Why the Time is Now for Pharmacist Provider Status

By Ken Perez, VP of Healthcare Policy and Government Affairs, Omnicell

Every profession has its own importance, and associations seek to ensure that message is understood by the general public. But when a profession seeks to address a significant societal problem, then its virtues and value that it delivers become much more evident.

Take, for instance, the commendable work of My Pharmacy in Lexington County, South Carolina. It began administering COVID-19 vaccines in mid-January and as of early-September, it had surpassed 15,500 shots administered. The pharmacy has prioritized vaccinating people in rural and underserved areas by utilizing its mobile van to host vaccination events for various small communities. In recognition of its efforts, the South Carolina Department of Health and Environmental Control named My Pharmacy a recipient of the agency’s Community Hero award.¹

In addition to combating COVID-19, there is an opportunity for pharmacists to help address not only a significant, but worsening, societal problem of another profession—the nation’s physician shortage.

Primary Care Physician (PCP) Shortage

The United States is projected to have a shortage of almost 140,000 physicians by the end of this decade.² To put that number in perspective, it’s one-seventh of today’s total physician population.

Moreover, the current primary care physician (PCP) shortage is widely estimated to be 15,000 PCPs, and that number is projected to jump to as much as 55,000 by 2033, according to a 2019 study commissioned by the Association of American Medical Colleges.³

Worse yet, the PCP shortage is distributed unevenly. There are, like food deserts, PCP deserts—places where there are not enough PCPs, less than one for every 3,500 people, according to the Health Resources and Services Administration (HRSA). HRSA reports that 39% of our nation’s counties and 44 million people (13% of our population) live in these areas without enough PCPs.^4,5 And it is estimated that some 10 million Medicare beneficiaries are included in this underserved population.

This problem has certainly not escaped the attention of Congress. It’s mentioned in the Democrats’ $3.5 trillion spending plan, sometimes referred to as the human infrastructure bill, though the plan’s proposed solutions, notably increased funding for graduate medical education, do not provide immediate relief.

Pharmacy and Medically Underserved Areas Enhancement Act

The acute shortage of PCPs—as well as the perennial public perception of pharmacists as among the most highly trusted people in their occupations, right behind physicians⁶—led to the introduction in Congress of the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 2759 and S. 1362) in late-April. This short, three-page and straightforward bill would give pharmacists provider status, enabling them to get reimbursed for providing pharmacist services to Medicare Part B enrollees in these medically underserved areas. And in this hyperpartisan era in Washington it is a rarity, introduced in a bipartisan manner in both the House and Senate, and with steady growth in the number of cosponsors. As of mid-September, H.R. 2759 had 52 cosponsors split almost equally between Democrats and Republicans, and S. 1362’s 10 cosponsors included senators from across the entire political spectrum, including conservative Sen. Tom Cotton (R-Ark.), progressive Sen. Raphael Warnock (D-Ga.), and moderate Sen. Susan Collins (R-Maine).

Granting Provider Status to Pharmacists

What kind of pharmacist services would be reimbursed by Medicare? Prime examples include medication management, immunizations, point-of-care testing, and chronic disease management. And since the average Medicare beneficiary is on about five prescription medications, these pharmacist services would be extremely beneficial to help improve medication adherence by seniors in medically underserved areas—a population whose medication adherence is below average.

Granting provider status to pharmacists would create many opportunities for the profession to serve this population. For health systems, there would be a significant financial incentive to deploy pharmacists in higher-value, more patient-focused tasks in outpatient settings. For retail pharmacy clinics, there could be greater use of an estimated 250-300 retail clinics currently in medically underserved areas as well as an incentive to establish more of them.

And of course, provider status would enable pharmacists to practice at the top of their license, be more clinical, and derive greater satisfaction from their work.

Ultimately, the rationale for pharmacist provider status is rooted in its benefits to society, in helping ameliorate the PCP shortage and improve access to care. A March 2021 Harvard Medical School study concluded that if the primary care shortage in medically underserved areas was fully addressed, more than 7,000 lives would be saved annually, and the average life expectancy of Americans would lengthen by an average of 56 days.⁷

Thus, pharmacist provider status would assist a significant underserved population, providing much-needed access to care and saving thousands of lives in the process. May majorities in both chambers of Congress join the cosponsors of this common-sense bill for the good of the nation.

 

 

Footnotes

1. South Carolina Department of Health and Environmental Control, “DHEC Bestows ‘Community Hero’ Award to My Pharmacy in Lexington for Continued COVID-19 Vaccination Efforts,” https://scdhec.gov/news-releases/dhec-bestows-community-hero-award-my-pharmacy-lexington-continued-covid-19, Sept. 9, 2021.
2. Zhang, Xiaoming, et al., “Physician workforce in the United States of America: forecasting nationwide shortages,” Human Resources for Health, https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-020-0448-3, Feb. 6, 2020.
3. Association of American Medical Colleges, “New AAMC Report Confirms Growing Physician Shortage,” https://www.aamc.org/news-insights/press-releases/new-aamc-report-confirms-growing-physician-shortage, June 26, 2020.
4. Norton, Amy, “Shortage of Primary Care Doctors Is Costing American Lives,” U.S. News & World Report, https://www.usnews.com/news/health-news/articles/2021-03-23/shortage-of-primary-care-doctors-is-costing-american-lives, March 23, 2021.
5. LaPointe, Jacqueline, “13% of People Live in an Area with a Primary Care Physician Shortage,” RevCycleIntelligence, https://revcycleintelligence.com/news/13-of-people-live-in-an-area-with-a-primary-care-physician-shortage, Sept. 17, 2018.
6. Crossley, Kristen, “Public Perceives Pharmacists as Some of the Most Trusted Professionals,” Pharmacy Times, https://www.pharmacytimes.com/view/public-perceives-pharmacists-as-some-of-the-most-trusted-professionals, March 18, 2019.
7. Harvard Medical School, “More primary care physicians could mean gains in life expectancy, fewer deaths,” https://www.eurekalert.org/news-releases/488443, March 22, 2021.