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Russians Get Crash Course in Pharmacy Management

In the spirit of global information sharing, the Michigan Pharmacists Association recently hosted 11 Russian pharmacists on a whirlwind eight-city pharmacy management study tour. During their two-week stay, the visitors received intensive instruction in pharmacy automation, the continuing education process, insurance claims processing, and other management and professional development techniques they seek to adapt to Russia's evolving market economy. The Russians prepared for the tour with many months of university coursework in their home regions of Novgorod, Pskov, and Ryazan.

Accompanied by retired Michigan pharmacy owner Olya Duzey, who arranged the tour through her work with Arlington, Virginia-based Management Sciences for Health, the group visited Michigan's three pharmacy colleges, the State Board of Pharmacy, and the state Medicaid agency, as well as independent, chain, hospital, and long-term care pharmacy practice sites.

Maryland Group Eyes Standardized Long-term Care

This month a broad-based consortium of Maryland long-term care facility providers, owners, and administrators took the first major step toward development and implementation of statewide clinical practice guidelines for use in all post-acute care settings. During a November 13 symposium on the University of Maryland campus, College Park, consortium members reviewed national and state experiences with practice guidelines and discussed strategies for overcoming barriers to statewide implementation.

The mission statement of the Maryland Clinical Practice Guidelines Consortium affirms members' commitment to "promoting standardized . . . guidelines in order to enhance resident outcomes" and working to ensure uniform use of adopted guidelines.

The Maryland ASCP State Chapter has endorsed the consortium and is exploring the possibility of joining or advising the group, whose membership currently includes the Health Facilities Association of Maryland, the Maryland Association of Non-Profit Homes for the Aging, and the Maryland chapters of the American College of Health Care Administrators and National Association of Directors of Nursing.

In other news, the Maryland chapter has accepted an invitation from the Center on Drugs and Public Policy (CDPP), Baltimore, to name a representative to an ad hoc consulting committee that will advise CDPP on its 1997 long-term care initiatives. One planned initiative will assess the statewide prevalence and costs of inappropriate prescribing and seek to identify prevention strategies. Other initiatives will study the feasibility of academic detailing to curb inappropriate benzodiazepine use, and strategies for improving nursing facility drug therapy outcomes through increased collaboration between pharmacy providers and state health officials.

California Pharmacists Urge Medicaid 'Paradigm Shift'

Stepping up its campaign to loosen managed care's control of pharmacy practice, the California Pharmacists Association (CPhA) has sent state health officials a "white paper" urging a switch from commodity- to services-based Medi-Cal reimbursement.

"In an effort to exert managed care principles on the health care system to control costs, payers have obscured the undeniable fact that a pharmacist's real value is not contained in a bottle or on a counting tray," CPhA official Carlo Michelotti said in a statement calling on the California Department of Health Services to develop a new Medicaid reimbursement system that rewards pharmacists' professional and dispensing services separately.

To achieve this "paradigm shift," CPhA says, pharmacy benefit and provider selection decisions must be driven primarily by quality of services and access considerations-not volume dispensed. The white paper puts forth key criteria for Medi-Cal to use in evaluating quality and ensuring access. Recommended criteria include formulary compliance, availability of 24-hour emergency services, high consumer satisfaction, responsiveness to health plan reports and objectives, accessibility to patients, professional training, and ability to perform patient assessments and establish therapeutic goals.

"The fewest number of highest volume locations delivering commodities at the lowest unit price can well be the most expensive pharmacy service of all," the CPhA paper cautions.

For more information, contact Michelotti at 916-444-7811, ext. 309.