NACDS Regional Chain Conference examines changing environment

NACDS chairman Martin Otto at the opening session of the 2017 Regional Chain Conference.

PALM BEACH, Fla. — Pharmacy is pivotal to the national reckoning about health care, and the National Association of Chain Drug Stores is highlighting its place by advancing a pro-pharmacy and pro-patient agenda.

That was the message of industry leaders at the NACDS Regional Chain Conference, with pharmacy-based answers to national uncertainties emerging as a key theme.

“We need to participate by leading public policy solutions for health care,” said NACDS chairman Martin Otto, chief merchant and chief financial officer at H-E-B. “We need long-term, end-to-end thinking about health care, its connection to other spending needs, and how individual actions affect the overall situation.”

“Health care sectors don’t understand each other’s situations,” he added. “That’s a prerequisite for collaboration and for development of an end-to-end solution, and to educate legislators and regulators.” NACDS is helping to identify these solutions, “benefiting total health care, patients and pharmacy.”

Looking at the business’ economics, Otto pointed out that reimbursement rates are declining while sales are growing as the population gets older and script counts grow — partly as a result of the Affordable Care Act. “The fact is that reimbursement rates aren’t keeping up, and it’s putting us behind in terms of what profitability looks like. We don’t participate adequately in the various plan revenues that get allocated to the different sectors of health care. The DIR [direct and indirect remuneration] fee situation … is a real problem. The situation is not economically sustainable over the long haul, and it needs to be rectified, as pharmacy is such an important element of patient care.”

Against this backdrop, NACDS’ priorities are ensuring that Medicare and Medicaid reimbursement are reasonable and allow for adequate care, Otto said. The association also must scrutinize regulations that may not meet their intended ends and/or are inefficient and costly. And it must also work to enact provider status legislation and scope of practice changes “to allow pharmacists to practice at the level that their education qualifies them to,” he said.

Pharmacists can boost health care access “if we can gain the kind of changes in laws that we need,” he said. “Because if we have those, we can create access for the 30 million-plus who don’t have access today, and also for others who aren’t able to get to a physician” conveniently. He said he hoped that through the work of NACDS president and chief executive officer Steve Anderson and his team, “we can make good progress here and be able to be in a position to provide access in a more affordable way and with the kind of quality that patients expect.”

Anderson said, “Companies and associations are going to have to totally change how they address issues in health policy, and in the political world that elects the leaders that establish the policy in which we are involved. I think associations are going to need to be fleet of foot, flexible, smart, shrewd, astute, respected and very politically savvy. It is absolutely essential that associations think more like start-ups, and position themselves more like think tanks as they come up with innovative solutions.”

The association’s leadership urged attendees to engage in NACDS RxImpact Day on Capitol Hill, which will be held March 14 through March 15. At the 2016 event, pharmacy advocates met with 90% of Congress. The event is one component of the comprehensive and far-reaching NACDS RxImpact grassroots advocacy program, which also includes congressional pharmacy tours; training programs for companies and for colleges and schools of pharmacy; get-out-the-vote programming; and other ­initiatives.

The conference’s lineup of sessions focused on political and policy dynamics; pharmacy patient care and pharmacy reimbursement, given the potential changes to the ACA; regulatory reform; DIR fees; the pharmaceutical market; new pharmacy services such as personalized medicine; provider status for pharmacists in Medicare; third-party negotiations and audits; naloxone developments; retail dynamics; human resources law; and value-based models and their relationship to immunizations.

Also, one-to-one business conferences brought together NACDS chain and associate members for company-specific discussions.