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Rx2013
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Major trends causing change in the role of community pharmacy
- healthcare spending in america
- incresed script volume
- aging population
- healthcare reform
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10% of national healthcare expenditures
prescriptions
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30% of national healthcare expenditures
hospital
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21% of national healthcare expenditures
physician or other professional services
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How do payors react to increased health care costs related to pharmacy?
lower reimbursement rates to pharmacies
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How do paitents react to increased health care costs related to pharmacy?
- increased out of pocket costs
- increased premiums and copays
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How do pharmacies react to increased health care costs?
seek opportunities to provide new services and revenue streams
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Why does script volume increase each year?
- more health problems are treatable today
- new drugs that were not available 10 years ago
- culture shift in medication acceptability
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___% of prescriptions each year are not taken correctly
60%
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How much does non-compliance cost the health care system each year?
- $100,000,000,000
- 125,000 deaths
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Affordable care act current changes
- increased funding for state programs
- $250 rebate checks for medicare gap
- insurance for pre-existing conditions
- 50% drug discount for rx medicare gap "donut hole"
- Insurers must spend premiums on HC services and HC quality improvement
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2012 Health care reform changes
- standardized electronic record keeping & billing
- integrated heath systems
- link paymets to quality outcomes
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2013 Health care reform changes
- improve preventative health coverage
- increased pmt for primary care physician (no less than medicare reimbursement)
- new funding for state medicaid programs to cover preventative care at no cost
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2014 Health care reform changes
health insurance exchanges
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2015 Health care reform changes
- payment for value vs. volume
- higher quality care recieves higher payment
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Other trends impacting community pharmacy
- technology and info sharing
- mail order
- focus on drug safety
- generic substitution carve out bills
- self care
- new corner drugstore
- diverse population
- medicare part B competitive bidding
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New perspectives for pharmacy practice
- improve technology
- improve safety
- improve outcomes through services and MTM
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DHHS pharmacists role in immunizations
- vaccine education and mobilization
- vaccine distribution
- vaccine access and administration
- vaccine registries and tracking systems
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___% of americans do not have or use a primary care physician.
70%
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may prove to be the most significant catalyst in moving the pharmacy profession beyond dispensing to direct patient care
pharmacist administered immunizations
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MTM services
- enhance pt understanding and adherence
- detect adverse events and gaps in therapy
- mandated for medicare part d patients
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Impact of MTM services
- most errors occur bc pt was not counselled
- ensures proper medication use
- provides foundation for measuring outcomes and value of pharmacist interaction
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