APhA has signed up to be a partner in a new public–private initiative with up to $1 billion in funding, Partnership for Patients: Better Care, Lower Costs. Announced April 12, the partnership’s twin goals for the end of 2013 are to decrease preventable hospital “all-cause harm” incidents, including adverse drug events, by 40% and to decrease preventable complications during transitions of care so that all hospital readmissions are reduced by 20%, compared with 2010 rates.
According to a U.S. Department of Health and Human Services (HHS) fact sheet on the partnership, the CMS Center for Medicare and Medicaid Innovation will set aside up to $500 million “to test different models of improving patient care and patient engagement and collaboration in order to reduce hospital-acquired conditions and improve care transitions nationwide.” While the partnership is targeting all forms of harm to patients, it will at first focus on nine types of medical errors and complications, including preventing adverse drug events.
As part of the partnership announcement, CMS held two off-the-record conference calls for stakeholders. APhA staff listened to both calls and reported that pharmacists were prominently mentioned as critical members of the health care team in improving care transitions and patient safety.
In conjunction with these efforts, the Community-Based Care Transition Program at the Innovation Center will also give $500 million “to community-based organizations partnering with eligible hospitals for care transition services that include … postdischarge education, medication review and management, and patient-centered self-management support within 24 hours of discharge.” Eligible community-based organizations and partnering acute care hospitals can begin submitting applications now on a rolling basis, for funding that will be awarded on an ongoing basis.
“The two initiatives under way provide tremendous opportunities for pharmacists,” Brian Gallagher, BPharm, JD, APhA Senior Vice President of Government Affairs, told pharmacist.com. For the first goal of decreasing preventable hospital-acquired conditions by 40%, the target reduction in one of the nine types of errors and complications—adverse drug reactions—is 50%, he said. “If that target’s reached, it’s going to go a long way toward the overall goal of improving patient safety. And pharmacists can contribute and play a major role in achieving this target.”
For the second goal of reducing preventable complications during transitions of care, Gallagher said, “Pharmacists providing services, such as medication reconciliation and other continuity of care activities, can help to prevent complications for patients moving between care settings. Patients are so vulnerable within that 30-day window [after discharge] that any misstep can land them back in the hospital, and a lot of the missteps involve taking their medications inappropriately.”
Describing how inappropriate use of medications and the lack of care transitions can lead to preventable hospital readmissions and how pharmacists can help with that, Gallagher said, “You need a coordinated handoff between the hospital pharmacist and the community pharmacists. Pharmacists can reconcile the discharge medications with those that the patient was taking at home prior to hospitalization with the potentially new medication regimen when the patient transitions home or to another care facility. Patients may get confused about what to take, when to take it, how to take it—and as a result, they may wind up back in the hospital again. Whereas if you have the pharmacist interacting with them, helping them to manage their medications and working as part of the patient’s health care team, [there’s a] tremendous opportunity to reduce hospital readmissions.”
According to HHS, the partnership is a public–private initiative among the federal government and a variety of organizations and professionals: hospitals; clinicians and other care providers, including pharmacists; consumer, community, and patient organizations; and employers, unions, health plans, and states. Participants signed pledges to work toward the partnership’s goals. The pledge for clinicians and other care providers includes working “to redesign activities across clinical settings to reduce harm, reduce preventable readmission, and improve care transitions”; engaging “with patients and families to implement practices that foster more patient-centered care that improves safety, communication, and care coordination”; and learning from and sharing with others “our experience with making care safer and more coordinated.”
Among the national pharmacy organizations already signed up in the category for clinicians and other care providers are APhA, the American Association of Colleges of Pharmacy, American Society of Health-System Pharmacists, National Alliance of State Pharmacy Associations, National Association of Chain Drug Stores, and National Community Pharmacists Association. HHS is also encouraging individual health care providers to sign the pledge, as well as state pharmacy associations and colleges of pharmacy.
According to HHS, achieving the goals of the partnership could save up to $35 billion in the health care system, including as much as $10 billion in Medicare savings, in the next 3 years. In 10 years, Medicare costs could be reduced by approximately $50 billion and billions more could be saved in Medicaid.
"The partnership encourages pharmacists and other providers to join as a way to share and receive information about successful initiatives that can be implemented in other communities," Gallagher told pharmacist.com. “We’re willing to partner with people who are doing things locally. We’re putting together materials to try to get people thinking about whom to partner with and what types of questions they should be asking.”
More information about Partnership for Patients, including how to join and share information, is available at www.healthcare.gov/center/programs/partnership/.