March 1, 2017
Every morning — like many of you — I settle behind my desk, take a sip of coffee and read the AMCP Daily Dose. This publication, full of valuable news and information, frequently highlights issues and individuals we’re featuring at our Annual Meeting, March 27-30, in Denver. Several caught my eye recently.
The Boston Globe last week reported on two Harvard Pilgrim pay-for-performance programs focused on rheumatoid arthritis and osteoporosis aligned with adherence and effectiveness measures. The strategy is designed to curb spending while giving patients access to costly treatments.
We’re delighted to have the primary architect of that program presenting in Denver. Jim Kenney, Manager of Specialty and Pharmacy Contracts at Harvard Pilgrim, will lead a session appropriately titled “Approaches to Managed Care Contracting with Pharmaceutical Manufacturers.” This encore session will discuss innovations in managed care pharmacy contracting, including indication-based contracts and price protection arrangements. You won’t want to miss this one.
Another recent article in Healthcare Risk Management Review described the launch of an Enhanced Medication Therapy Management (MTM) program by Tabula Rasa HealthCare. This pilot program of the Part D Enhanced MTM Model involves seven states: Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming. Among other things, the story explains requirements of the Centers for Medicare and Medicaid Innovation (CMMI), which oversees the model.
Again, we’re delighted to have an architect of this program at our meeting. Nicholas Minter is Health Insurance Specialist at CMMI and lead of the Part D Enhanced MTM Model. His session is aptly titled “The CMMI Perspective on the Enhanced MTM Model: A Look at Today and Tomorrow.” Nicholas will explain the preliminary impact of the model on managed care pharmacy stakeholders, MTM providers, and other pharmacies and pharmacists.
Finally, as you know, one can barely turn on the television — let alone open the Daily Dose — without reading or hearing about Congress’s plans to repeal and replace the Affordable Care Act (ACA). The New York Times recently reported that repeal is facing obstacles in the House and Senate. How this all plays out, and what it means to the health care marketplace, is a topic on the minds of many AMCP members.
Once again, we are fortunate to have two leading experts who will give us a glimpse into some possible scenarios. Kevin Grabenstatter and Todd Clark, both Managing Directors at the global management company L.E.K. Consulting, will present “What Lies Ahead for the Business of US Health Care?” They will identify the market forces most likely to shape the health care system and explain how these forces may affect managed care organizations and other key industry stakeholders.
This is just a taste of what we’re seeing in the news and what you will experience first-hand when you attend the AMCP Annual Meeting in Denver, March 27-30. See you there.
Susan A. Cantrell, RPh, CAE is CEO of the Academy of Managed Care Pharmacy