A new Health Affairs article focuses on the role of pharmacy services in accountable care organizations and how pharmacy care has been overlooked in value-based reimbursement models.
The article identifies pharmacy care as an overlooked area in value-based payment models such as ACOs since the models provide no incentive to physicians to promote cost-effective medication use. In addition, Part D plans are not able to share in the savings they produce through better outcome for ACOs.
However, the role of appropriate use of prescription drugs will be central to ACOs achieving their goals of improving quality of care while reducing costs, as a tremendous amount is spent each year on managing and preventing chronic conditions through the use of prescription drug therapy.
With approximately half of all prescribed medications not being taken in accordance with directions, non-adherence to prescription drug regimens by patients leads to an additional $300 billion in healthcare costs in the
The article suggests the following ways Part D plans and pharmacies can help improve quality of care and cut healthcare costs.
- Part D plans can use innovative benefit designs and more restrictive formularies to promote efficiency.
- Part D plans can actively monitor patient purchasing data to identify patients who do not adhere to therapy, and intervene to communicate with patients and physicians to elevate awareness of pharmaceutical issues.
- Pharmacies can use data to target patient care interventions.
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