The value of pharmacists within and beyond value-based care

The Association Report column in JAPhA reports on activities of APhA’s 3 academies and topics interest to members those groups.The APhA Academy Pharmacy Practice Management (APhA--APPM) is dedicated assisting enhancing the profession pharmacy, improving medication use, advancing patient care. Through APhA–APPM Special Interest Groups (SIGs), provides a mechanism network support profession, by addressing emerging issues. To learn more about access listing APhA—APPM SIGs, visit https://www.pharmacist.com/apha-academy-pharmacy-practice-and-management.The mission Research Science (APhA--APRS) stimulate discovery, dissemination, application research improve health. are source authoritative information key scientific issues work advance pharmaceutical sciences quality pharmacy practice. APhA--APRS Sections (Clinical Sciences; Basic Pharmaceutical Economic, Social, Administrative Sciences), for experts all areas influence policymaking process. APhA--APRS, https://www.pharmacist.com/apha-academy-pharmaceutical-research-and-science.The Student Pharmacists (APhA–ASP) be collective voice student pharmacists, provide opportunities professional growth, care, envision future pharmacy.The written Officers respective coordinated staff. Suggestions content may sent Margaret Tomecki, Director, Academies ( [email protected] ). groups. https://www.pharmacist.com/apha-academy-pharmacy-practice-and-management. https://www.pharmacist.com/apha-academy-pharmaceutical-research-and-science. pharmacy. push value-based care gained traction 2010 with Michael Porter’s article, “What value health care?”1Porter M.E. What care?.N Engl J Med. 2010; 363: 2477-2481Crossref PubMed Scopus (2978) Google Scholar This set foundation turn care’s focus from volume, quotas, “fee-for-service” repayment outcomes through (VBHC) repayment. Porter skillfully dissects opposition VBHC giving examples how challenges comprehensive outcome measurement can overcome. By 2012, Institute Healthcare Improvement had identified as potential in-road optimizing U.S. system performance, describing their goal triple aim “Improving experience (including satisfaction); populations; reducing per capita cost care.”2Institute ImprovementThe IHI aim.http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspxDate accessed: September 13, 2021Google A decade ago, idea United States have been considered mostly fiction. In 2013, there were just 6 programs that linked payment value. January 2020, nearly 50 many which operating than 4 years federal backing. One leader this space Center Medicare Medicaid Services (CMS), reaching 90% its having component 2018.3Value-Based Care America: State-By-State.http://images.discover.changehealthcare.com/Web/ChangeHealthcare%7Ba7b8bcb8-0b4c-4c46-b453-2fc58cefb9ba%7D_Change_Healthcare_Value-Based_Care_in_America_State-by-State_Report.pdfDate 12, Scholar,4MacLean C.H. Kerr E.A. Qaseem A. Time out—charting path performance measurement.N 2018; 378: 1757-1761Crossref (81) CMS firmly believes average population growing older (e.g. silver tsunami5RevCycleIntelligenceTransitioning while risks.https://revcycleintelligence.com/news/transitioning-to-value-based-care-while-reducing-risksDate 15, Scholar), must refocus outcomes, rather quantity new economy landscape.6Comlossy M. Walden J. tsunami: states fairly long to-do list get ready needs an aging America.State Legis. 2013; 39: 14-19Google Scholar,7Bluethmann S.M. Mariotto A.B. Rowland J.H. Anticipating “silver tsunami”: prevalence trajectories comorbidity burden among cancer survivors States.Cancer Epidemiol. Biomarkers Prev. 2016; 25: 1029-1036Crossref (536) appears committed despite global pandemic, 2 programs, Primary First model Hospital Value-Based Purchasing (VBP) Program, launched 2021 supplement other currently underway. For VBP, describes weighted criteria acute reimbursement “Clinical Outcomes (25%), Person Community Engagement Safety Efficiency Cost Reduction (25 %).”8Hospital purchasing program. CMS. Available at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/Hospital-Value-Based-Purchasing-. Accessed 2021.Google method or process analyzing grading provided surpasses “quantity” we come know. At heart these models inclusion social determinants (SDoH), not only create equity but also preserve resources, ultimately reduce costs personalizing plans. SDoH include domains such access, economic stability, education level, community support, built environment.9Centers Disease Control PreventionAbout (SDOH).https://www.cdc.gov/socialdeterminants/about.htmlDate With these, providers might ask themselves: “Is my food insecure? How has impacted current illness ability recover?” “Does transportation? Can they go pick up make next visit?” Studies done patients between 2009 2014 demonstrate providing transitions services “making interventions transportation, housing conditions establish linkages reduced 30-day readmissions well total healthcare cost.”10Larimer Malone D.K. Garner M.D. et al.Health public service use before after provision chronically homeless persons severe alcohol problems.JAMA. 2009; 301: 1349-1357Crossref (416) Scholar, 11Boutwell A.E. Johnson M.B. Watkins R. Analysis work–based transitional hospital readmissions: preliminary data.J Am Geriatr Soc. 64: 1104-1107Crossref (17) 12De Jonge K.E. Jamshed N. Gilden D. Kubisiak Bruce S.R. Taler G. Effects home-based primary high-risk elders.J 2014; 62: 1825-1831Crossref (125) Ultimately, making commonplace our estimated $1.7 trillion annual savings costs.13Social Trillion opportunity slash spending. IT News, April 10, 2018https://www.healthcareitnews.com/news/social-determinants-health-and-17-trillion-opportunity-slash-spendingDate However, study published American Medical showed, 2019, “24% hospitals 16% physicians screen at all.”14Fraze T.K. Brewster A.L. Lewis V.A. Beidler L.B. Murray G.F. Colla Prevalence screening insecurity, instability, utility needs, transportation interpersonal violence US physician practices hospitals.JAMA Network Open. 2019; 2e1911514Crossref (102) Enter most accessible provider.15Manolakis PG, Skelton JB. Pharmacists' contributions collaborating address unmet needs: role pharmacists shortage providers. Pharm Educ. 2010;74(10)(suppl7):S7.Google importance adequately preparing practice lead comes into focus. Accreditation Council Education (ACPE) regularly monitors considers data, trends, within space. As result, first time, 2007, ACPE Standards changed cultural diversity16Accreditation Education. 2007. https://www.acpe-accredit.org/pdf/S2007Guidelines2.0_ChangesIdentifiedInRed.pdf. one required PharmD program, teaching recognize different based patient’s background. culture stand-in background worldview. Therefore, standards again 2016, adding education.17Accreditation elements program leading doctor degree. Standards.https://www.acpe-accredit.org/pdf/Standards2016FINAL.pdfDate: 2016Date standardized implementation learning remains vague. review active found schools indeed students operate compassion culturally competent gap where understanding (e.g., literacy) socioeconomic stability) environmental factors housing, neighborhood) taught far less understood.18Kiles T. Jasmin H. Nichols B. Haddad Renfro C.P. scoping active-learning strategies pharmacy.Am 2020; 84: 8241Crossref (9) Teaching adjust lectures labs then applying them Introductory Experience Advanced Experiences (APPE) experiences crucial real-world models. plan this, colleges should consider strategic partnerships when identifying securing final-year APPE rotations. example, placing being practiced. because rotations fundamental shaping students’ interests, career goals, networking. emphasis clinical training could numerous downstream effects, expansion postgraduate focused VBHC. Finally, policy advocacy important ways impact become familiar Unfortunately, Medicare, outcome-based repayment, continues decline providers.19Medicare provider status recognition. Association.https://www.pharmacist.com/Advocacy/Issues/Medicare-Provider-Status-RecognitionDate Scholar,20The Grassroots PharmacistProvider Status Explained: Do Advocate Provider Status.https://grassrootsrph.com/2021/04/25/provider-status-explained-what-pharmacists-can-do-to-advocate-for-provider-status/Date pharmacist, it help positively decrease mortality, costs, increase adherence treatment management chronic conditions. organizations like APhA–ASP, foster leadership involvement, unique concerns, advocate communicate local national leaders participating various care–related demonstration projects initiatives. APhA–ASP engage fellow across country, www.pharmacist.com/apha-asp today. Zachary Coleman, Final-year Candidate, Washington State University College Sciences, Spokane, WA; Chair, 2021–22 Policy Standing Committee; E-mail: