations, and reduce the burden of the physician shortage, particularly with the influx of new patients in 2014 through the Health Care Marketplaces and the expansion of Medicaid eligibility," NACDS said in its statement. "As we move forward with the reform of the health care delivery system, it is imperative for all health care providers to practice to their maximum capabilities, working in partnership to provide accessible, high-quality care to patients."
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