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Pharmacy gets involved in HHS reimbursement project

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WASHINGTON — The Department of Health and Human Services (HHS) has launched the Health Care Payment Learning and Action Network, a public-private initiative to foster the adoption of value-based health care models.

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Sylvia Burwell at the Health Care Payment Learning and Action Network launch.

Rite Aid, Walgreens and Walmart are among the network’s more than 2,800 participants, which include payers, providers, states, consumer groups and employers. The network will serve as a mechanism to facilitate the sharing, learning and implementation of alternative payment models that emphasize the quality rather than the quantity of health care, HHS said. These include accountable care organizations, bundled payments and advanced primary care medical homes.

The National Association of Chain Drug Stores board joined President Obama and HHS Secretary Sylvia Burwell in an event at the White House late last month to launch the ­network.

Reflecting the underpinnings of the Affordable Care Act, the Health Care Payment Learning and Action Network aims to sharpen the efficacy of health care services by giving providers a financial incentive to coordinate care — in short, getting the right care to the right patient the first time.

“It is in our common interest to build a health care system that delivers better care, spends our health care dollars more wisely, and results in healthier people,” Burwell said at the event. “When government and business work together, we can all benefit.”

Obama described the initiative as “the start of a new phase” of the ACA in which health professionals and other stakeholders “come together in one new network with one big goal, and that is to continue to improve the cost and quality of health care in America.”

NACDS president and chief executive officer Steve Anderson and NACDS chairman John Standley, who is also chairman and CEO of Rite Aid Corp., attended the White House event.

“We look forward to working with the administration and other industry stakeholders to promote the value pharmacy and pharmacists bring to advancing patient health and a more efficient health care system,” Anderson stated. “We will continue to highlight the need to ensure pharmacy is included in innovative care delivery models.”

Rite Aid noted that one of its efforts in this direction is the Rite Aid Health Alliance, an integrated delivery model in which its pharmacists and health coaches partner with physicians to help patients with chronic diseases better manage their conditions.

“Rite Aid is committed to the goals of value-based health care and remains highly focused on delivering quality, cost-effective care that drives the best possible health outcomes for our patients,” Rite Aid said in a statement. “We support the administration and Congress in their efforts to achieve these critical goals and look forward to actively participating in the Health Care Payment Learning and Action Network.”

The drug chain reported it is working with its benefit administration partners to, by 2018, have more than 50% of the company’s and employees’ medical spend supported by health care delivered via alternative models.

In January, HHS unveiled plans to boost the use of value-based payments in Medicare and set annual goals that tie rising percentages of fee-for-service payments to quality or value via alternative payment models. The plan is to move 30% of Medicare payments into alternative payment models by the end of 2016 and 50% of payments into these models by the end of 2018.


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