April 25, 2019 | GTMRx Institute to champion appropriate medication use

Industry News

Primary Cares Initiative to launch in Jan. 2020

CMS announced its Primary Cares Initiative, slated to launch in January. The voluntary, risk-based initiative builds on earlier programs and is part of a larger effort to transform primary care from a volume-based to value-based system. It will, according to the Health and Human Services announcement, “reduce administrative burdens and empower primary care providers to spend more time caring for patients while reducing overall health care costs. HHS Secretary Alex Azar says he expects 25% of traditional Medicare beneficiaries to participate. (HealthLeaders Media; HHS announcement; press conference)

Employers embrace wellness; academics, not so much

A study recently published in JAMA finds little evidence that employee wellness programs boost health or productivity, but employers remain bullish on them. Fidelity and the National Business Group on Health’s just-released annual Health and Well-Being Survey found that large employers expect to spend an average of $3.6 million in 2019 on wellness programs, much of it on incentives that encourage participation. Robert Kennedy, of Fidelity Workplace Consulting, told FierceHealthcare that employers aren’t necessarily looking for lower health care costs or improved health; instead, they view these programs as part of the company’s overall value proposition. (FierceHealthcare; Fidelity—NBGH report; JAMA)

Innovation & Transformation

GTMRx Institute to champion appropriate medication use

The Get the Medications Right™ (GTMRx) Institute launched last week. It describes itself as a “multi-stakeholder catalyst for change—to raise awareness of and champion a solution for effective and appropriate use of medications.” The Institute has a clear call to action: Get the Medications Right. The GTMRx Institute is funded by a three-year commitment from leading-edge health care organizations in support of the multi-stakeholder approach. The Institute currently has more than 100 members, including providers, payors, consumer groups, drug manufacturers and other key constituencies. (Pharmbiz; GTMR announcement)

Geriatric EDs aim to avoid admissions

Emergency departments are seeing more and more elderly patients, and some have been customized to meet their needs. They are changing: Increasingly, hospitals are providing geriatric EDs. The primary goal is to keep the elderly from being admitted to the hospital; hospitalizations can have detrimental long-term effects. “Older patients tend to not bounce back as well if they’re admitted to the hospital the way a younger person would have,” Denise Nassasi, director of the geriatric ED at Mount Sinai, tells the Wall Street Journal. “They will often lose one of their activities of daily living, perhaps irreversibly.” (Wall Street Journal)

Consumers & Providers

CMS rule aims to promote generics by limiting coupons

CMS has issued a new rule that aims to increase use of generic drugs. It will allow health insurers to implement copay-accumulator programs to prevent manufacturer coupons from applying to a patient’s annual limit on out-of-pocket when a generic option is available, Modern Healthcare reports. It will apply to individual market, small group, large group and self-insured group health plans starting in 2020. Ten states have or are considering legislation to ban copay accumulators. Patient advocates say they limit access to medication. CMS says the rule would encourage patients to use generic drugs and lower drug spending. (Modern Healthcare)

Hospitals could suffer under Medicaid for All

The gap between payments to hospitals by Medicare and by private insurers for the same medical services may be the biggest obstacle to “Medicare for all,” the New York Timesreports. If private insurance were abolished and all rates cut to Medicare level, the results could be devastating for hospitals. Struggling rural hospitals would be among those which could close “virtually overnight,” policy experts warn. Others would try to offset cuts by firing workers and abandoning lower-paying services, including mental health. (New York Times)

New & Noted

Digital recommendations: The World Health Organization has issued 10 recommendations on how nations can use digital health technology to improve people’s health and essential services. “Ultimately, digital technologies are not ends in themselves; they are vital tools to promote health, keep the world safe, and serve the vulnerable,” WHO Director-General Tedros Adhanom Ghebreyesus, MD, said in a prepared statement. (FierceHealthcare; WHO announcement)

Genetics and obesity: A genetic test appears to identify newborns at risk of becoming severely obese by middle age. Middle-aged people with scores in the top 10% were 25 times as likely to be severely obese as those in the bottom 10%, according to research published in Cell. (Cell; AP)

OTC Naloxone a step closer: The FDA approved the first generic version of naloxone nasal spray to halt or reverse suspected opioid overdose in a community setting. It’s designed for those without medical training. The move is part of the agency’s strategy to expedite over-the-counter naloxone. (MedPage Today)

Multi-media

Another provider assaulted; ZDoggMD is angry

ZDoggMD is “so, so, so tired, so tired of reading story after story, after story, after story of healthcare workers being attacked.” The most recent example: A nurse at Baton Rouge General Hospital was attacked by a patient. She finished her shift, but died days later of a massive pulmonary embolism. Details remain unclear, but “the overall arch of this repoints out how we are devaluing our frontline healthcare professionals, putting them in harm’s way and expecting our healers to make the ultimate sacrifice in service for their patients, to die in service for their patients.” (MedPage Today)

MarketVoices...quotes worth reading

“For the patient, it comes down to one simple question: Are these the right medications for me?”—Get the Medications Right™ Institute Co-founder and President Terry McInnis, MD, MPH, in a press release announcing the Institute’s launch