EXCLUSIVE PHARMACY TECHNOLOGY CONTENT
Star Standards: Are You Ready to Reinvent Your Career with the Changes in Healthcare?
By Al Babbington, CEO, PrescribeWellness
Pharmacists, your careers just became much more exciting. With the implementation of the Affordable Care Act, pharmacy professionals can seize the opportunity to become more proactive and forever shed the image of being reactive order takers.
The ACA represents the most significant healthcare system overhaul since the 1965 passage of Medicare and Medicaid. It will significantly change how $600 billion in Medicare spending and $2.5 trillion in healthcare costs will be distributed.
The emphasis is on improving patient outcomes while reducing costs, and pharmacies are at the center of this trend. Everyone is looking for ways to improve patient knowledge about the prevention and treatment of chronic disease. To become a part of this revolution, start by following the money. Every year, each Medicare Advantage Plan is rated on a scale of 1 to 5 “Stars” based on how well the plan performs in several key areas. The CMS is now using the Star rating system as a financial incentive to reward quality plans with bonuses and rebates. Medicare Advantage plans will focus on improving Star standards to increase rebates and to attract new patients likely to choose top-rated plans.
You can take steps to assure your patient population performs well with Star standards. By sharing this data, you will find employers, ACOs, Advantage Plans and other organizations sending additional patients your way. The areas that will have the greatest impact are medication adherence, chronic disease management, and other care gaps such as screenings, immunizations, and support for transitional care. Prescription drug measurements are triple weighted and combined with clinical quality measures that improve with adherence (e.g., cholesterol and blood pressure control measures), accounting for as much as 22%of the overall Star ratings. Interventions released to diabetes treatments and high-risk medications will also contribute to improved Star standards.
Pharmacists can start taking positive steps to position their business at the center of community wellness:
- Provide timely and relevant educational, behavioral, and motivational communications to improve patient loyalty and adherence.
- Offer medication reconciliation or full MTM services for patients on three or more meds.
- Offer med-time reminders and other opt-in digital support communications.
- Consider Simplify My Meds or other appointment-based medication services.
- Offer support tools to improve knowledge and skills for diabetes management.
- Consider offering monthly classes or consulting for patients with chronic disease.
- Identify and recruit at-risk patients for screenings.
- Offer a broad spectrum of immunization services and educate your patients on their importance.
- Offer to do medication reconciliation for newly discharged patients from local hospitals.
- Measure and share your patients’ performance in medication adherence.
Execute on these steps and you will be making history by putting pharmacists at the forefront of the greatest healthcare reform of our time. Your business is where the patient comes first, and your role is key — the path has been cleared for you to achieve greater job satisfaction and patient loyalty than ever before. CT