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On Jan. 1, 2015 hospitals became eligible for reimbursement when treating patients with two or more chronic conditions…Under CPT code 99490, in fact, the Centers for Medicare and Medicaid Services will pay clinicians an average of $43.12 for spending at least 20 minutes in non-face-to-face consults…CMS could pay out as much as $17 billion a year under chronic care management…a surprisingly small number of providers have thus far taken to 99490…While there is a strong appreciation of the benefits of chronic care management, both as fee-for-service revenue...and as a foundation for population health management, providers are struggling to incorporate CCM in their current operations…What's the hold up?...three obstacles: insufficient reimbursement for the time required, lack of awareness about the opportunity, and compliance concerns…the median time spent delivering the service is 35 minutes per patient per month...although non-face-to-face services may be furnished by any qualified clinical staff member, half…are using registered nurses – a more expensive resource than other types of clinical staff – to engage patients.

A number of stories published in the midst of the Disneyland measles outbreak last winter looked at the trend of doctors, particularly pediatricians, “firing” families that refused vaccines for their children. The practice remains controversial among pediatricians but relevant enough that a recent session at the American Academy of Pediatrics Annual Conference addressed how pediatricians can legally protect themselves when parents refuse vaccines and the most appropriate way to dismiss a family from the practice, even though the AAP discourages such dismissals.

What’s in a name?..A contentious debate over identifying biosimilars is sparking concern from antitrust regulators. These drugs are designed to emulate expensive biologics and are forecast to save billions of dollars in US health care costs. But finding the best approach for naming biosimilars has confounded regulators and divided the pharmaceutical industry amid clashes over patient safety and the potential for big profits…At issue is whether biosimilars should be given the same name as biologics. Two months ago, the Food and Drug Administration issued draft guidelines that suggested both biologics and biosimilars can use the same name. But the agency also proposed that biosimilar names add a four-letter suffix that differs from the four-letter suffix that should follow a biologic brand name medicine…

Sherwin-Williams wants to paint a cleaner picture of hospitals…The company created a paint that it claims will kill bacteria -- a major cause of healthcare-associated infections in hospitals. Among the targeted bacteria are Staph, MRSA, E. coli, VRE, and Enterobacter aerogenes…"Paint Shield" claims to kill over 99.9% of these bacteria after they've been on a painted surface for two hours. It also reduces the growth of "common microbes."…It's one of the most significant technological breakthroughs in our nearly 150 year history of innovation…By killing infectious pathogens on painted surfaces, Paint Shield is a game-changing advancement in coatings technology...

Eli Lilly Co…announced plans to add a 130,000-square-foot building to its Indianapolis research-and-development headquarters…The $70 million investment is the latest in a string of moves by the Indianapolis-based drugmaker to bulk up its hometown presence…"We are excited to grow our presence in Indianapolis, which is home to our largest global R&D facility and where our research efforts began,"…Lilly employs 4,400 R&D workers in Indianapolis, the biggest chunk of its 7,000 R&D employees worldwide…Lilly has applied for a real-property tax abatement on the proposed expansion that will save it $6.6 million over a 10-year abatement period…Lilly will still pay about $6.7 million in property taxes during the abatement period on the increased value of the property…This is Lilly's fourth R&D expansion this year. In May…it would build a delivery and device innovation center in Cambridge…In July…announced an expansion of its biotechnology center in San Diego…In October…an expansion of its presence at the Alexandria Center for Life Science in New York City.

When I wrote Healthcare’s Trillion Dollar Disruption, I recounted how a collection of senior executives assembled by Oliver Wyman representing every sector of healthcare foresaw a radical reshaping of the industry. They predicted that over the course of ten years major winners and losers would be created as one-third of the annual revenues of the industry shifted from one set of players to another…More important than the revenue shift is who would be the catalysts for a much higher performing system as measured by the Quadruple Aim. In this list, I highlight the game-changers. Some may also be big revenue winners but that isn’t the point of this list. After all, there are plenty of organizations profiting from today’s wasteful system, so revenue is only one metric of success. Rather, the actions of the organization are putting the wheels in motion for a massive transformation of the industry.

1. MassMutual will slow healthcare’s heist of retirement accounts
2. Collective Health will turn employers fully into the insurance companies they already are
3. Rosen Hotels will show how employers can transform the lives of their employees and their community with a great benefits plan
4. Iora Health will prove primary care is the linchpin to a consumer-centric health future and achieving the Quadruple Aim
5. Surgery Center of Oklahoma will be replicated to overcome severe price failure of healthcare services ranging from surgeries to chronic disease management
6. Oscar will demonstrate that their data science expertise will deliver a superior health plan package that is about more than just consumer-friendly packaging
7. Geisinger Health System will raise awareness of the massive over-investment in hospital infrastructure at the expense of community health

Todd Semla, MS, PharmD, BCPS, FCCP, AGSF, of the Department of Veterans Affairs explains how the AGS 2015 Beers Criteria will affect pharmacists' practice. (video)

…executives at both Pfizer and Allergan acknowledged that they have begun merger talks. Pfizer’s goal in such a move is pretty simple – to finally achieve the tax-saving corporate inversion it has been seeking for some time. This move would enable Pfizer to become an Ireland-based company, thereby substantially lowering its corporate tax rate… speculations are being made as to what such a new organization would look like, and some have expressed concerns over the impact of yet another merger on Pfizer’s R&D organization… R&D folks, meanwhile, are polishing up their resumes in anticipation of mass firings...However, this Allergan deal is unlike the others… there is little evidence that there is a lot of overlap from an R&D perspective between Pfizer and Allergan. If anything, one wonders if Pfizer will retain Allergan research efforts…

…lawyers for AndroGel maker AbbVie will present their selection of 16 plaintiffs they’d like to represent the growing class of men who are suing the company over allegations that its product, a topical form of testosterone, caused blood clots, heart attacks and other adverse events. Lawyers representing the men will do the same in a process that will culminate in the selection of 12 “bellwether” cases to be tried starting late next year…men suing over testosterone has soared…to 2,744…Claims have been filed against seven makers of testosterone products…The court chose AbbVie as the subject of the first trials, with the first six bellwethers to involve men alleging “thromboembolic” injuries…and the second six alleging heart attacks or strokes...

Ron Lanton with True North Political Solutions interviews Kurt Proctor, Ph.D., RPh Senior Vice President, Strategic Initiatives with the National Community Pharmacist Association while at the NCPA 2015 Annual Conference in Washington D.C. (podcast 14:43m)