Date

RE:      Addressing Medication Use in a New Delivery System

Dear <<Senate Finance Committee Member>>

We understand that as part of the Committee’s health reform efforts, you are looking at restructuring the health care delivery system through new models of care such as accountable care organizations and medical homes.  These physician-led teams seek to provide more patient-centric, integrated, collaborative, and coordinated care by more complete and effective use of the specialized knowledge and skills of those professionals working as part of the medical home patient care team. 

The composition of these teams is likely to vary based on a range of factors, including the specific needs of patients and the scope of services to be offered and/or coordinated by the team.  In addition to physicians, current models include providers such as physician assistants, nurse practitioners, clinical social workers, patient educators, and pharmacists.   However, despite the nearly universal role of medications in the care of patients with both chronic and acute disease, the incorporation of pharmacists’ clinical services within these care teams is rarely mentioned explicitly in current policy discussions. 

Given the experience of many long-standing integrated delivery systems that have demonstrated the success of pharmacists’ clinical services in enhancing the safety and effectiveness of medication use in both the private sector (Kaiser Permanente) and public sector (Veterans Administration, Indian Health Services, HRSA Patient Safety/Clinical Pharmacy Services Collaborative), their inclusion in the national medical home “conversation” represents an important opportunity to promote enhanced health care quality and more effective collaboration among health professionals striving to meet their patients’ health care needs. 

The attached document presents seven principles for the incorporation of pharmacists’ clinical services within the framework of a patient-centered primary care “medical home”.   Our organizations have been working closely with the Patient-centered Primary Care Collaborative (PCPCC) to develop specific language in their materials that recognizes the clinical role that pharmacists have in the medical home model.

We urge you to seriously consider these as you engage in the design, operation, and evaluation of these new collaborative care models.  Incorporating pharmacist clinical services on care teams has been proven to enhance a team’s capability to further improve patient care quality, safety, and outcomes related to the use of medications.

Thank you for considering the views of the pharmacy community.  As the upcoming health care reform debate proceeds, we look forward to working with you to find ways to improve the use of prescription medications, the primary form of therapy in our health care system. 
Sincerely,

Academy of Managed Care Pharmacy
American Association of Colleges of Pharmacy
American College of Clinical Pharmacy
American Pharmacists Association
American Society of Consultant Pharmacists
American Society of Health-System Pharmacists
Food Marketing Institute
National Alliance of State Pharmacy Association
National Association of Chain Drug Stores
National Community Pharmacists Association
Rite Aid Corporation
Walgreen Co.

enclosure

cc: <<Health LA>>