Managed Healthcare Executive - January 2009 - (Page 22)

{ PHARMACY BEST PRACTICES } cover nancial outlays. “The CMS ruling should get the attention of physicians,” says Ashley Allen, director of health information technology for Blue Cross and Blue Shield of Florida. “For those sitting on the fence, the incentives should help them jump the hurdle.” Allen says the Florida model could likely be applied in other states. Southeast Michigan created the ePrescribe Initiative, which enables physicians to write prescriptions on a desktop computer or hand-held device, transmit to dispensing pharmacies and have real-time access to patient’s eligibility, formulary, drug- ll history, allergies and drug interactions. The rst-year implementation costs approximately $2,000 per physician with ongoing costs of $500 to $600 per year. The Southeast Michigan Initiative o ers a total incentive of $1,000—the rst $500 after the 10th e-prescription and another $500 after 20 prescriptions per month for six months. From January 2005 to April 2008, 4.5 million prescriptions were sent electronically. BLEEDING EDGE Va.-based SureScripts-Rx Hub, is condent that the new ruling will have signi cant implications and encourage more adoption and use of e-prescribing—especially for smaller primary care practices who cannot a ord the cost of an electronic medical record. SureScripts-Rx Hub is a collaborative of the two largest national e-prescribing networks. EXECUTIVE VIEW Physicians will be penalized for not e-prescribing, beginning with 1% fees in 2012. Medicare is expected to save up to $156 million over ﬁve years. Promote e-prescribing among your networks by offering incentives. David Collins, director of healthcare information systems for the Healthcare Information and Management Systems Society, says the new law’s incentives will not push potential users over the edge because no one wants to be rst to use the technology. Many will take a wait-and-see approach before changing their business practices. “Once providers see their peers are successful and receive positive feedback from their patients, then they will adopt e-prescribing,” he says. Managed care organizations hoping to encourage e-prescribing should anticipate some hesitation among providers at rst. Kate Berry, senior vice president of business development for Alexandria, 22 JANUARY 2009 Mark Merritt, president and CEO of PCMA, the national association representing pharmacy bene t managers, says there are three key initiatives that have to occur for physicians to adopt eprescribing: universal standards consistent with Medicare Part D; substantial, realistic and accessible incentives; and physician encouragement. Most stakeholders believe the CMS incentives will stimulate e-prescribing adoption and are con dent that the penalties in 2012 will also have a positive e ect. Many observers say that logistically at a certain point, there have to be penalties. Dr. Popiel likens the penalties for manual prescribing to the way CMS and other payers refuse to pay providers for certain never events and other arguably avoidable medical errors. “Penalties may encourage physicians to adopt e-prescribing,” says Je Smith, vice president of strategy and business development for CVS Caremark. The organization is connecting physicians though iScribe, an e-prescribing tool accessed via hand-held devices. It is also increasing penetration of e-prescribing by the highest prescribers and providing prescribers with patient drug history, potential drug interactions and bene t design. CVS Caremark has increased the use of generics by 8.5% by its clients using e-prescribing and has doubled the number of prescriptions led electronically between 2007 and 2008. A collaborative report from the eHealth Initiative and the Center for Improving Medication Management indicates that at the end of 2007, at least 35,000 prescribers were actively e-prescribing, not including those in closed systems such as Kaiser Permanente. The number is expected to jump up to 85,000. The report, developed with the guidance of a multi-stakeholder steering committee, recommends the alignment of incentives to help accelerate the widespread adoption of e-prescribing, as well as the adoption of e-prescribing by all prescribers across all healthcare settings. There is yet another issue on the eprescribing radar: Under current rules, entities that transmit prescriptions using computer-generated faxes are exempt from the requirement that they comply with federal e-prescribing standards. A proposed rule would eliminate this exemption, thus requiring prescribers and dispensing pharmacies to modify or change their systems. The law does not require physicians to use e-prescribing, but if they do, they must follow CMS standards for electronic sharing of information. MHE FOR MORE INSIGHT See more Pharmacy Best Practices on managedhealthcareexecutive.com http://www.managedhealthcareexecutive.com

Table of Contents Feed for the Digital Edition of Managed Healthcare Executive - January 2009

Managed Healthcare Executive - January 2009 Contents Editorial Advisors For Your Benefit News Analysis Politics & Policy Letter of the Law Managed Care Outlook New Day 5 New Realities of Disease Management Pharmacy Best Practices Health Management Technology State Report: Hawaii MHE Resource Ad/Edit Index

Managed Healthcare Executive - January 2009

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