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OBJECTIVE: To examine the federal government's current health care initiatives in the Centers for Medicare and Medicaid Services (CMS) to improve quality of care and cost-effectiveness around the prescription drug benefit. SUMMARY: The government has a unique perspective on quality and outcome. Pharmacists need a working knowledge of 3 areas: (1) Medicare Part D, (2) medication therapy management efforts, and (3) demonstration projects. All of these will make demands on health care providers but should result in better outcomes data and patient care. All of these areas also have value components, and all have strategic implications as 2006 moves into 2007.CONCLUSION: CMS does not consider managing cost and providing value to be mutually exclusive and is attempting to move America's health care toward a valuebased program.

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OBJECTIVE: To present the issues, concerns, and advances possible as private (commercial) payers attempt to incorporate value into their health care plans, using a commercial provider of disease and medication management as a model. SUMMARY: Most approaches to health care have dealt with persistent or chronic diseases, but, increasingly, payers are expanding their interests to include wellness, high-risk case management, and care management. Technology is crucial in health care today, enabling clinicians to reach out to patients, capture data, and integrate medical and pharmaceutical data. Data integration will help build efficiencies and effective ways to deal with the growing population of patients who have chronic disease. The disease-centric model is being replaced with a patient-centric model. Health care providers must help patients identify their unique motivators and demo-tivators and encourage them to be self-sufficient partners in their own health care. CONCLUSION: Adding value to traditional health care is a task that seems daunting at first. It is not insurmountable, however, and ultimately, adding value decreases cost in unprecedented ways.