Accountable Care Organizations (ACOs) are going to be a reality whether we like it or not. It’s clear the government will implement some form of cost saving reimbursement model within the existing healthcare system, and the current model under consideration is the ACO model. While the exact nature of an ACO has yet to be determined, the foundation has been laid.
In the simplest terms, an ACO is designed to hold a group of providers within a healthcare system accountable for the quality of care a patient receives by way of financial incentives and penalties. This is supposed to encourage healthcare systems to be more efficient and diligent with patient care.
The success of healthcare systems under the ACO model will be directly tied to the health and wellbeing of patients with chronic disease states like diabetes, heart disease, hypertension and other conditions managed in large part with medication. And of course, there’s no one better at managing medications than a pharmacist.
This sentiment is echoed in a recent article in Hospital Pharmacist.(1) “Pharmacists can benefit ACOs as they have been proven to improve outcomes and lower costs while maintaining high-quality care. Pharmacists in the inpatient and outpatient settings can contribute to the continuity of care through communication of the patients’ therapeutic plan and medication changes.”
“Every day, pharmacists utilize their skills as medication experts to manage chronic conditions, ensure appropriate medication use, answer medication-related questions, and counsel patients. These roles directly improve the probability of ACOs reaching their performance measures.”
Of course pharmacist involvement in ACOs will not be automatic since the profession is not specifically mentioned in the ACO legislation. As a result, pharmacists will have to force their way onto healthcare teams where they will have to prove their value. As ominous as that sounds, it is nothing new to the profession. Organizations like the American Society of Health-system Pharmacists (ASHP) along with grassroots movements from pharmacists within healthcare systems will be the key to the successful involvement of pharmacists in ACOs.
According to the authors of the article cited above “[pharmacists] can still advocate their involvement by educating themselves and increasing awareness about the importance of pharmacy services in the quality of health care. The pharmacy director should educate hospital administrators who are likely to be unfamiliar with the many roles pharmacists can fill and should ‘‘be at the table’’ and participate in ACO development. Clinical proposals and business plans that include pharmacy services to improve the quality of care will create the opportunity for pharmacist involvement in ACO development.”