Accountable Care Organizations Have Made Progress Toward Optimizing Medication Use, But Still Face Challenges

For Immediate Release
Contact: Andrea Hofelich, ahofelich@npcnow.org, 202-827-2078

(Washington, DC, June 1, 2017)—The use of medications is an important part of helping accountable care organizations (ACOs) meet quality measures and improve patient outcomes, but a new study shows that ACOs still face barriers to optimizing medication use across their networks.

The study, “Optimization of Medication Use at Accountable Care Organizations,” sought to understand how ACOs optimize medication use, and how those efforts affect the ACOs’ achieving their financial and quality goals. Conducted with Leavitt Partners LLC, the study builds on prior survey work developed in partnership by the National Pharmaceutical Council (NPC), the American Medical Group Association (AMGA) and Premier, Inc. (NASDAQ: PINC). It was published online ahead of print in the Journal of Managed Care & Specialty Pharmacy.

“ACOs recognize that, along with the changing payment and delivery environment, they need to make changes as well,” said Kimberly Westrich, MA, NPC vice president for health services research and study co-author. “Today, so much of how ACOs are measured and reimbursed depends on outcomes directly affected by medication use. Making these changes takes time and effort, but we’re already seeing a significant move in the right direction.”

Compared to NPC’s prior assessment of ACOs’ readiness to optimize use of medications, more ACOs are now involving pharmacists in direct patient care and have expanded their focus on the appropriate use of generic medicines. More ACOs also give themselves higher scores on educating patients about diagnostic and therapeutic alternatives and their implications when determining the recommended medication regimen; this is significant considering that the Centers for Medicare and Medicaid Services is reviewing the inclusion of patient education as a quality measure. In addition, more ACOs are utilizing health information technology to identify and notify care providers of potential adverse events, alert providers to gaps in preventive care, and electronically transmit prescriptions for non-controlled substances.

In the study, ACOs recognized that medications are key components of care, but note that there are barriers to implementing more comprehensive optimization strategies. Barriers include a lack of reimbursement for pharmacists’ services, poor technology interoperability and the difficulty of isolating and evaluating the cost savings associated with better medication use practices.

“Many quality measures are directly or indirectly tied to medication use. Results from our survey validate that ACOs appreciate the need to optimize medication use across their networks,” said Kristina Lunner, principal, Leavitt Partners and a co-author of the study.

A framework for the role of medications in achieving ACO success, results from the initial ACO readiness assessment survey, and case studies of ACO best practices are available on NPC’s website.

About the National Pharmaceutical Council
The National Pharmaceutical Council is a health policy research organization dedicated to the advancement of good evidence and science, and to fostering an environment in the United States that supports medical innovation. Founded in 1953 and supported by the nation's major research-based pharmaceutical companies, NPC focuses on research development, information dissemination and education on the critical issues of evidence, innovation and the value of medicines for patients. For more information, visit www.npcnow.org and follow NPC on Twitter @npcnow.

About Leavitt Partners
Leavitt Partners is a health care intelligence business. The firm helps clients successfully navigate the evolving role of value in health care by informing, advising, and convening industry leaders on value market analytics, alternative payment models, federal strategies, insurance market insights, and alliances. Through its family of businesses, the firm provides investment support, data and analytics, member-based alliances, and direct services to clients to support decision-making strategies in the value economy. For more information visit LeavittPartners.com or call (801) 538-5082.