A new Pharmacy Study Commission to review Medicaid’s pharmacy delivery and reimbursement system and to evaluate options for reform held its first meeting August 23.
The commission was appointed in June by Governor Robert Bentley and is specifically charged with analyzing the current system, comparing Alabama’s program with other states’ operations, identifying alternative pharmacy systems that could maintain quality and save money for Alabama and determine the estimated savings and economic impact for each described system if implemented. The commission is to report its findings to the Governor no later than December 1, 2013.
State Health Officer and commission chair Dr. Donald Williamson emphasized that the commission will not make specific recommendations. Instead, the focus of the group’s effort will be on developing consensus on the facts upon which a solution can be built.
“We want to look at all of the options,” he said. “This commission won’t make any recommendations, but I hope that we can agree on a set of facts about where we are now, how we compare to other states, and what the potential savings are of other delivery system modifications.”
Commission members will review data from states that have lower costs along with the initiatives that are contributing to those savings. For example, Dr. Williamson explained that the numbers have to be evaluated relative to Alabama Medicaid’s pharmacy-eligible enrollment, covered drugs, and the pricing methodology implemented in September 2010.
“You can’t figure out if there is any opportunity without knowing how we stack up against other states,” he said. “No one is interested in taking actions which limit the access of Medicaid recipients to needed pharmacy services in the state. Likewise, no one wants to take actions that either disproportionately impact pharmacy, nor which create major financial problems for a critical component of the healthcare infrastructure in Alabama, namely pharmacies.”