Magazine article Drug Topics

When CMS Wants CMR, Ben Franklin Says "Ahem"

Magazine article Drug Topics

When CMS Wants CMR, Ben Franklin Says "Ahem"

Article excerpt


This time they may really mean it... I'm talking about pharmacy getting away from being paid only for putting a product in a bottle. I know that statement means that a lot of you just stopped reading. I understand why.

Around the time of Nirvana and Bill Clinton, I started hearing that there was no future in count, pour, lick, and stick. We were on the verge of a new era, so the story went, when pharmacists would get paid for actually affecting the outcome of drug therapy; they would be viewed as valuable healthcare partners, contributing clinical knowledge toward improvement of a patient's well-being.

More than 20 years later, I found myself with a vantage point deep within chain pharmacy, where I saw two major changes in the profession: a check box added to the signature log for a patient to decline counseling and the imposition of a flu shot quota. Two decades later, we were still predominantly doing work that had "no future." So I can understand why you're skeptical.

But seriously, this time they may really mean it.

The feds are talking money

What's different? This time the federal government is involved - and with something more meaningful than a toothless, unfunded requirement that we counsel patients at prescription pickup. Money is on the table, and mandates are in the air.

Along with the two major changes I mentioned above, you also may have noticed a minor one. Medication therapy management (MTM) cases might have begun to dribble into your computer, bringing with them the opportunity to make a few for such activities as coaching people on their medication compliance or contacting doctors about potentially inappropriate therapy.

I say "may" have noticed, because MTM hasn't exactly caught on like wildfire. The Centers for Medicare & Medicaid Services (CMS), the agency of the federal government responsible for administration of Medicare and Medicaid, recently reported that among Medicare Part D patients, only 11 % of eligible MTM cases were being completed. CMS is not happy about this.

By the way, if you are not convinced that the federal government can force major changes in heathcare practice when it really wants to, take a look at that separate trash can you now keep for garbage with anyone's name on it. …

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