The future is notoriously difficult to predict. For example, no one predicted in 1997 that 10 years later there would be such a thing as the iPhone, or that it would become a staple of everyday communication. Healthcare evolves at a more leisurely pace than consumer electronics, but it seems equally likely that 2028 will look a lot different than 2018. So, for those of you who will remain engaged in long-term care pharmacy ten years from now, what do you imagine your profession will look like?
Automated dispensing has made substantial inroads into our industry. Automation is especially suited to repetitive tasks requiring recognition of anomalies, like dosage, contraindications and drug/disease incompatibility. Boards of pharmacy have routinely allowed automation to replace some pharmacist tasks in verifying the accuracy of prescription dispensing.So, will dispensing pharmacists become obsolete in LTC pharmacy?
The big payoff for automation may be in the retail environment. If you're a new dispensing pharmacist in a retail store, what are the chances you will be a traditional dispensing pharmacist in 10 years time? Is it feasible to replace the dispensing function with automation, especially if the pharmacy can save $100, 000 or more for each pharmacist it replaces?
OK, you say, I am a clinical pharmacist. Cognitive services are my specialty. I add value to the healthcare experience beyond rote functions like dispensing. If anything, I expect my services to increase in demand. Surely, my skills are future proof.
Take a look at how machine learning and artificial intelligence is impacting the financial services industry. This is an industry that has always put a premium on cognitive and interpersonal skills. Successful brokers, traders and analysts reaped handsome financial rewards. The new reality: financial services companies have begun openly discussing replacing these high-cost professionals with robots.
The death of the skilled nursing facility has been predicted for the last decade. Certainly, nursing home censuses are at near-record lows, despite a rapidly-aging population, but will they disappear? Probably not, but trends suggest there will be fewer SNFs in the years to come. The most popular venue in which to age is the home or in a home-like setting. Assistive technology is evolving so quickly that the notion that the nursing home is inevitable for the oldest among us may not be true.
As noted in the beginning, the future is likely to be nothing like what we imagine. Just like the iPhone, there will be unexpected developments that will change how we think about aging with chronic disease. This may mean that pharmacists' skills may be more in demand than now, or perhaps the profession and industry will take on different responsibilities more in line with the future nature of healthcare. Good news is this probably won't happen overnight. If we pay attention we will see it coming.
Looks like it's been awhile since I've posting anything here. That's because we've had the privilege of having Elise Smith keep us updated on the latest policy and payment initiatives affecting the LTC industry. Elise is working away on another important update so I thought I might step in and cover CMS' latest pronouncements related to the calendar year 2019 (CY 19) Medicare Advantage and Medicare Part D program changes.
Each year about this time CMS issues payment rates and policy changes for the next Medicare calendar year. We generally refer to this as the "Call Letter". This year we got a bonus, with not just one, but two announcements. You may recall that late last year CMS issued a Notice of Proposed Rulemaking (NPRM) proposing new policies in the Medicare Drug Benefit, much of it related to implementation of the Comprehensive Addiction and Recovery Act (CARA). So, we got a bit of extra reading in early April when both final documents were released on the same day.
Both documents contain much of the same information. This is because CMS needed to change some policies through formal notice and comment rulemaking and then had to formally implement these changes through the annual ratemaking and Call Letter process. So, you ask, what's the news in the Call Letter?
The Final Rule had many of the same provisions, but went into some detail that was absent in the Call Letter. Here are some highlights from that document:
These changes were anticipated and it appears that they shouldn't be too disruptive. Don't overlook the importance of CMS' decision to allow plans to add supplemental benefits beyond what are currently offered. This represents opportunity for the enterprising LTC pharmacist. We will go into that in depth in the next post.
It's been three years since the launch of LTCPharmacy.net and the monthly newsletter. We now have over 1500 subscribers and the feedback has been generally positive.
Reporting on the regulatory and legislative developments that affect the members of the LTC Pharmacy industry has been the centerpiece of the effort and will remain an important part of what we do going forward. However, that leaves a lot of ground left uncovered.
It is becoming clearer with each passing day that what we do is changing. The facilities we serve are being swept along by the changing expectations of consumers and payers; fewer elders will seek care in institutional settings and new models will eventually overtake the old models that have become so common to us all. Consider the new demands that CMS is making on LTC providers; more accountability for re-hospitalizations, more emphasis on drug regimen review, more incentives to move people out of institutional settings. All this is likely to accelerate change in the way we look at what we do.
This is why the LTC Pharmacy News is undergoing a change. First of all, the regular news will be found at www.ltcpharmacynews.com. The old ltcpharmacy.net site is undergoing a major overhaul and will eventually become a paid site. The general newsletter will always be free to anyone who wishes to subscribe, but in order to cover the expanding breadth of the industry and provide meaningful content to professionals in our field, we will need to invest more resources in uncovering new trends, talking with new voices, moving away from summaries of what others have said and toward original content. In short, we look forward to providing original content on the trends in our industry that you won't find anywhere else.
Moving from free to paid will put pressure on us to dig deep to introduce you to important policy makers, create thoughtful analysis you will actually be able to use, and have significant discussions with the enterpreneurs shaping the new LTC Pharmacy industry. We will also be delivering news and content in new formats with a new focus on video and interactive media.
In the next newsletter I hope to be introducing a new collaborator to LTC Pharmacy News. This will be a name that will be familiar if you've been in the industry for any length of time. Stay tuned for that!
Work continues on the new site and I promise you a chance to take a long look for free before we limit access to paid subscribers.
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