Magazine article Drug Topics

NARD Leaders Deny Health Reform Is Pro Managed Care

Magazine article Drug Topics

NARD Leaders Deny Health Reform Is Pro Managed Care

Article excerpt

Forget all the hoopla about health-care reform as the great promoter of managed care pharmacy; Clinton's reform means independents will finally be able to cut better deals with third-party plans.

That was the word from two NARD spokesmen who met with Drug Topics to discuss the impact of Clinton's health-care reform plans on managed care pharmacy. According to Todd Dankmyer, senior v.p., communications, and Ken Whittemore, director of third-party programs, Clinton's health-care reform would give independent pharmacists more leverage to negotiate with managed care organizations.

As Dankmyer put it, "The only way you could say [Clinton's] plan is sympathetic to managed care is that Clinton has acknowledged the role of HMOs. To say the plan advances the role of HMOs--we haven't seen that."

Three options: For one thing, he pointed out, Clinton "is requiring three options in every federally approved plan, and fee-for-service is one of them. If he were truly a managed care guy, he wouldn't be giving all these options."

Instead of serving as a promotion vehicle for managed care organizations, he added, Clinton's healthcare reform plan "is an opportunity to make third parties just third parties. The simple fact is they dominate the marketplace right now. Who put them in charge? This is an opportunity to change all that."

There are several ways in which Clinton's health-care reform plan opens the door to a new relationship between independent pharmacists and managed care organizations, he argued. Consider the following:

Clinton's plan would give independents a "safe harbor," which would enable them to organize themselves to truly bargain with third-party prescription organizations for the first time about pharmacy services and prices, Dankmyer said.

"[Pharmacists] are being given a safe harbor from antitrust," he explained. Though pharmacists would not be permitted to use boycotts as a negotiating ploy, they would be able to use their collective bargaining powers to shape better contracts with third-party plans. …

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