Mike Hennessy, Chairman

In today’s publishing industry, focus is the key to success. An astute publisher finds a niche market with a need, gets to know its customers and investors, and provides them with the value they seek. If value is delivered, the readers, page views, and sponsorship should follow, because word about value—or lack of it&mdash;travels at the speed of social media.

Conversely, a focus on numbers, instead of value, is how health care and big government often fail us. How much money was saved? How many prescriptions were filled? Institutions and organizations live and die by the answers to these short-sighted questions while missing the most important question for long-term sustainability and growth: how much value are we providing to our customers?

Businessman Gary Vaynerchuk describes it well: "When I hear people debate the ROI [return on investment] of social media? It makes me remember why so many business[es] fail. Most businesses are not playing the marathon. They’re playing the sprint. They’re not worried about lifetime value and retention. They’re worried about short-term goals."

	Your organization may have high patient turnover, but it won’t be sustainable without quality products and services. Patients still care about value and can easily change their pharmacy, especially these days when so many competing pharmacies are adjacent to each other.

	To truly know the value we provide our customers, we need to ask them. For example, 

 conducts monthly reader surveys and regular focus groups to learn how we can best provide you with the information you need to deliver value to your customers. The content in this Digestive Health issue has been carefully tailored to you and your patients, with topics including probiotics, opioids and constipation, gastroesophageal reflux disease, and nausea and vomiting.

 team to learn that it is on track in providing pharmacists with the value they seek. So we are pleased to announce that 

 outranked all competitors in Average Issue Readership among the total sample studied, according to the 2016 Kantar Media Pharmacy Readership Data. We couldn’t achieve this high honor without you, so we thank you and pledge to continually strive to provide you with the most useful and up-to-date information to help you in your everyday practice.

	Thank you for reading, and enjoy the summer!

Articles

Focus on Value, and Growth Will Follow

Zika virus, which the World Health Organization has called a “public health emergency of international concern,” continues to move toward the United States, with alarming developments along the way:

		The CDC has confirmed sexual transmission of the virus, and it is more common than expected.

		The effect on fetal brain development seems to be more serious than first thought.

		The geographic range of the mosquitoes that transmit Zika far exceeds initial estimations. (For more on this, see “Zika Virus Outbreak May Spread to More US States” on page 24 in this issue.)

In February, the White House asked Congress for $1.9 billion in emergency funding to combat Zika virus by supporting mosquito control, disease detection and testing, vaccine development, and support for maternal women’s health. Congress sat on this request for 3 months while the Zika virus became poised to infect residents of red and blue districts alike. Eventually, the Senate passed a compromise $1.1 billion measure. In the meantime, the White House had reprogrammed nearly $600 million of existing funds, earmarked for addressing Ebola, to help support the Zika response.

Instead of waiting on government to protect us, Americans should proactively prepare for the Zika virus, especially by getting educated. Fortunately, pharmacies and pharmacists are in a pivotal position to make a difference. Denise J. Jamieson, MD, medical officer in the CDC’s Division of Reproductive Health, previously told 

 that pharmacists can help manage the Zika virus by helping patients recognize symptoms after traveling. They can also recommend that patients seek medical care, especially by their obstetric providers, if they are pregnant.

“Many travelers visit their pharmacy before trips abroad to fill prescriptions, get immunized, or buy other OTC medications,” Dr. Jamieson said. “That visit to the pharmacy could provide a great opportunity for patient education about Zika virus transmission.”

In addition, pharmacists should advise their patients to follow CDC recommendations by (1) throwing away water-holding containers, and cleaning items such as bird baths and pet dishes, on a weekly basis, (2) wearing long-sleeved clothing, socks, and shoes when outdoors, and (3) applying a bug repellent on exposed skin.

If we experience a Zika virus outbreak, pharmacists are likely to become a go-to resource for information. The government, on the other hand, is likely to be overwhelmed and ineffective, based on its track record during previous crises. In the meantime, let’s all get educated and otherwise prepared for what could be an interesting summer.

Zika virus, which the World Health Organization has called a public health emergency of international concern," continues to move toward the United States, with alarming developments along the way.

Zika Virus Is Moving Fast, but Congress Isn't

Have you ever noticed a disconnect between a reported trend in pharmacy and what’s actually happening in the trenches? For example, a report may indicate that demand for pharmacists exceeds supply in a certain region, but community pharmacists in that region may say otherwise via social media.

Another example is value-based care—a hot topic that’s expected to significantly affect how pharmacy is practiced and measured. However, 

 recently spoke with a small group of community pharmacists who had never heard of value-based care. Apparently, it’s not affecting them right now in their trenches.

 is here to help bridge the gap between pharmacy trends and what’s happening in the pharmacy trenches. We strive to help you prepare for changes on the horizon and provide you with the latest news from the pharmacy “street.” When the trends and the trenches don’t seem to align, our print and online contributors speak up, but it’s also an opportunity for you to react to the discrepancies via Facebook, Twitter, LinkedIn, and Instagram.

Here’s a trend to prepare for: as Americans are exposed to more sun over the next several months, they’re more likely to develop related skin or eye health issues—and have questions about them. Fortunately, pharmacists are an accessible consumer resource on skin and eye health issues, regularly making product recommendations and guiding patients toward better health.

To support pharmacists in these endeavors, 

 provides this Skin & Eye Health issue. Within these pages, the OTC Focus gives advice on relieving dry eye, the Rx Focus discusses new treatments for rosacea, and the Health & Wellness feature on sunburn sheds light on lesser-known factors regarding this all-too-common problem.

This is a good time of year to break out of our ruts and embrace change. Let me leave you with these suggestions for channeling your spring and summer energy into a positive career move:

		Exercise your freedom to live and practice where you like, no matter what the market trends say. Just because the results of a survey or statistical analysis indicate few opportunities in certain regions doesn’t mean there aren’t some great opportunities for the right individuals in those places.

		Seek opportunities to be entrepreneurial. This doesn’t have to mean starting your own business. Many pharmacist entrepreneurs work within their organizations and are rewarded for their initiative. For some guidance and inspiration, check out “6 Tips for Pharmacist Entrepreneurs” and “Are You a Pharmacist Intrapreneur?” by our online contributors.

		Don’t wait for government, big or small, to solve your problems. That next piece of promising legislation may not live up to its expectations. Many pharmacists are taking action, without the help of government, to improve themselves, their organizations, and their communities, as 

 demonstrates through its annual Next-Generation Pharmacist

Have you ever noticed a disconnect between a reported trend in pharmacy and what's actually happening in the trenches?

The Trends and the Trenches: Bridging the Gap

The pharmacist’s role continues to evolve from a distribution focus toward an emphasis on value-based health care. As a result, pharmacists are becoming more active drug-therapy decision makers and an increasingly important part of team-based health care. By enhancing appropriate drug-therapy outcomes, pharmacists are ensuring the value of health care services.

Provider status also seems poised to propel pharmacy. The House of Representatives, and eventually the Senate, are expected to pass bill HR 592. Passage of the bill would allow immediate billing of medication therapy management (MTM) by pharmacists, prompting most medical practices to require MTM and, in turn, ensure better medication adherence and patient outcomes. The federal legislation supports having pharmacists recognized as providers by CMS, and it is hoped that commercial payers will also come on board.

Pharmacists should support grassroots activities that promote passage of HR 592 and any supportive state legislative bills. With the passage of these bills, pharmacists will have new opportunities to practice in current environments and in potential new practice areas. Provider status could also be an incentive for additional professional training, residencies, and board certifications.

Together, value-based care and provider status are looking like a winning combination for empowering pharmacy and individual pharmacists in terms of patient care, especially for treating chronic conditions such as respiratory disorders— the clinical focus of this issue. According to the Centers for Disease Control and Prevention, the proportion of Americans with asthma grew by nearly 15% in the past decade; more than 22 million Americans are now affected.

 Another major respiratory issue is allergies, which are now the sixth leading cause of chronic illness in the United States. More than 50 million Americans suffer from allergies each year.

 In addition, approximately 15 million Americans have been diagnosed with chronic obstructive pulmonary disease.

 The numbers are staggering, but advances in diagnosis and treatment continue. Pharmacists are doing their part to help, but we can only imagine the positive impact that they might have if empowered by provider status.

Now the good news: pharmacists are in a unique position to mitigate the physical and economic burdens of these diseases. To support pharmacists in their efforts to improve Americans’ respiratory health, this issue offers practical information that can be applied immediately. Topics include OTC intranasal steroid inhalers, cystic fibrosis, e-cigarettes, and allergen immunotherapy—plenty of information to help you and your patients breathe easier this spring.

		Asthma. Centers for Disease Control and Prevention website. cdc.gov/asthma/faqs.htm. Accessed February 18, 2016.

		Allergies. Centers for Disease Control and Prevention website. cdc.gov/healthcommunication/ToolsTemplates/EntertainmentEd/Tips/Allergies.html. Accessed February 18, 2016.

		Chronic obstructive pulmonary disease (COPD). Centers for Disease Control and Prevention website. cdc.gov/copd/index.html. Accessed February 18, 2016.

The pharmacist's role continues to evolve from a distribution focus toward an emphasis on value-based health care.

Value-Based Care and Provider Status: A Winning Combination

This month marks the official kickoff for the election season. Caucuses like Iowa’s resemble the NFL playoffs in that they aggressively determine which candidates will be on the ballot for the general election, which is essentially the Super Bowl of the presidential race.

Before the actual voting began at the Iowa caucus on February 1, party officials did some lastminute campaigning or gave speeches to sway voters at each of the state’s 1681 precincts. In a Republican Party caucus, voters then cast secret ballots in private voting booths, just as they would during the general election. In a Democratic Party caucus, however, voters swarm into groups for each candidate, and any candidate who does not have at least 15% of the total head count is removed. Those who voted for removed candidates must then be swayed to a new candidate and counted off again. This process, which got pretty intense at the 2008 Iowa caucus, continues until only viable candidates are left. 

Sounds outright complicated for a small part of the voting process, right? One idea to simplify this course comes from a 12-year-old boy named Jackson Jarrett in his book, 

. Doing away with caucuses and primaries, Jackson recommends limiting polling locations to just 5 vicinities in the United States, not allowing any political signs to be displayed within those polling places, and giving voters 1 month to cast their ballot.

For this year’s Next-Generation Pharmacist

 awards (nextgenerationpharmacist. com), 

 and Parata Systems are giving you until April 24, 2016, to nominate a fellow pharmacist, technician, or pharmacy student who deserves to be honored as an outstanding pharmacy leader. We keep the selection process based on merit by having all eligible entries evaluated by an independent panel of esteemed judges who use only professional standards, experience, and advancement in the profession as scoring criteria. As Jackson argues in 

, those holding the ballots should not have to know the candidates to vote for them, but should simply vote for the best candidates.

The winners and their stories inspire others to pursue excellence in their own careers. Learning about someone who has beaten the odds, accomplished a major feat, or created something unique expands our vision of what is possible for ourselves. Go to pharmacytimes.com/ NGPawards to read about past Next- Generation Pharmacist® winners and get inspired! Notice that they credit others with helping them achieve their goals: These leaders know that collaboration ensures quality.

Caucuses like Iowa's resemble the NFL playoffs in that they aggressively determine which candidates will be on the ballot for the general election, which is essentially the Super Bowl of the presidential race. 

Simplifying the Election Season

Almost 6 years ago, the Affordable Care Act (ACA) was signed, a law constructed with the notion of making health care more affordable, accessible, and of higher quality. Although health reform was well-intended, questions remain about the ACA’s directional effectiveness, with many employers concerned that costs are rising, not abating, and that consumer expectations of coverage and plan design will not be met as insurance products are watered down to accommodate newly covered populations under new regulatory guidelines.

Indeed, the jury is still out on the ACA and much ambiguity remains as to its future implementation and sustainability. Regardless, one of the enduring aspects of the ACA that will likely live on with some certainty is a healthy dialogue on quality over quantity, or value over volume. The recent shift out of the Centers for Medicare & Medicaid Services toward value-based care and reimbursing health care providers for the quality of the care they provide rather than the quantity of patients they serve is profoundly impacting health care and opening the doors for new avenues of care delivery, such as telehealth and retail clinics. Payers are quick to learn where their money is going, while providers have been quick to learn how they will be reimbursed.

 is dedicated to reviewing the new measures and practices in pharmacy that have developed as a result of the ACA. Articles in this issue address how community pharmacies will be affected in terms of reimbursement, how enacting pay-for-performance measures needs to coincide with recognizing pharmacists as health care providers, and why pay-for-performance plans will need to provide prospective payments for a standard base of services along with a shared savings program determined by each plan.

Patients, who have been compelled to bear the heavy burden of rising health care costs and mandatory coverage regulations, now want to know that their hard-earned money is going toward high quality care. Therefore, we included in this issue an article that explores value-based insurance design and how it rewards evidence-based services and high-performing providers, with the intent of providing improved care to patients. Authors in this issue also discuss how a greater overall focus on health care quality is prompting a focus on medication therapy management programs to improve medication use, and they outline steps pharmacies can take to achieve this.

Another effect of the ACA is health system consolidation. An increased focus on cost and value is also causing health systems to stand up and take notice of the value pharmacists bring to the health care team and the additional services their knowledge and training allow them to provide. The authors in this issue argue that pharmacists should be acknowledged as providers to ensure that their clinical services are sustainable. In addition, we include 2 articles that provide insights into the latest legislation out of West Virginia and Iowa, measures that are tied to assigning a level of accountability to all players in the game.

As we near the end of 2015, a year in which 

 focused on quality, adherence, advances in health information technology, the patient, and wellness, we look forward to carrying all we’ve learned with us into a new year in which health care will be at the forefront of political debates. 

 will continue to provide our readership with multiple stakeholder perspectives that offer engaging, thought-provoking, and future state-oriented content.

Almost 6 years ago, the Affordable Care Act was signed, a law constructed with the notion of making health care more affordable, accessible, and of higher quality.