Health Care Reform and the Role of Managed Care Pharmacists

Managed care pharmacists will play a key role in reforming the current health care system by continuing to develop innovative programs that reduce costs and improve quality of care, said Mark McClellan, MD, PhD, director of the Engelberg Center for Health Care Reform at the Brookings Institution in Washington, DC. He discussed the effects of the recent health care reform legislation in a presentation at the Academy of Managed Care Pharmacy meeting.

“Real health care reform” will entail “bending the curves” to increase value, said McClellan. Speaking to a packed audience of conference attendees, he explained that rather than “squeezing the system” to create health care reform-in which costs increase and prices and billing are squeezed to restrict access and gain short-term savings-health care reform must increase efficient utilization as well as personalized medicine that is focused on prevention.

“What we want is better quality with lower costs,” said McClellan. This requires system-wide accountability that can be accomplished by 4 key elements of reform:
• Improving measurements of quality and cost.
• Reforming payment to be based on quality and costs.
• Redesigning benefit programs to be of higher value. This can be accomplished by using experiences from the Medicare Part D program.
• Developing better evidence through comparative effectiveness research.

These efforts entail public-private sector collaboration, said McClellan. He encouraged the audience “not to wait to implement reforms that increase value,” and to continue taking steps toward accountability for “patient-level results.”