Former CMS, FDA chief McClellan helps frame timeline for real health reform

DENVER – Pharmacy is in a state of deep transformation, but it could take some time for the trend to gain traction.

That was one of the messages behind a keynote speech delivered Monday morning at the National Association of Chain Drug Stores' Pharmacy & Technology Conference in Denver on the dynamics, challenges and opportunities of healthcare reform. The speaker, Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institute, also said that regardless of the outcome of the 2012 elections, the retail pharmacy industry will be called to step up. “The trend toward more personalized care outside traditional institutions will continue,” McClellan said.

In addition, regardless of the elections, there will be a continued trend toward limited Medicaid and employer health coverage, a tighter Medicaid financing environment. “It's going to be a much tougher environment for health care at the federal and state levels than we've ever faced before,” the former head of CMS and FDA  told NACDS attendees.

Still, according to McClellan, the overriding goal of healthcare reform remains the same: improving care while reducing costs; but lowering prices and expanding insurance wouldn't be enough. The risk is that efforts to lower costs can lower quality as well. “The payment rates go down, and the quality of care is squeezed,” McClellan said. Meanwhile, allowing healthcare costs to rise risks squeezing out funding for other services like infrastructure, research and development and education, he said. This created a need to get out of the “vicious circle” of holding healthcare costs down while not improving quality and outcomes.

In the meantime, he said, pharmacy would have a significant role to play in the drive to achieve better outcomes, including helping in the management of disease states like diabetes and cardiovascular disease through services like improving medication adherence. “Those are treatable chronic diseases – lots of opportunities to improve quality and reduce costs there,” McClellan said. “There are opportunities to build on pharmacy leadership.”

Other opportunities included preventive services and partnerships with other providers like hospitals and physicians.