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The president of the American Hospital Association told health system pharmacists that first and foremost their work has to be safety and quality, but they might think about loosening up a little on method.
In terms of aligning information systems, Umbdenstock said, "if we could build one communitywide medication administration record, or something like that, we would really be helping the consumer enormously." Asked about AHA's stance on payment for cognitive services in pharmacy, he said, "We do believe that the continued ratcheting down on payment, in this case payment for the pharmaceutical or drug only, makes no sense. Eventually it's going to starve the system." AHA wants "to work very closely with you to make sure that we put forth the right information and the right position for our policymakers, so that you continue to have the resources necessary to do the job right."
Telling the meeting that pay-for-performance is probably here to say, Umbdenstock said, "Some linkage between the outcome of our work and the financial incentive or reward will, I think, only continue to grow." Some of that new emphasis is good, he said. "For years, people in the healthcare sector said, 'If you cut the dollars, quality will go down.' In fact, the studies are starting to show that the right care, at the right time, in the right method actually gives you a better outcome, reduces your mistakes and your rework, and saves you money."
However, he went on, "with hundreds of different pay-for-performance schemes out there, this cacophony around quality measures must be brought into some coherent dialogue and progression toward the right set of measures in the various disciplines. We are involved with the Hospital Quality Alliance and the National Quality Forum to try to help streamline that process."
Noting that the AHA board has developed some core principles for healthcare reform which the organization is presenting to the various stakeholders ("Health for Life" at http://www.AHA.org/ under "Issues"), Umbdenstock warned: "The level of public discontent with costs is rising rapidly. Our data show that it went from about a third of the public saying they were dissatisfied with the costs of the system to over half, 51%, in one year."