What Role Do Pharmaceuticals Play in Accountable Care Organizations?

Pharmaceuticals can play an important role in helping to deliver value-based care and minimizing overall costs while meeting recognized standards for quality patient care, according to a recent report published in the American Journal of Managed Care.  

The report is a collaborative effort among the National Pharmaceutical Council, American Medical Group Association and Premier healthcare alliance, along with seven provider organizations. Participants formed the Working Group on Optimizing Medication Therapy in Value-Based Healthcare to consider how pharmaceuticals fit into accountable care organizations and similar care models.

"Value-based care programs need to leverage every available strategy to address the greatest challenges facing our healthcare system — the unsustainable escalation of costs and the fragmented nature of care," Marv Feldman, RPh, MS, managing principal of Premier's Pharmacy Consulting Program and co-author of the article, said in a statement. "Medications are important assets in helping providers achieve these objectives."

Here are five findings from the report:
  • Success in a value-based environment will depend on understanding how medications contribute to care and then optimally using them across conditions and populations.
  • Medications should not be viewed as a "siloed expense." Instead, they should be integrated so that the cost offsets and quality benefits resulting from medication use can be calculated in a shared savings plan.
  • Medication therapy management cannot be undertaken as a one-size-fits-all approach. The role of medication in care will vary by condition.
  • Composite risk can be used to identify patients who are candidates for medication therapy to watch for drug-drug, drug-disease or polypharmacy concerns.
  • Where there are incentives to achieve economic savings in value-based care, there should also be a quality metric to detect the under-use of pharmaceuticals.

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BCBS of North Carolina, Wilimington Health Launch ACO

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