Fall 2016 Pharmacy Directors Collaborative Meeting

Overview

The Alliance of Community Health Plans (ACHP) Pharmacy Directors Collaborative, Medical Directors Council, Clinical Executives Collaborative and Marketplace Leaders met concurrently on October 25 – 26 in Chicago, Illinois. The Pharmacy Directors Council provides a forum for member plans to address the growing challenges faced by pharmacy as the health care system continues to evolve. Steve Marciniak, Priority Health; Eileen Wood, Capital District Physicians’ Health Plan; Jim Slater, CareOregon; and Jennifer Sulkin, ACHP serve as leaders of the collaborative. The meeting agenda included discussion on the relationship between community health plans and biopharmaceutical manufacturers, ACHP pharmacy strategy, novel strategies for managing pharmacy costs, a policy update, managing chronic pain and opioid use, medical benefit management challenges, key performance indicators and states and prescription drugs.

Summary

ACHP Pharmacy Directors Collaborative Summary October 2016

Agenda

ACHP Pharmacy Directors Collaborative Linked Agenda (includes presentations)

Pre-work/Pre-reading Materials

  • ACHP plans to announce a signature initiative at its 30th annual symposium in April 2017. This initiative aims to elevate and solidify the ACHP brand and to demonstrate a shared commitment by its member organizations. We have narrowed the list of potential initiatives down to five, with an overview of each provided for your review. If you have any feedback on the options outlined, please send your comments by Wednesday, October 19. We will be discussing the initiative in greater detail with the medical directors and board of directors at the meeting.
  • During the two-hour pharmacy strategy session, the medical directors and pharmacy directors will reflect on the drug cost efforts to date and discuss opportunities to strengthen our approach over the next 3-5 year. As background information, we have provided a list of organizations focused on the drug cost issue and a policy document – prepared by ACHP in early 2016 with input from its members – highlighting various policy options under consideration nationally.
  • We will look to finalize the key performance indicator data collection template at the meeting. As communicated previously, will be using the CVS Comprehensive Specialty Pharmacy Drug List to define “specialty” for our data collection. While we acknowledge that not all ACHP plans consider all of the drugs on CVS’s list to be specialty (based on their internal plan definitions), we do want to move forward with a standardized definition to ensure we’re comparing apples to apples and have a strong citation if we ever decide to report blinded data externally. Please let us know if you have any questions or additional suggestions by Wednesday, October 19.
  • ACHP is looking to streamline its Learning and Innovation programming (i.e. clinical collaboratives) in 2017 to enhance the organization’s influence, accelerate learning and create more focus and alignment with overall organizational objectives. The proposed framework outlines a few modest changes. Greater explanation will be provided at the meeting.
  • Please also come prepared to describe the utilization management tactics your plan is implementing to manage drugs processed under the medical benefit, as well as share what platform your plan is using.