Four Insights to Prepare your Pharmacy for Value-Based Payments

Nov 28, 2016Independent Pharmacy Insights, Pharmacy Insights, Value Based Payments

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a bill that ushers in new incentive programs for providers working in a value-based care ecosystem. It is the most current, and sweeping, healthcare reform law passed by congress, and it will have lasting effects on healthcare providers, including pharmacists.

Value-based payments are now written into law, and they’re here for the duration

Value-based care is a system of payment that compensates doctors and hospitals for helping keep people healthy and for improving the health of those suffering from chronic conditions in an evidence-based, cost-effective way.

Healthcare providers are now gearing up for the implementation of Value-Based care reimbursement, due to go into effect January 1, 2017.

As a pharmacy owner, your organization should also be preparing for this implementation. With the kick-off date just a few weeks away, we did some digging and found the following four insights significant in their ability to help your pharmacy meet the MACRA requirements efficiently and effectively:

  1. All healthcare is local, and by keeping the solutions local, pharmacists can be more effective. Consider health-related groups that tackle the correct way for diabetics to eat, or lifestyle groups that focus on stress reduction. Incorporating workshops and small groups such as these into your pharmacy’s offerings can help keep long-term maintenance care local, making it convenient, accessible, and more likely to be effective.
  2. High Quality! One way to deliver higher quality service is to use the team approach. Your team will now be more than your employees. Pharmacies must remember that the patient is now at the center of that team. Listen to them, their thoughts are invaluable. Incorporate their concerns and needs into how your pharmacy operates and provides services.
  3. Providers, including pharmacists, will be responsible for coordinating patient care. Some ways your pharmacy can help coordinate care are:
    • Medication management
    • Preventative care services
    • Education and behavior counseling
    • Medication reconciliation
  4. Performance measurements are going to be critical. Value-based payments will require each provider to demonstrate the improvements. Patient compliance, hospital readmissions, HCV counts, and diabetes A1c counts are all ways to illustrate improvement.

Better care, communication, outcomes, and lower costs = driving motivations for value-based care

The value-based payment model is just getting started and, no doubt, will continue to evolve and improve as it gets rolling. Pharmacists and healthcare organizations now have the opportunity to pull customers into their healthcare planning at a more foundational level. And, by keeping customers involved, they will cultivate a better understanding of their care and increase the chances of success in their healthcare journey.

Get your pharmacy prepared to meet the demands of value-based payments and ensure your growing business’ success.

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