Pharmacists as providers: The expanding, changing role

Although many states and the federal government are taking a close look at granting provider status for pharmacists, the two entities have slightly different priorities.

ThompsonKasey Thompson, vice president, American Society of Health-System Pharmacists (ASHP), says his organization is hoping to amend the Social Security Act to grant recognition to pharmacists as providers eligible for Medicare Part B reimbursement.

Bipartisan companion bills introduced last January-the Pharmacy and Medically Underserved Areas Enhancement Act (S. 314) and H.R. 592, target that objective.

"It is about coverage of services and access to them by Medicare beneficiaries, not about a designation as provider," says Stacie Maass, senior vice president, pharmacy practice and government affairs, American Pharmacists Association.

Related: The new patient-centered pharmacy

Maass says there have been discussions on the topic for more than a decade, with more activity in recent years as states seek new ways to deliver more efficient, coordinated and team care; promote better access; and free up physician time as more individuals seek coverage under the Affordable Care Act.

Maass is optimistic that if the federal law makes it possible for pharmacists to gain reimbursement under part B, commercial insurers will follow suit in compensating pharmacists for their services. "Pharmacists have more medication expertise than anyone," she says.

Varying levels

Thompson says most states already consider pharmacists to be "providers," which he says is the first level of ascribing more recognition. The next level is an expanded role including such services as prescribing, furnishing immunizations and working with other healthcare team members to assess patient conditions. The highest tier is providing reimbursement for services.

"The federal legislation is important with today's insufficient number of providers and more complex medications that need special expertise," Thompson says.

Related: New weapons combat opioid addiction

By 2025, there will be a nationwide shortage of between 45,000 and 90,000 primary and specialty care physicians, according to the Association of American Medical Colleges.

If pharmacists get their way, they will join a number of non-physician practitioners who are already compensated under Part B.

 

Internal server error