Content about Presidency of Lyndon B. Johnson

January 10, 2014

One of the principles of association leadership says that an association should reflect the membership. Hopefully, NACDS’ approach to member service has resembled the can-do spirit of community pharmacy during the launch of exchange-based insurance.

One of the principles of association leadership says that an association should reflect the membership. Hopefully, NACDS’ approach to member service has resembled the can-do spirit of community pharmacy during the launch of exchange-based insurance. 
 

February 19, 2013

By now we are all well aware of the healthcare IT transformation taking place across the nation. This transformation is expected to continue for the foreseeable future with further implementation of Meaningful Use and the expansion of state Medicaid programs in 2014 as a result of the Patient Protection and Affordable Care Act requirements. Providing clinical services through the coordination of care among a variety of providers in the healthcare space will continue to be a focal point in the future of healthcare as well. For example, we will likely see more elaborate collaborative care models through the expansion of accountable care organizations, patient centered medical home efforts, and the development of health insurance exchanges in one form or another.

By now we are all well aware of the healthcare IT transformation taking place across the nation. This transformation is expected to continue for the foreseeable future with further implementation of Meaningful Use and the expansion of state Medicaid programs in 2014 as a result of the Patient Protection and Affordable Care Act requirements. Providing clinical services through the coordination of care among a variety of providers in the healthcare space will continue to be a focal point in the future of healthcare as well.

February 5, 2013

Money is a powerful motivator. Look no further than the sports world for validation. The PGA’s FedEx Cup encourages golfers to earn “points” towards participation in playoffs that offer a big season-ending payoff. Tennis has a similar format with the U.S. Open Series where performance in a series of events equates to a huge prize purse. Both instances use hefty prize money to help ensure the top performers participate and at high levels. The Centers for Medicare and Medicaid Services (CMS) have applied this sports theory to its rankings system of Medicare Advantage (MA) and Prescription Drug Plans (PDP) plans. And there’s billions of dollars up-for-grabs for healthcare plans.

Money is a powerful motivator. Look no further than the sports world for validation. The PGA’s FedEx Cup encourages golfers to earn “points” towards participation in playoffs that offer a big season-ending payoff. Tennis has a similar format with the U.S. Open Series where performance in a series of events equates to a huge prize purse. Both instances use hefty prize money to help ensure the top performers participate and at high levels.

August 28, 2012

CVS Caremark and the Centers for Medicare and Medicaid Services have teamed up to increase awareness of the new services available under the Patient Protection and Affordable Care Act. To announce the partnership and highlight new benefits and options for Medicare beneficiaries, U.S. Health and Human Services Secretary Kathleen Sebelius recently visited a CVS/pharmacy and MinuteClinic in Jacksonville, Fla.

WOONSOCKET, R.I. — CVS Caremark and the Centers for Medicare and Medicaid Services have teamed up to increase awareness of the new services available under the Patient Protection and Affordable Care Act. To announce the partnership and highlight new benefits and options for Medicare beneficiaries, U.S. Health and Human Services Secretary Kathleen Sebelius recently visited a CVS/pharmacy and MinuteClinic in Jacksonville, Fla.

April 9, 2014

Emphasizing implementation challenges that could impact patient access to pharmacy services, a coalition is urging Secretary of Health and Human Services Secretary Kathleen Sebelius to allow a one-year transition period for states to fully implement the Medicaid average manufacturer’s price-based federal upper limits for prescription medications.

ARLINGTON, Va. — Emphasizing implementation challenges that could impact patient access to pharmacy services, a coalition is urging Secretary of Health and Human Services Secretary Kathleen Sebelius to allow a one-year transition period for states to fully implement the Medicaid average manufacturer’s price-based federal upper limits for prescription medications.

April 4, 2014

Hospital patients who participated in Walgreens' WellTransitions program were 46% less likely to experience an unplanned hospital readmission within 30 days of discharge, according to new company research released Friday.

DEERFIELD, Ill. — Hospital patients who participated in Walgreens' WellTransitions program were 46% less likely to experience an unplanned hospital readmission within 30 days of discharge, according to new company research released Friday. 

April 2, 2014

Symphony Health Solutions on Wednesday released research on the affects of the Affordable Care Act on Medicaid drug spending.

HORSHAM, Pa. — Symphony Health Solutions on Wednesday released research on the affects of the Affordable Care Act on Medicaid drug spending.

The research found that prescription claims for Medicaid patients increased in January by 10% and in February by 14% over the same periods last year. The study also uncovered that average out-of-pocket cost for contraceptives has dropped more than 58% since 2012.

March 28, 2014

More smokers would quit if state Medicaid programs covered more cessation treatments and removed barriers to coverage, according to a Centers for Disease Control and Prevention study published in Thursday's Morbidity and Mortality Weekly Report.

ATLANTA — More smokers would quit if state Medicaid programs covered more cessation treatments and removed barriers to coverage, according to a Centers for Disease Control and Prevention study published in Thursday's Morbidity and Mortality Weekly Report.  

“There’s evidence suggesting that smokers enrolled in Medicaid, like other smokers, want to quit and will take advantage of covered cessation treatments to help them quit for good,” commented Stephen Babb, co-author of the article. 

March 26, 2014

Message to federal health plan payers from community pharmacy: We have the systems in place and the professional expertise to help millions of patients to better their health outcomes at a lower cost. Message to pharmacy from the U.S. Department of Health and Human Services and its Centers for Medicare and Medicaid Services: Prove it.

Message to federal health plan payers from community pharmacy: We have the systems in place and the professional expertise to help millions of patients to better their health outcomes at a lower cost. Message to pharmacy from the U.S. Department of Health and Human Services and its Centers for Medicare and Medicaid Services: Prove it.

March 12, 2014

Citing pharmacist-administered medication therapy management, recognition of pharmacists as healthcare providers, the need for fair and accurate pharmacy reimbursement in state Medicaid programs and other pharmacy services, the National Association of Chain Drug Stores has sent a statement to lawmakers urging them to consider pharmacy provisions within the “Fiscal 2015 Budget,” released by the administration last week.

ARLINGTON, Va. – Citing pharmacist-administered medication therapy management, recognition of pharmacists as healthcare providers, the need for fair and accurate pharmacy reimbursement in state Medicaid programs and other pharmacy services, the National Association of Chain Drug Stores has sent a statement to lawmakers urging them to consider pharmacy provisions within the “Fiscal 2015 Budget,” released by the administration last week.

March 11, 2014

The Centers for Medicare and Medicaid Services has decided not to move forward on several of the proposed provisions of the Medicare Advantage and Part D prescription drug program, according to reports.

WASHINGTON — The Centers for Medicare and Medicaid Services has decided not to move forward on several of the proposed provisions of the Medicare Advantage and Part D prescription drug program, according to reports.

March 11, 2014

Bipartisan legislation that would designate pharmacists as healthcare providers under the Medicare program was introduced in the U.S. House of Representatives on Tuesday. The bill would amend The Social Security Act of 1935 to enable pharmacists to work to their full capability by providing underserved patients in the Medicare program with services not currently available to them.

ARLINGTON, Va. — Bipartisan legislation that would designate pharmacists as healthcare providers under the Medicare program was introduced in the U.S. House of Representatives on Tuesday. The bill would amend The Social Security Act of 1935 to enable pharmacists to work to their full capability by providing underserved patients in the Medicare program with services not currently available to them.

February 18, 2014

Now that most generics have declined in cost, plans will look for new ways to control health spend and ensure that generics are being used whenever possible.

Now that most generics have declined in cost, plans will look for new ways to control health spend and ensure that generics are being used whenever possible. Prescription drug spending is down, and generic drugs made up 77% of all 2012 prescriptions, according to the Centers for Medicare and Medicaid Services. Could this generic utilization percentage go even higher as a result of recent healthcare legislation?

Medicaid is increasingly becoming a managed care program, and states are looking to entities like pharmacy benefit managers to help them manage their drug spend.

February 18, 2014

The federal agency in charge of Medicare is pushing for a major overhaul of its Medicare Part D drug benefit program for seniors.

The federal agency in charge of Medicare is pushing for a major overhaul of its Medicare Part D drug benefit program for seniors. Those changes, if adopted, could help level the competitive playing field for pharmacy retailers in Part D plan networks, reduce competitive advantages for preferred pharmacy networks and mail-order pharmacies, and put a tighter squeeze on pharmacy benefit managers.

Thus, the proposals by the Centers for Medicare and Medicaid Services for the 2015 federal fiscal year could spell big changes for retail pharmacies. Among the most far-reaching are:

February 12, 2014

A Medicare proposed rule change limiting the number of prescription drug plans that insurers may offer in the Part D market could require 39% of all enhanced plans to be eliminated in 2016, according to an analysis from Avalere Health that was released Wednesday.

WASHINGTON — A Medicare proposed rule change limiting the number of prescription drug plans that insurers may offer in the Part D market could require 39% of all enhanced plans to be eliminated in 2016, according to an analysis from Avalere Health that was released Wednesday. The change, which limits standalone PDP sponsors to one basic and one enhanced plan per region, was proposed by the Centers for Medicare and Medicaid Services in a January proposed regulation. 

February 12, 2014

Members of Congress are contacting the U.S. Centers for Medicare and Medicaid Services in support of pro-patient improvements the agency proposed for Medicare Part D prescription drug plans in 2015, a development applauded today by the National Community Pharmacists Association.

ALEXANDRIA, Va. — Members of Congress are contacting the U.S. Centers for Medicare and Medicaid Services in support of pro-patient improvements the agency proposed for Medicare Part D prescription drug plans in 2015, a development applauded today by the National Community Pharmacists Association.

In response to problems with “preferred pharmacy” networks, CMS has proposed allowing any willing pharmacy to offer a plan’s lowest, or preferred, cost-sharing to give seniors more choice and to foster greater competition among pharmacies. 

February 7, 2014

In a report released by the U.S. Government Accountability Office, the GAO found that the total draft federal upper limits amount based on the new formula under the Patient Protection and Affordable Care Act was about 1.4% lower than the total National Average Drug Acquisition Cost amount in aggregate for 1,035 outpatient drugs subject to the FUL in first quarter 2013.

WASHINGTON — In a report publicly released Thursday by the U.S. Government Accountability Office, the GAO found that the total draft federal upper limits amount based on the new formula under the Patient Protection and Affordable Care Act was about 1.4% lower than the total National Average Drug Acquisition Cost amount in aggregate for 1,035 outpatient drugs subject to the FUL in first quarter 2013.

January 31, 2014

Interim financial results for 114 ACOs that began work in 2012 show that they generated $128 million in savings for the Medicare trust fund in the first year, the Centers for Medicare and Medicaid Services reported in a blog posted Thursday.

WASHINGTON — Interim financial results for 114 ACOs that began work in 2012 show that they generated $128 million in savings for the Medicare trust fund in the first year, the Centers for Medicare and Medicaid Services reported in a blog posted Thursday. Additionally, initial results from an independent evaluation of 23 Pioneer ACOs, which are those that have more experience with coordinated care, show that they saved the Medicare program $147 million in their first year of operation.

January 23, 2014

When selecting an exchange health plan under the Affordable Care Act, consumers should be able to evaluate plans’ success in medication management, among other quality measures, the National Association of Chain Drug Stores stated in comments to the Centers for Medicare and Medicaid Services.

ARLINGTON, Va. — When selecting an exchange health plan under the Affordable Care Act, consumers should be able to evaluate plans’ success in medication management, among other quality measures, the National Association of Chain Drug Stores stated in comments to the Centers for Medicare and Medicaid Services.

Specifically, NACDS urged CMS to adopt measures related to medication adherence and appropriate medication use as part of its Quality Rating System for Qualified Health Plans, which are offered through health insurance exchanges.

January 15, 2014

Reform of eligibility criteria for MTM services would improve access to care for seniors and boost medication adherence, according to an article co-authored by Laura Miller, senior economist with the National Association of Chain Drug Stores.

ARLINGTON, Va. — Reform of eligibility criteria for MTM services would improve access to care for seniors and boost medication adherence, according to an article co-authored by Laura Miller, senior economist with the National Association of Chain Drug Stores.

The article — titled “Should Eligibility for Medication Therapy Management be Based on Drug Adherence?” — is in the January 2014 Journal of Managed Care Pharmacy.

January 7, 2014

Growth in health spending has slowed in recent years, including spending by private and public payers, according to data released by the Centers for Medicare and Medicaid Services that also found a small contribution to the lower growth from the healthcare reform law.

WASHINGTON — Growth in health spending has slowed in recent years, including spending by private and public payers, according to data released Monday by the Centers for Medicare and Medicaid Services that also found a small contribution to the lower growth from the healthcare reform law.

January 7, 2014

The National Community Pharmacists Association on Tuesday expressed support of several policy changes proposed by the Centers for Medicare and Medicaid Services.

ALEXANDRIA, Va. — The National Community Pharmacists Association on Tuesday expressed support of several policy changes proposed by the Centers for Medicare and Medicaid Services, according to a document filed in the Federal Register. 

January 6, 2014

InComm, a leading prepaid product and transaction services company, announced that six health plans across Arizona and Texas will be providing over-the-counter benefits through Medagate, InComm's healthcare platform.

ATLANTA — InComm, a leading prepaid product and transaction services company, on Monday announced that six health plans across Arizona and Texas will be providing over-the-counter benefits through Medagate, InComm's healthcare platform. 

January 3, 2014

Adults who are covered by Medicaid use emergency rooms 40% more than those in similar circumstances who do not have health insurance, according to a new study, co-authored by an MIT economist, that sheds empirical light on the inner workings of health care in the United States.

CAMBRIDGE, Mass. — Adults who are covered by Medicaid use emergency rooms 40% more than those in similar circumstances who do not have health insurance, according to a new study co-authored by an MIT economist that sheds empirical light on the inner workings of health care in the United States.

The study takes advantage of Oregon's recent use of a lottery to assign access to Medicaid, the government-backed healthcare plan for low-income Americans, to certain uninsured adults. The research examines emergency room records for roughly 25,000 people for a period of 18 months.

December 23, 2013

The Centers for Medicare and Medicaid Services is encouraging health plans to cover patients' existing non-formulary drugs as though they were formulary drugs for the first 30 days after the Jan. 1 rollout of the insurance coverage provided under the Patient Protection and Affordable Care Act.

ARLINGTON, Va. — The Centers for Medicare and Medicaid Services is encouraging health plans to cover patients' existing non-formulary drugs as though they were formulary drugs for the first 30 days after the Jan. 1 rollout of the insurance coverage provided under the Patient Protection and Affordable Care Act.