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Elevated professional status drives patient access
Converging trends in health care, including a rapidly aging baby boomer population, a steady rise in chronic disease and massive policy changes such as those associated with the Affordable Care Act, are creating increased demands for patient care just as the shortage of primary care physicians continues to become ever more pronounced — in five years it is expected that the United States will have about 100,000 fewer primary care physicians than needed — and threatening to further compromise an already overtaxed healthcare system.
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The Pharmacy and Medically Underserved Areas Enhancement Act — now pending in Congress as H.R. 592 and S. 314 — would address that by leveraging the convenience and the clinical expertise of the community pharmacist, helping to expand access to care for millions of underserved Americans, lowering the cost of delivery of critically important frontline health services and fostering new models for collaborative care.
The legislation “would designate pharmacists as healthcare providers in Medicare Part B — empowering them to deliver services to Medicare patients in underserved communities, according to pharmacists’ scope of practice laws in each state,” explained Steve Anderson, president and CEO of the National Association of Chain Drug Stores. He called the growing support for the legislation from Congress and within the U.S. population “just one example of the growing recognition of pharmacy’s value, and the ability of highly trusted, highly educated and highly accessible pharmacists to improve and save lives.”
The “lack of pharmacist recognition as a provider by third-party payers, including Medicare, has limited the number and types of services pharmacists can provide, even though they are fully qualified to do so,” Anderson said. “The adoption of policies and legislation to increase access to much-needed services for underserved Americans, such as … the Pharmacy and Medically Underserved Areas Enhancement Act, would allow Medicare Part B to utilize pharmacists to their full capability by providing those underserved beneficiaries with services not currently reaching them.”
Among the nation’s pharmacy leaders, the bill is perhaps better known simply as provider status legislation. Why? It would confer professional status as healthcare providers on pharmacists who provide health services to seniors in need, putting them on roughly equal footing with other professional caregivers, such as nurse practitioners and physician assistants, as members of the modern, coordinated healthcare team.
“H.R. 592 and S. 314 would build on existing law that allow nurse practitioners and physician assistants to be reimbursed by Medicare by covering services delivered by pharmacists,” noted the Patient Access to Pharmacists’ Care Coalition, an advocacy group whose members include NACDS, the National Community Pharmacists Association, the National Consumers League, the National Rural Health Association and many other groups.
“Similar to the law for NPs and PAs,” added the advocacy group in a report, “the Pharmacy and Medically Underserved Areas Enhancement Act would limit rates to 80% or 85% of what would be paid to physicians, helping limit Medicare spending while improving access.”
Unleashing innovation in cost-effective care
Efforts to expand the pharmacist’s scope of practice have steadily gained traction in Congress. Prior to the end of the last session, H.R. 592 had drawn 264 Democratic and Republican co-sponsors in the House — more than 60% of the total membership — and 41 co-sponsors in the Senate.
Public support for elevated status for pharmacists also is solid. The most recent national opinion research poll from NACDS shows that more than 8-in-10 consumers are in favor of the bill.