Here at Apex we’re thinking a lot about the proposed changes in today’s healthcare system and what they really mean for pharmacists and consumers. Despite the shifting winds of healthcare reform in politics or around the kitchen table, the pharmacist’s role will undoubtedly expand. Because of the Accountable Care Act (ACA) that President Obama signed into law this year, numerous provisions have been designed to increase care coordination through interdisciplinary health teams. Pharmacists will have new opportunities in integrated care partnerships involving providers, patients, employers and insurers according to Bruce Stuart, professor at the University of Maryland School of Pharmacy. The ACA provides for a care delivery system called the Accountable Care Organization (ACO) which focuses on primary care with responsibility for coordination of all specialty services. “One of the health reform law’s elements most dear to the hearts of pharmacists is a provision offering grants to community pharmacists to develop medication therapy management (MTM) services,” said Stuart. Good medication management procedures are key to effective care coordination and this is where pharmacists can play a major role.
Models of MTM services have been proposed by many pharmacy and retail organizations and strive to improve collaboration and communication among pharmacists and other members of the healthcare team in order to improve patient outcomes. Perhaps most important is the emphasis on empowering patients to take an active role in managing their medications. This means that MTM services would shift from the present medication dispensing , product-centered model to a patient-centered one and would encompass the assessment and evaluation of a patient’s complete medication therapy regimen, rather than focusing on individual medication products. And, since according to the American Pharmacists Association, some 1.5 million preventable medication errors costing over $177 billion in terms of morbidity and mortality occur in the US annually, change is long overdue. One argument against healthcare reform is that it costs too much. But such arguments fade in light of the fact that as changes in the way healthcare is delivered are instituted, more efficient and accurate methods will prevent deaths and injuries, in turn saving money.
The idea of healthcare and how it should be delivered is shifting among practitioners in the US, if not yet among politicians. The vision is more holistic, and proposes a team approach in which treatments and medications are instituted through communication and collaboration among medical specialists with the patient/consumer at the center, as opposed to outside of his own care. In this new model there are fewer errors and less replication of tests and treatments, saving money. Through consumer education an emphasis is put on prevention rather than cure, further reducing costs. But money cannot be the only consideration when considering healthcare reform. In the end care of our health is a personal issue which speaks to the well-being of our families and institutions, not just our bank accounts. New approaches to keeping us well, such as MTM services, are clearly called for; by partnering with members of the health care team and encouraging collaboration between medical specialties, the image of bettering our lives through an efficient, accessible healthcare system comes into focus.