Unprecedented opportunities for managed care organizations and community pharmacies to work together.

■■ Unprecedented Opportunities for Managed Care Organizations and Community Pharmacies to Work Together Over the years, a considerable amount of discontent and distrust has been expressed between community pharmacies and managed care organizations (MCOs), especially between community pharmacies and pharmacy benefit managers (PBMs). In fact, one can deduce from the pharmacy press that the discontent between the 2 industry groups continues to grow. Most of the friction between MCOs/PBMs and community pharmacies has revolved around the MCO/PBM business model with transparency issues and lack of a “level playing field” for PBM-owned mail-service pharmacies. Some of these fairness issues are being addressed by state legislatures. Despite the troublesome issues, one would expect the rift between these groups to diminish as common ground became more obvious with the advent of the Medicare Part D prescription drug program. In fact, some groups are working together to improve patient care and deliver medication management programs. For example, Community Care Rx, which provides patient care services with its network pharmacies, and Maryland BlueCross BlueShield’s Medi-CareFirst Part D plan are paying pharmacists for pharmacist-patient drug consultations.1 MemberHealth, a PBM, just recently honored Medicine Shoppe International, Inc., for patient care services provided to beneficiaries.2 Surprisingly, however, not many patient care-focused partnerships have evolved between community pharmacies and MCOs/PBMs. Early signs indicate that community pharmacies are not the principal providers of medication therapy management (MTM). A 2005 survey of 97 Medicare Advantage and stand-alone prescription drug plans (PDPs) revealed that only 8.2% planned on using community, long-term care, hospital, or clinic pharmacies to deliver MTM. The majority indicated they were going to use pharmacists employed by the MCOs.3 A 2006 survey of 21 distinct MTM programs from 70 health insurance plans representing 50 PDP and 221 Medicare Advantage plans and covering 12.1 million beneficiaries found that only 4 MTM programs had service contracts with community pharmacies.4