Are ACOs Ready to be Accountable for Medication Use?

Dubois, Robert W.; Feldman, Marv; Lustig, Adam; Kotzbauer, Greg; Penso, Jerry; Pope, Scott D.; Westrich, Kimberly

doi:10.18553/jmcp.2014.20.1.17

Cited by 14 publications

(21 citation statements)

References 7 publications

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“…Previous research has shown that although medications are a critical component to achieving the lower costs and improved quality in this model, ACOs have yet to fully optimize the utilization of medications to meet these goals. 2 Adverse drug events are a leading cause of morbidity and mortality in the United States. The Patient Safety and Clinical Pharmacy Services Collaborative, a national quality improvement effort administered through the Health Resources and Services Administration, defines potential adverse drug events (pADEs) as "medication errors that were identified and stopped with appropriate interventions before harming the patient."…”

mentioning

confidence: 99%

Best Practices: An Electronic Drug Alert Program to Improve Safety in an Accountable Care Environment

Griesbach¹,

Lustig²,

Malsin³

et al. 2015

JMCP

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BACKGROUND: The accountable care organization (ACO), one of the most promising and talked about new models of care, focuses on improving communication and care transitions by tying potential shared savings to specific clinical and financial benchmarks. An important factor in meeting these benchmarks is an ACO's ability to manage medications in an environment where medical and pharmacy care has been integrated. The program described in this article highlights the critical components of Marshfield Clinic's Drug Safety Alert Program (DSAP), which focuses on prioritizing and communicating safety issues related to medications with the goal of reducing potential adverse drug events.

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mentioning

confidence: 99%

Best Practices: An Electronic Drug Alert Program to Improve Safety in an Accountable Care Environment

Griesbach¹,

Lustig²,

Malsin³

et al. 2015

JMCP

Self Cite

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show abstract

“…Dubois et al concluded that though some ACOs have developed key information technologies to manage prescription drug use, there are critical gaps in their preparedness, and current progress is likely a response to the Medicare electronic health record incentive program, which pays providers to use technology to improve patient care. 18 The study by Dubois et al . did not evaluate ACO’s broader strategies to manage drug use or their accountability for pharmacy spending.…”

Section: Discussionmentioning

confidence: 99%

“…Effective measures could incentivize use of the safest and most effective drugs, while incorporating some degree of cost management (e.g., financial penalties for medication errors; rewarding clinicians for pursuing appropriate, cost-effective alternatives to medication; penalties for use of drugs without proven clinical benefit or risk of harm). 17,18 Such measures would encourage ACOs to implement a broad program to manage prescription drug use, rather than narrow initiatives related to specific intermediate outcomes (e.g., blood pressure).…”

Section: Discussionmentioning

confidence: 99%

Role of Pharmacy Services in Accountable Care Organizations

Colla

Lewis²,

Beaulieu‐Jones³

et al. 2015

JMCP

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Background The accountable care organization (ACO) model being adopted across the U.S. aims to improve patient care and reduce costs. Little is known about whether commercial ACO contracts include accountability for prescription drug spending or how ACOs are engaging outpatient pharmacies and managing prescription drug use. Objective To explore how ACOs are addressing drug spending and pharmacy services, a potentially important determinant of both quality and total spending. Methods We use data from two waves of the National Survey of ACOs (N=270), a survey completed by ACOs that were established prior to July 2013. ACO executives were asked about ACO engagement of pharmacy services, pharmacy-related health information technology capabilities, and ACO accountability for prescription drug spending. Results Among ACOs with commercial contracts, 77% report being held responsible for prescription spending by their largest contract. Considering all ACOs (Medicare, Medicaid and/or commercial contracts), 45% report at least one contract includes prescription drug spending responsibility. Nearly half of ACOs report a formal relationship with a pharmacy; 26% include a pharmacy within the ACO; and 19% have contracted pharmacy services. On average, compared to those that do not, ACOs engaging pharmacies have a broader range of services and provider types, both commercial and public contracts, and greater experience with payment reform. Conclusion Management of pharmacy services and prescription spending will likely influence commercial ACO contract success. Given the broad potential impact of prescription use on overall spending and quality, payers might encourage integration of pharmacy services in ACOs through prescribing quality and prescription spending performance measures.

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“…1 One of the most important and often overlooked challenges for ACOs is ensuring the optimal use of pharmaceuticals, which can be accomplished by utilizing pharmacists' skillsets and leveraging their full clinical expertise. 2 With some ACOs struggling to effectively manage medication-related capabilities, organizations should look for effective ways to leverage pharmacists as an integral part of patient care. One such way to take advantage of pharmacist skill and expertise is through medication therapy management (MTM) programs.…”

Section: What This Study Addsmentioning

confidence: 99%

“…One such way to take advantage of pharmacist skill and expertise is through medication therapy management (MTM) programs. 3 Developing capabilities that support, monitor, and ensure appropriate medication use, efficacy, and safety is critical to achieving optimal patient outcomes and, ultimately, to an ACO's success. MTM is defined by the American Pharmacists Association as a service or group of services that optimizes therapeutic outcomes for individual patients and may include medication therapy reviews, pharmacotherapy consults, anticoagulation management, and many other clinical services.…”

Section: What This Study Addsmentioning

confidence: 99%

Best Practices: Improving Patient Outcomes and Costs in an ACO Through Comprehensive Medication Therapy Management

Brummel

Lustig²,

Westrich³

et al. 2014

JMCP

Self Cite

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BACKGROUND: One of the most important and often overlooked challenges for accountable care organizations (ACOs) is ensuring the optimal use of pharmaceuticals, which can be accomplished by utilizing pharmacists' skillsets and leveraging their full clinical expertise. Developing capabilities that support, monitor, and ensure appropriate medication use, efficacy, and safety is critical to achieving optimal patient outcomes and, ultimately, to an ACO's success. The program described in this article highlights the best practices of Fairview Pharmacy Services' Medication Therapy Management (MTM) program with additional thoughts and considerations on this and similar MTM programs provided by The Working Group on Optimizing Medication Therapy in Value-Based Healthcare.

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Are ACOs Ready to be Accountable for Medication Use?

Cited by 14 publications

References 7 publications

Best Practices: An Electronic Drug Alert Program to Improve Safety in an Accountable Care Environment

Best Practices: An Electronic Drug Alert Program to Improve Safety in an Accountable Care Environment

Role of Pharmacy Services in Accountable Care Organizations

Best Practices: Improving Patient Outcomes and Costs in an ACO Through Comprehensive Medication Therapy Management

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