ORLANDO, Fla. – On the final day of meetings at McKesson’s ideaShare 2014 Wednesday morning, Ann Richardson Berkey, McKesson SVP public affairs, reviewed the key political issues impacting pharmacy today — from controlled substances to provider status — and closed the session with an interview with Florida state Rep. Matt Hudson, R-District 80.
How healthcare reform is going to play out is still one of the leading issues facing the pharmacy community today, especially as the government represents the single largest payer of healthcare services between Medicaid and Medicare. The government paid for 51% of prescription medicines in 2012, Berkey said. “The trend is going to continue with Medicare Part D as well. The expectation is that there will be a 30% increase in Americans on Medicare Part D in the next decade,” she said.
Participation in the exchanges will continue its upward trajectory, as well. “In the next decade, the expectation is that there will be roughly 24 million people in the exchanges,” Berkey said. “As many as 87% of people in exchanges today are getting subsidies. There were actually two court decisions yesterday. They didn’t agree with each other about subsidies, so I think this is still very much in play in terms of what’s going to happen. It’s more of a ‘stay tuned’ for any additional changes in healthcare reform.”
Here’s a roundup of what Berkey had to say about some of today’s other top political issues impacting pharmacy:
Controlled substances. “This is an increasingly problematic issue across the country,” she said. “Legislators are talking about up-scheduling, at the federal and state level, up to schedule II. Does that help? That’s still to be determined.”
PBM audits. “This is one of those issues that has to be socialized over a period time, so talk to your legislators about this as a problem and where you can try to bring a solution to the table,” she said.
Provider status. “Your role is clearly evolving,” Berkey said. “Estimates are that there’s going to be a shortage of approximately 20,000 doctors by the end of the decade. All of us are aging and we’re going to need care. So how does the pharmacist's role change so much so that you can be out there delivering the care and practicing at the top of your license?” she asked. “California’s already passed a law; other states are moving in that direction. The issue with the California law, as you’ve probably heard, is there is no additional reimbursement attached to that.”
During Berkey’s discussion with Hudson, the state representative advised community pharmacists to actively engage their state and federal politicians, sharing with them the value proposition pharmacy brings to the community. “This is important for you as pharmacists; you play such a unique role in your community. It’s important that you are always telling your elected officials about what you bring to the table. Because if you tell them the value proposition that you bring, the things that make you who you are and what you do and how you can bring that to the community, the legislators are going to be far more open to expanding the scope of practice,” he said. “You have got to educate people why it’s important and how you can make change in the entire healthcare continuum. They would just have to hear what you have to say.”
Arbitrary PBM audits should be another topic of conversation with elected officials. Hudson recently sponsored legislation in Florida, which goes into effect Oct. 1, that provides for a seven-day notice of a pending audit and disallows extrapolated recoveries.
Overall, Berkey was positive and upbeat about the many opportunities independent pharmacists have to make a difference in the delivery of patient care in this country. “Politics matter,” Berkey concluded. “I feel in my bones this is going to be a great future for pharmacy. You have a terrific opportunity to get involved and bring solutions to the table.”