- Health Care, Drugs & Insurance
Health Care Provider Status for Pharmacists
Pharmacists In Direct Patient Care
Despite the overwhelming evidence of the positive impact that pharmacists have on patients’ health, pharmacists are not recognized as healthcare providers under the Social Security Act, and therefore, cannot be paid by Medicare for medication therapy management and other patient consultation services. The Social Security Act currently recognizes other healthcare professionals, including dieticians, nurse practitioners, physician assistants, nurse midwives, and clinical social workers. This jeopardizes patient safety and does not benefit patient care.
How Pharmacists Help
For millions of senior citizens and individuals in the United States, with chronic illnesses, pharmacists play a vital role in ensuring optimal drug therapy. Pharmacists are medication therapy experts, so they ensure that a patients’ medications are the most appropriate, the most effective, the safest possible, and are used correctly. They also help identify, resolve, and prevent medication related problems that may interfere with the goals of therapy.This serves to help improve drug therapy and quality of life for patients across the United States.
Pharmacists also play a role on the front lines of public health as community health providers. Often patients approach a pharmacist for help as they are the most accessible healthcare professional in their community. Patients who are not insured, cannot afford copay, unable to go to a hospital, or fearful of consulting a physician, usually end up approaching a pharmacist for advice on their medical needs. Pharmacists make important recommendations for over the counter products (OTCs) that are appropriate and fit into the proper patient care model. Pharmacist also play an important role in making sure all medications that the patient takes are compatible, safe, effective and appropriate. Many times patients visit multiple doctors or healthcare providers so one provider may contradict another provider's care plan or provide a medication that may interact with another doctor's prescriptions. Thus pharmacist are at a unique position to verify all prescriptions of a patient and ensure that its safe and appropriate.
Quick Facts on Healthcare Costs
How Pharmacists Help
Direct cost of Medication-related problems for Seniors
Pharmacists check to make sure medications are safe for the patient (based on patient's body functions, labs etc.), that they are safe with other medications the patients are taking and that the medication is appropriate for the patient's condition.
28% of hospitalizations among seniors are due to adverse drug reactions
$516,034,829 among Medicare patients
Pharmacists counsel patients on the proper usage of medications, how to take it, what to avoid while on the medications and how to minimize the occurrence of adverse drug reactions. Pharmacists also verify that all medications the patient takes are appropriate and safe.
Total costs of drug abuse, addiction and enforcement are rising
Pharmacists can monitor medication refills and refer abusing patients for counseling and assistance with their addiction. Pharmacists can also help stop abuse and report offending physicians to reduce the cost of abuse.
Medication Adherence is a major problem for healthcare
33% of all patients take all of their medications as prescribed, 33% take some of their medications, and 33% do not take their prescribed medications at all. Pharmacists can play an important role in ensuring patients are taking their medications and help educate their patients on how to take their medicine properly. This will reduce the cost of non-adherence on the US healthcare system.
Pharmacists: Community Health Providers
How Pharmacists Save Money
Many studies exist that clearly show the benefit of having pharmacist work together with physicians and patients to reduce healthcare costs, optimize care and promote patient welfare. In a study known as the The Asheville Project, they studied the effect of how a pharmacist can be beneficial to patients with cardiovascular or cerebrovascular risk facts. According to the study, regular cardiovascular or cerebrovascular (CV) risk reduction education and followup by a pharmacist using scheduled consultations, monitoring, and recommendations to physicians reduced CV events and related medical costs while improving CV medications usage and showing clinical improvements in the patient population. The full study can be read here.
Another prospective, nonrandomized, proof-of-concept investigation was conducted in North Carolina to assess the clinical and economic impact of a pharmacist-focused health management program for patients with depression. The study showed that when outpatient-based pharmacists provided assessment, self-management services follow-up, and treatment recommendations to primary care providers within a collaborative care management model, it reduced the total health care costs per patient per year while significantly showing an improvement in the PHQ-9 clinical indicator of depression severity. The study details can be access here.
A study conducted in the various hospital, university and research organizations in Brazil and Croatia, such as the Department of Pharmacology and Therapeutics, State University of Maringá in Brazil and Department of Clinical Pharmacology, University Hospital Dubrava, Zagreb in Croatia, showed that if a pharmaceutical care program was implemented , it resulted in better clinical measurements and reduced the cardiovascular risk scores in elderly diabetic and hypertensive patients. Pharmacists are uniquely positioned to provide such a care plan in the United States and can be used to reduce risk factors, significantly improve clinical measurements in patients with chronic conditions while reducing the overall cost of treatment failures to the healthcare system. The study can be viewed via Google Documents.
In one study, Employers, who are the largest providers of healthcare plans in the United States, demonstrated a willingness to offer a voluntary health benefit to employees and their dependents with diabetes that uses pharmacists to help participants achieve self-management goals. Patients participating in the first year of the diabetes ten city challenge (DTCC) had measurable improvement in clinical indicators of diabetes management, higher rates of self-management goal setting, and increased satisfaction with diabetes care. This study can be viewed in detail here.
Based on these study results and other studies, pharmacists are uniquely suited to help drive the total direct patient medical costs down while reducing the overall cost to the U.S. Healthcare system.
How You Can Help
Start by letting our elected officials know about the important role pharmacists play in the healthcare system. Society needs to understand the key roles that pharmacists have in ensuring positive health and clinical outcomes. This includes, but is not limited to, the safe and effective use (and delivery) of medication. The benefits to society and impacts on human lives cannot be overemphasized. Pharmacists are not only key healthcare providers, but also lifesavers.
Thus, please join me in advocating for our profession, and let President Obama know that the pharmacists in the United States of America need to be given healthcare provider status. The petition can be found on the whitehouse.gov website.
- Whitehouse.gov Petition to recognize pharmacists as health care providers!
Whitehouse.gov petition to recognize pharmacists as healthcare providers under the Social Security Act
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- Fox News - Secret Weapon in Health Care: Your Pharmacist
Pharmacists may still dispense pills, but they’ve ramped up their role to become an important member of a patient’s health care team, enhancing access, improving outcomes and integrating care.
- Improving Patient and Health System Outcomes through Advanced Pharmacy Practice
This comprehensive Report to the U.S. Surgeon General Dr. Regina Benjamin on current pharmacy practice has been reviewed and discussed collaboratively between U.S. Public Health Service (PHS) Pharmacy leadership & the Office of the Surgeon Genera
- ACCP - Report on Provider Status for Clinical Pharmacists
Although current payment policy and traditional practice focus on the prescribing and distribution of medications, they fail to provide for a coordinated process of care that ensures effective and safe medication use.
- ASHP - Achieving Provider Status for Pharmacists
Achieving provider status under Section 1861 of the Social Security Act is important for the profession. It is essential to recognize pharmacists for the patient-care providers that they already are