WASHINGTON—As healthcare providers set up accountable care organizations (ACOs) and other value-based care programs, pharmaceuticals offer one avenue to help minimize overall costs and meet recognized standards for quality patient care.
To support the delivery of value-based care, the American Medical Group Association (AMGA), the National Pharmaceutical Council (NPC), and the Premier health care alliance teamed with seven provider organizations to form the Working Group on Optimizing Medication Therapy in Value-Based Healthcare. The group developed a framework for considering the role of pharmaceuticals in achieving value-based success. The article was published as a web exclusive in the July 2012 issue of the American Journal of Managed Care.
Providers are shifting to value-based care models to provide better care for individuals, improve population health and slow cost growth. Many of these models, such as the Centers for Medicare & Medicaid Services’ Medicare Shared Savings Program, include quality benchmarks and incentives for reducing costs. As providers evaluate optimal care for their patient populations in these new models, prescription medications should be thoughtfully integrated into the process, said NPC Chief Science Officer Robert Dubois, MD, PhD, who is one of the article’s authors.
“It is crucial for ACOs to view prescription drugs as a tool, not simply an expense,” Dubois said. “When medications are appropriately used, they can contribute significantly to improving patient outcomes and reducing overall costs.”
Congestive heart failure medications, for example, make up a small portion of overall treatment costs for the condition. Yet these medications reduce the risk of hospitalization for patients, which is an important criterion for ACOs in meeting quality standards and reducing costs.