One of the best ways to understand the Medicaid pharmacy landscape and the challenges and opportunities facing pharmacy directors is to sit down with them, literally.
I am a consultant member of the Pharmacy Learning Community of NESCSO (New England States Consortium Systems Organization), a nonprofit group comprising Medicaid pharmacy directors and other health and human services professionals across New England.
Meeting face-to-face with this vital group to share knowledge and collaborate is an example of Commonwealth Medicine’s commitment to supporting Medicaid Pharmacy teams in their service to members.
Collaboration promotes cost-effective, transparent programs that align with best practices
The Pharmacy Learning Community meets throughout the year to discuss topics of mutual interest, such as opioid management, value-based arrangements for pharmaceuticals, innovative programs, and regulatory compliance.
Our collaboration includes engaging in joint projects, such as the forum, “Benefit Design and Coverage of Gene and Cell Therapies”; a multi-state survey of pharmacy dispensing fees; and a regional analysis of hepatitis C medication uptake.
Another product of Commonwealth Medicine’s connection with NESCSO is our white paper, The Effective Medicaid Pharmacy Program. I was privileged to co-author this paper with NESCSO’s former executive director, Elena Nicolella, MPH, to provide practical information to Medicaid leaders and programs.
We reinforce how an effective Medicaid pharmacy program can provide members with access to medications that are cost-effective, aligned with best clinical practice, and provided in a transparent environment. Our study suggests that these goals can be achieved by pharmacy leaders who consider their program’s administrative structure, pharmacy benefit delivery system, and the influence of external factors.
The white paper provides effective strategies that could only result from listening and learning from pharmacy leaders and their teams and offering perspectives and expertise from Commonwealth Medicine.
Meeting of minds allows discussions of pharmacy priorities and industry trends
As convener of the Pharmacy Learning Community meetings, I bring my experience in researching health outcomes and leveraging data to optimize medication policies and utilization, ensuring equitable access to therapies for all patients.
My Commonwealth Medicine colleague, Manager of Pharmacy Clinical Accounts Mark Tesell, PharmD, offers his decades-long experience within Medicaid pharmacy and current oversight of our team of pharmacists responsible for developing and maintaining clinical pharmacy initiatives for MassHealth.
In turn, pharmacy directors in the Learning Community expand our understanding of their experiences as they describe the priorities needing their attention every day. They look to us to offer suggestions for addressing them because we have our fingers on the pulse of the entire industry, evaluating developments and trends to assist our clients today and prepare them for what’s next.
Additional resources for Medicaid pharmacy teams
I am incredibly grateful for the opportunity to engage with my state colleagues through NESCSO; doing so constantly reminds me of their dedication to serve Medicaid members. And the vital information I receive from them helps ensure Commonwealth Medicine remains responsive to our clients’ needs.
Supplementing direct engagement with pharmacy directors, the Commonwealth Medicine Clinical Pharmacy Services team frequently contributes insights on matters relevant to Medicaid pharmacies and programs. Below are recent examples:
- New CMS rule brings value-based purchasing arrangements to state Medicaid pharmacy programs
- The Accelerated Approval Pathway: serving its drug review purpose?
- Catching the next wave advancing health care: digital therapeutics
- Drug pipeline monitoring helps prescribers and payors meet patient needs and control costs
For more information about Commonwealth Medicine Clinical Pharmacy Services, please contact me at Bonnie.Greenwood@umassmed.edu.
Bonnie C. Greenwood, PharmD, BCPS, director of Clinical Programs, Clinical Pharmacy Services and assistant professor of family medicine and community health, UMass Chan Medical School