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What We’re Watching: April 1, 2019


A new study of health system pharmacists found that two-thirds of those surveyed grapple with more than 50 drug shortages each year, leading to drug rationing.

Key findings include:

  • 4 in 5 pharmacists said they hoarded scarce medications
  • 1 in 3 pharmacists said the hospital had to ration medications and in some cases deny patients necessary treatment
  • 1 in 3 pharmacists said their hospital had no valid administrative mechanism to help them respond to a shortage

What we’re saying: The findings underscore Premier’s commitment to creating a stable and reliable supply chain for generic drugs. While our members have access to 92 products that are currently in shortage, we are building on this success with our subsidiary, ProvideGx, which is using unique approaches to bringing shortage drugs to market.


In February, the CMS announced a new alternative payment model designed to avoid unnecessary hospital ED visits, the Emergency Triage, Treat, and Transport (ET3) Model. The CMS has since shared additional detail about the ET3 model, including announcing that they will make a 15% add-on payment to qualified health practitioners (physicians, nurse practitioner and physician assistants, in some cases) for “after hours” care provided on site or via telehealth during an ambulance call.

What we’re saying: We remain concerned that this model will further fragment care delivery when the focus should be on integrating care delivery through ACOs. Premier submitted comments identifying challenges and solutions that CMS should consider when finalizing the model, including:

  • Requiring ambulance providers to demonstrate how they will acquire patient data at the time of dispatch so as to coordinate care, especially with ACOs.
  • Ensuring coordination with paramedicine interventions are already in place in many settings, providing for treatment in place and transport to alternative destinations.
  • Evaluating payer coordination among applicants as emergency care standards should be dictated by best clinical practice rather than payer source.

Premier has been studying ED savings opportunities for quite some time, most recently identifying an $8.3 billion savings opportunity with more preventative and coordinated ambulatory care.


Premier joined 20 other organizations in sending a letter to the Office of the National Coordinator for Health IT and CMS requesting an extension of the comment period for the complex and far-reaching proposed rules on health IT interoperability.

What we’re saying: The rules affect many health information data sources beyond EHRs, including insurance claims and provider registries. As a result, the rule will significantly alter patient and provider access to information, increasing transparency on quality and cost information. Premier is working with our members to develop comments on the proposed rule.


What We’re Watching is a weekly blog focused on the current events Premier is following and their relevance to the work of Premier and its members.

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