Pharmacies emerge as centers for health screenings
One of the most promising recent developments in the nation’s search for a more accessible and cost-effective healthcare system has been the rapid rise of health events and free testing services at chain and independent pharmacies. The events have boomed in popularity over the past few years, to the benefit of millions of Americans.
These “non-traditional mechanisms to engage patients,” said Alex Hurd, senior director product development, growth and payer innovation at Walmart health and wellness, are helping hundreds of thousands of Americans spot potentially dangerous conditions like diabetes and high blood pressure early.
“Knowledge is the first step in your personal journey to health improvement, and you can’t take action unless you know that you have issues,” Hurd pointed out. “It’s about early … detection and prevention, and providing access points for health services for millions of Americans who normally don’t engage with the system, either because they lack health insurance, lack the time or simply because they don’t go."
“We’ve heard hundreds of stories of customers who sought out medical professionals [after being screened],” he added. “And from a public health perspective, if you look at the sheer amount of traffic we see, [with] 140 million customers every week … it just makes sense.”
Indeed, the positive impact that these health screenings are clearly having on population health are spurring companies like Walmart to expand the scope and frequency of the events. “They’re not just important for Walmart; I think they’re critical to the health of our country,” Hurd asserted. “They represent one of the most exciting trends in health care in the last decade, and one of the simplest mechanisms out there for spreading massive health awareness. I am absolutely convinced that these types of community-based health programs will play a key role in creating a more sustainable health system for our country.”
Added a spokesman for Walgreens, “the main focus … is to bring needed healthcare services to where people live and work. The response has been extremely positive at events within our stores, as well as those we host within the community.”
Here’s a look at what just a few pharmacy chains are doing:
• Between October 2015 and January 2016, CVS Health hosted nearly 750 Project Health events at select stores in 20 markets, “delivering more than $10 million worth of free health services to multicultural communities with a significant number of uninsured or underinsured individuals across the United States,” said David Casey, the company’s VP of workforce strategies and chief diversity officer. ”Since 2006, Project Health has delivered more than $80 million worth of free healthcare services to more than 845,000 people,” Casey added.
• Walgreens hosts or participates in a variety of health events throughout the year, often in partnership with other national or local community health providers — and even with the federal government. “When appropriate, and as often as we can, we utilize our own providers for health events,” a Walgreens spokesperson explained.
• Rite Aid rotates monthly health fairs through many of its more than 4,200 stores, offering screenings for conditions like osteoporosis, diabetes, hyperlipidemia and skin diseases, as well as counseling on healthy eating, heart health and smoking cessation. The chain also sponsors mobile screenings with specially equipped buses, staffed by physicians and nurses, that will park at store locations to offer free tests for skin conditions and diabetes, as well as free annual wellness screenings for patients age 65 years old and older.
• Costco Wholesale’s pharmacy team organizes hundreds of individual store health events each year, offering free screenings for osteoporosis, heart and lung health and, most recently, diabetes.
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Open for business: Pharmacies respond to emergency
When Hurricane Sandy flooded the streets of big cities and beachside communities on the East Coast, when Winter Storm Jonas dumped several feet of snow on cities up and down the eastern seaboard, when tornadoes devastated towns in Texas and Oklahoma, and when floods in the Midwest turned streets into waterways, local pharmacies and national pharmacy retailers were among the first responders.
Retail pharmacies play an important role in disaster and emergency situations, often acting to provide first response aid for people needing food, water, medical supplies and healthcare services.
In recent years, the integrated efforts of the retail pharmacy community have led to an increased ability to react quickly and dedicate targeted aid during emergency situations.
“For our part, community pharmacies are a valuable emergency response resource for reaching the public with essential medications and vaccines,” said Kathleen Jaeger, the National Association of Chain Drug Stores’ SVP of pharmacy care and patient advocacy. “Pharmacists are uniquely positioned to reach broad segments of a community, especially since 93% of Americans live within five miles of a community pharmacy.”
Examples abound. Jaeger noted in an emergency preparedness forum sponsored by the Pharmaceutical Research and Manufacturers of America, “During the 2009 H1N1 influenza pandemic, pharmacists improved the capacity and reach of the public health system by administering more than 5 million doses of H1N1 vaccine in a matter of weeks. The partnership between pharmacy and the public health community that formed during this outbreak provided a foundation to strengthen and expand connections between public health entities and community pharmacies, and recognize the extensive reach and capacity of pharmacies as a vital component of emergency response.”
“As we have witnessed from forest fires to hurricanes to broad pandemics,” she added, “pharmacies play an essential role as a trusted access point for care and are committed to working … to build a stronger healthcare preparedness system.”
To that end, when natural disasters and public health emergencies occur, pharmacies work diligently to provide continued access to medicine for patients during times of crisis.
During the aftermath of Hurricane Sandy, CVS Health partnered with the U.S. Department of Health and Human Services and the N.Y.C. Department of Health and Hygiene to waive co-payment deductibles for New York residents affected by the storm.
Rx Response, set up by PhRMA in 2006, is dedicated to protecting patients’ continued access to medicine during times of crisis. This charitable organization features an integrated network of pharmacy chains that can provide real-time information to help people find open pharmacies during emergency situations, so they can continue to fill needed prescriptions. In 2015, Rx Response changed its name to Healthcare Ready to reflect its coordination of the broader healthcare system and the public sector during natural disasters, terrorist attacks, disease pandemics and other emergency situations.
In a recent response to Winter Storm Jonas, Healthcare Ready activated its Rx Open online resource tool to provide information on open pharmacies in 17 states and Washington, D.C.
Apart from making major investments in relief efforts, retail pharmacy chains are establishing policies that will allow for maximized aid during times of crisis.
Walmart, with more than 4,500 pharmacies, has been operating an Emergency Operations Center at its headquarters in Bentonville, Ark., since the early 2000s. This facility is staffed with an in-house meteorologist who monitors weather patterns and a team of dedicated associates trained to respond to disaster situations.
Last year, Walmart and the Walmart Foundation invested more than $1.5 million, according to a company source, to “strengthen technological infrastructure for disaster response and resiliency, build capacity to facilitate skills-based volunteerism during disasters, and convene leaders in disaster relief to share best practices.”
CVS Health, Walgreens Boots Alliance and other retailers have responded to disasters in part by setting up mobile pharmacy trailers in affected communities to fill prescriptions and offer essential supplies. Most recently, CVS Health, Walmart and other retail drug chains have rallied support for the Flint, Mich., community through donations, education and online services.
In addition, point-of-care facilities within retail pharmacies, such as Kroger’s The Little Clinics, CVS Health’s MinuteClinics or Walgreens Boot Alliance’s Healthcare Clinics, are staffed by nurse practitioners who can provide much needed healthcare services during times of crisis. Those services can range from administering tetanus shots to dressing wounds. Retail clinics also can staff storm shelters with nurse practitioners from their in-store clinics to provide healthcare services during disaster situations.
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Amid access and cost challenges, U.S. health system turns to pharmacy
With the nation struggling to pay its massive health bill, medical schools turning out fewer and fewer primary care doctors, 10,000 boomers a day turning 65 years old and putting new stress on Medicare and health services, the Affordable Care Act demanding new cost-saving solutions to front-line care, and chronic diseases reaching epidemic proportions, it’s clearly time to fully engage the nation’s nearly 180,000 community pharmacists in the urgent campaign for a more effective, more accessible and less costly healthcare system.
The pharmacy profession — and the industry it drives — is up to the challenge. Armed with a doctorate in pharmacy and advanced training in pharmacology, population health, clinical care and patient counseling, today’s community pharmacists are ready and able to do more to help relieve the stress on the nation’s vast, overburdened and staggeringly expensive healthcare system.
Indeed, they’ve already stepped up as frontline providers of vital services like immunizations, medication therapy management, disease prevention, health screenings and healthy lifestyle counseling. And with a fairer and more rational payment system for pharmacy services in place, they could do much more to improve Americans’ overall wellness and curb the rising health cost spiral.
“Retail community pharmacists provide high quality, cost-efficient care and services, especially for patients with chronic conditions,” noted Steve Anderson, president and CEO of the National Association of Chain Drug Stores. “However, the lack of pharmacist recognition as a provider by third-party payers, including Medicare and Medicaid, has limited the number and types of services pharmacists can provide, even though fully qualified to do so.”
“Pharmacists play an increasingly important role in the delivery of services, including key roles in new models of care beyond the traditional fee-for-service structure,” Anderson added. “Pharmacists are engaging with other professionals and participating in models of care based on quality of services and outcomes, such as ACOs (accountable care organizations). They’re also partnering with healthcare providers working in nearby health systems and hospitals, serving as part of care teams to help improve patient health and outcomes.”
NACDS calls pharmacists “the face of neighborhood healthcare — the final link in a chain of care that extends from health providers to patients, and unquestionably the nation’s most accessible health professional.”
‘We need to make changes’
The growing reliance on pharmacists as fully engaged and clinically capable members of the modern patient-care team couldn’t come at a better time. Costs of acute care services and hospitalizations have skyrocketed. And the nation’s growing shortage of primary care physicians — traditionally the first line of care for most Americans — is reaching critical levels.
This growing squeeze on the number of primary care physicians has made access to affordable healthcare a hot-button issue. And it comes even as the U.S. health system is in the midst of a “back to basics” movement that’s “making primary care once again the critical touchpoint,” according to PriceWaterhouseCoopers’ Health Research Institute. “Besides elevating the role of primary care physicians, that movement is also elevating the critical importance of pharmacists, retail clinicians and other health professionals who extend and supplement the role played by family-practice doctors in a team-based, more collaborative network of frontline care,” PwC reported recently.
“America’s population is living longer than ever before; however, the number of people suffering from chronic disease is at an all-time high and growing,” noted Dr. Harry Leider, chief medical officer at Walgreens, in a report for the Congressional newspaper The Hill. “Almost half of U.S. adults — approximately 117 million people — have at least one chronic disease, resulting in three-quarters of our nation’s annual healthcare expenditures going toward costs for treatment and management of these conditions.
“We’re also challenged with a primary care physician shortage that’s only supposed to worsen, with the Association of American Medical Colleges predicting that in five years there will be nearly 100,000 fewer doctors than the number needed,” Leider added. “And, of course, there is the influx of newly insured individuals into the healthcare system as a result of the Patient Protection and Affordable Care Act.”
“Against this backdrop, it’s clear we need to make changes to our system to counter these trends that will only continue to hinder patient access,” he noted. “One viable solution is to promote the important role that community pharmacists can play in providing patient care, in the same manner as other non-physician providers like nurse practitioners and physician assistants.”
Many of the stakeholders who will determine the future direction of health care in America are beginning to heed that advice. Government and privately run health plan payers, hospital-based health systems and time-pressed family physicians are turning to pharmacies nationwide to provide more cost-effective and accessible frontline healthcare services.
“It’s often said that pharmacists are the most underutilized healthcare professional in the healthcare system,” said Anne Burns, VP of professional affairs at the American Pharmacists Association. “That’s changing as policy-makers, media outlets, healthcare administrators, and physicians and other members of the healthcare team highlight the value that pharmacists can bring to improving patients’ health and medication outcomes.”
To see the full report, click here.