So the title may be a bit misleading, there is still a long way to go for pharmacists’ recognition as health care providers. Numerous studies have illustrated the benefits of pharmacists in an expanded role, including the notable Asheville Project, started back in 1996, but the profession as a whole has not received enough of the needed support to fully assume the desired position with other health care members. Despite reports by the United States Public Health Service and even a former Surgeon General supporting pharmacists’ recognition as health care providers, legislation and policy still limit a pharmacist’s role in optimizing patient outcomes. Section 1861 of the Social Security Act doesn’t yet recognize pharmacists as health care providers, limiting the scope of practice and reimbursement of pharmacists throughout the health care system. In fact, access to Medicare Part B outpatient services are stymied by this absence of recognition, leading other health plans to follow Medicare’s footsteps and prevent coverage to patients and compensation to pharmacists for patient-centered care programs.
Now, in those last few sentences some people heard “reimbursement” and “compensation,” thinking that pharmacists are just pushing for provider status to line their pockets with more money, but that’s not the case. The case is that, without a certain amount of compensation, pharmacist-provided programs and medication therapy services (MTS) will never garner traction. No patient would expect a free office visit to the physician regardless of whether a prescription was written, so why is it so objectionable that pharmacists expect payment for such cognitive services as well? Given the amount of schooling pharmacists have to receive, their current utilization for health care services is questionable, to say the least. Beyond the previous arguments, without widespread implementation of such programs, overall health costs will not improve and patient care will stay suboptimal. While pharmacists do have some MTS capabilities in Missouri, the actual implementation of such services has not been widely accepted, mainly due to funding issues from lack of reimbursement.
With California’s acceptance of pharmacists as providers, a new precedent has been set. California pharmacists have been given many new clinical roles they may take on, and has set the standard for other states to emulate. The federal government has also created legislation to amend the Social Security Act, but this has only been recently introduced and needs much more support before Medicare Part B gives provider-status recognition to pharmacists. Until then, I urge you to continue supporting your local, state, and national organizations to push for pharmacist provider status. Without a continued and sustained effort, pharmacists may never receive the recognition they justly deserve.
PharmD candidate 2014
UMKC School of Pharmacy
Missouri Pharmacy Association Rotation Student, March 2014