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    Pharmacists in Accountable Care Organizations

    AMCP resource illustrates important role pharmacists play on ACO health care teams. 

    The Academy has developed a white paper that illustrates the role of pharmacists in accountable care organizations (ACOs) — the entities created under the 2010 health care reform law to improve quality and lower costs in the delivery of Medicare services. The resource, "Pharmacists as Vital Members of Accountable Care Organizations:  Illustrating the Important Role That Pharmacists play on Health Care Teams," is being funded by a grant from GlaxoSmithKline. 

    The document is available by Clicking Here. (pdf)

    As defined by the law, ACOs are networks of physicians and other providers who work together to improve the quality of health care services and reduce costs for patient populations. The Accountable Care Act authorizes the Centers for Medicare and Medicaid Services (CMS) to contract with ACOs starting in 2012.

    Discussions of ACOs have broadened from a focus on hospital-centered systems to include models based on various physician practice models, including large, multispecialty groups and independent practice associations. The AMCP document fills a gap in the current discussions about the design of these entities. To date, ACO planners have focused on physicians and hospitals within these evolving organizations without mention of a role for pharmacists.

    Existing today, however, are multiple examples of integrated approaches to the delivery of care that incorporate pharmacists and medication therapy as an essential element. While these arrangements may not be known as ACOs, their modus operandi typifies what ACOs are striving to achieve.

    “Appropriate medication regimens are universally accepted as being essential to positive patient outcomes, particularly for those patients with chronic conditions,” says AMCP Chief Executive Officer Judith Cahill. “The lack of attention to pharmacy and the value that appropriate medication therapy provides in comprehensive patient care underscores the need to make those involved in building ACOs aware of the vital role pharmacists have been playing in ACO-like organizations.”

    To this end, AMCP has developed and is disseminating information that enlightens the discussion on the role for pharmacists and medication therapy in ACO-like organizations. This has been done by:

    • Identifying ACO-like arrangements that use both pharmacists and medication therapy to advance patient care, while focusing on various approaches that are readily available within the AMCP membership;
    • Interviewing ACO-like organizations engaged in this work to derive essential operational aspects;
    • Compiling data in a readable format that can be used as a guide to incorporating pharmacy practice within ACOs;
    • Distributing information to target audiences in both hard copy and online; and
    • In partnership with Avalere Health, conducting an audio conference on the topic.

    Six ACO-like organizations that depend on the inclusion of appropriate medication therapy by pharmacists as an essential component of health care delivery participated in the project.

    These organizations illustrate different approaches to care models that work well today. Their examples can provide ACO designers a guide to alternatives for integrating medication therapy into the ACO models they are building.

    “New models of healthcare delivery will only improve patient outcomes and control system costs with careful attention to the pharmacy issues,” said Dan Mendelson, CEO of Avalere Health. “Proper alignment of economic incentives, ensuring that cost burden does not disproportionately fall on patients, meaningful quality metrics, and medication management programs need to be carefully contemplated as ACOs and other models of integration are developed.”

    The primary audience for this document is health care executives in integrated delivery systems, multi-specialty group practices, physician-hospital organizations, independent practice organizations, virtual physician organizations and consultants who are, or may be tasked, with developing an ACO in preparation for contracting with CMS.

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