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• W2318191853 abstract "On June 28, the U.S. Supreme Court upheld the Affordable Care Act (ACA) in a landmark decision that will have widespread repercussions on health care. In a 5–4 vote, the Justices upheld the individual mandate as a tax. But their restrictions on forced Medicaid expansion on state governments could have serious repercussions for the hospitals that must provide care to the uninsured. (See page 12 of this month's issue for the overall pharmacy impact of the decision.) Like previous groundbreaking social legislation, ACA may go down in history as a social game changer—or the controversial law could be restricted, revised, or repealed after this November's elections. Whether through ACA or other changes in the health care system, a tipping point could be approaching for pharmacists, with new opportunities created with the potential to take the profession to the next level. The ruling preserves the law's health care delivery and payment reforms which will provide an enhanced role for health-system pharmacists on interprofessional teams, said the American Society of Health-System Pharmacists chief executive officer, Paul W. Abramowitz, PharmD, FASHP, in a statement. While health-system pharmacy was not a central focus of the highly anticipated Supreme Court ruling, several provisions of the ACA will directly affect pharmacists in this setting. These include the following:■Integrated care models such as accountable care organizations (ACOs), medical homes, and independence at home■Care transitions among hospitals, nursing homes, and the community■Health care-acquired conditions■Value-based purchasing■Hospital readmissions reductions For health-system pharmacists, these and other provisions in the ACA create countless opportunities to improve patient care. Through various aspects of the law, millions of Americans will be given access to health care, said Laura Carpenter, BSPharm, JD, LLM, of Carpenter Law Firm PC, based in Phoenix. Because pharmacists are the most accès sible and respected members of the health care team, we have the opportunity to further educate patients not only about their health and médications, but about the value that pharmacists add to the health care team. As ACA provisions are implemented in the coming years, health-system pharmacists will be moving toward becoming fully engaged in team-based approaches to delivering care. Pharmacist-provided patient care services are critical to the success of new models for care such as ACOs and medical homes. Health-system pharmacists are also playing a key role in transitions of care, including medication reconciliation and discharge planning, and helping to reduce hospital readmissions. Hospitals that have not yet fully integrated pharmacists into their interprofessional teams will be incentivized to further rely on pharmacy departments' expertise, said Carpenter. By hospitals more fully taking advantage of pharmacists' expertise, I feel confident that studies will show that the early involvement of medication experts will help greatly improve patient care, decrease medication-related incidents, and reduce overall health care costs. For example, medication therapy management (MTM) is an area in which health-system pharmacists are already making great improvements in patient care, including helping to reduce readmissions that can seem like a revolving door for patients. Kevin Colgan, Corporate Director of Pharmacy at Rush University Medical Center in Chicago, noted in the July 2010 issue of Pharmacy Today that without pharmacist-delivered MTM services, 30-day readmisrates were 32%. With MTM services, readmission rates were 13%. By advancing MTM, other providers and health insurers will clearly be able to see the value of pharmacists in improving access and reducing overall health care costs, said Carpenter. In addition, the new quality-based payment systems created by the ACA are encouraging health systems to transition the pharmacist's role from compounding and dispensing to providing direct patient care at the bedside and up on the hospital floors. Staff pharmacists will spend a greater percentage of their time reviewing patient charts, developing protocols, educating other hospital staff on medication issues, performing MTM roles, and consulting with physicians, Carpenter said. As the ACA provisions are implemented, health-system pharmacists should be proactive in developing new avenues for pharmacy services. Continue to learn more about how health care reform can help you reach more patients, improve care, and demonstrate the value that pharmacists provide as a key member of the overall health care team, said Carpenter." @default.
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• W2318191853 date "2012-08-01" @default.
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• W2318191853 title "Hospitals make choices after Supreme Court decision" @default.
• W2318191853 doi "https://doi.org/10.1016/s1042-0991(15)31724-2" @default.
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