Medicare is a beneficial program for Americans who are over age 65 or have certain disabilities, but providers sometimes find compliance issues a challenge. An understanding of mandates and how to properly submit claims will ensure organizations are reimbursed for Medicare Part B-covered medications, equipment and supplies, such as nebulizer-inhalation medications, oral immunosuppressive drugs and diabetic testing supplies. Occasionally, providers may unknowingly submit noncompliant or even fraudulent claims for the products and services they offer.
News: Community Pharmacy
Your patients are adherent to their medication protocol, now you have to ensure they don’t wash the pills down with grapefruit juice or use an over-the-counter (OTC) herbal supplement that could unintentionally dilute or alter the benefits of their prescribed drugs.
I recently read a book, If You Can Keep It: The Forgotten Promise of American Liberty, by Eric Metaxas. The book title is part of a quote from Benjamin Franklin in 1787, the year the Constitution was drafted.
The healthcare industry in its entirety is becoming more aware of what QS/1 has known for some time now; pharmacists are the heroes of healthcare. As heroes, pharmacists can intervene, nurture patient populations, help lower overall healthcare costs and decrease patient hospitalizations.
We often equate regulatory mandates to government overreaching that impose roadblocks, which prevent pharmacists from providing solid healthcare to patients. However, changes and goals stemming from the Affordable Care Act (ACA) could actually give community pharmacies a new competitive advantage.
When the Meaningful Use process started, practices started being more diligent in collecting Business Associate Agreements from all their contractors who had access to their software.
Healthcare is ever changing and with those changes must come adaptation. There is a focus on quality of care versus quantity of care. Team-based care and pay-for-performance models are on the rise and pharmacists are a part of the equation.
In the previous edition of Insight, I said, “One competitive opportunity that never changes in pharmacy services is the percentage of your current customers who would recommend you to others.” I also mentioned, “Accomplishing high percentage scores requires a full-court press inside your operation for every employee to excel.”
From drug and patient safety to cyber safety and personal safety - pharmacies must always be on top of their game. The healthcare industry is always evolving, from drug scheduling to processing credit card transactions. An article in Pharmacy Times explained it best, “Pharmacists are like the umpires of the health care game. They enter, verify, and triple check prescriptions, orders, and final products until they are satisfied.”
Earlier this year, QS/1 partners, the Kentucky Department for Public Health (KDPH) and the Kentucky Pharmacists Association (KPhA), participated in a showcase to display the region’s overall capabilities to respond to a natural disaster or emergency and demonstrate services the state could provide, including fire, police, pharmacy and other disaster-response resources.