In advance of legislation, Cardinal Health readies community pharmacists for provider status

With three states — Oregon, Washington and California — already setting the stage for provider status for pharmacists, there is a steady momentum behind provider status legislation that is spawning an optimism among the industry that pharmacists may soon be recognized — and fairly compensated — for all that they do.



That optimism is not without its merits.



Clearly, support continues to grow at the federal level. Currently, 45% of the Senate and 65% of the House of Representatives have signed on as co-sponsors to support provider status legislation, now pending in Congress as The Pharmacy and Medically Underserved Areas Enhancement Act, otherwise known as bills S. 314 and H.R. 314, respectively.



But according to noted provider status expert, Brad Tice, who is director, marketing and product management — performance and clinical outcomes at Cardinal Health, there are two steps to achieve before this legislation can be considered. The first is a cost analysis conducted by the Congressional Budget Office that scores the cost associated with provider status legislation for pharmacists. That step may very likely come to pass before Cardinal Health gathers in Chicago for its RBC meeting in July, Tice told DSN. “Once that is done, that sets the stage for identifying whether [this legislation] can be passed now in an election year,” he said, adding that passing legislation in an election year is normally difficult at best.



The other step that needs to happen before provider status legislation can become enacted is a hearing in the House. “Typically that would happen after the [Congressional Budget Office’s] scoring,” he said. “That’s being worked on as well.”



Provider status is expected to be a game-changer for the business of pharmacy — and not only because it better matches remuneration for the contribution pharmacists are making to the overall healthcare delivery system. “There is the old fee-for-service world where providers are authorized to bill in Medicare for services, and pharmacists have not been included on that list,” Tice said. “There’s also a new payment world of value-based care. One of the aspects that we’re finding is that because pharmacists have not been listed as providers, they have not been included in some of the conversations around the new payment structures,” he said. “[Provider status] gives pharmacists a seat at the table in these efforts.”



Meanwhile, Cardinal Health continues to work hard to ready the independent pharmacy community for a new business model. “Currently Cardinal Health is working in several areas in advance of this [legislation], such as medication therapy management and transitions in care [from hospital to home] where we are actively working to bring programs forward to get pharmacists compensated for the services they deliver,” Tice said.



Provider status also represents a “transition in practice” from a retail environment to a service environment. And that transition could prove challenging for pharmacists as they reconfigure their pharmacy workflow to incorporate more patient consultations without impacting the number of prescriptions dispensed each week.



To help with that transition, Cardinal Health in February launched MedSync Advantage™ (link to MedSync Advantage story), the newest offering in a comprehensive suite of solutions from Cardinal Health, which the company refers to as “Reach for the Stars.” The online platform was designed by Fuse, the innovation lab by Cardinal Health, which seeks to connect technology with health care.



With Cardinal Health MedSync Advantage™, a pharmacy can coordinate a patient's prescriptions to be picked up on the same day each month. “The reason medication synchronization changes the game is because it enables the appointment-based model,” Tice explained. This simplifies the process for patients and caregivers filling multiple prescriptions, and improves patients' medication adherence by helping to ensure they fill all prescriptions each month.



The system also increases prescription volume by helping to improve adherence, capture lost fills and confirming the number of prescriptions a patient fills each month, also helping improve inventory management for the pharmacy.  



“You’ve got improved operations, improved workflow, improved inventory management, it’s better for the patient, you improve adherence – it works all the way around,” Tice said. And it sets the stage for more outcomes-oriented partnerships with local health providers.



To that end, Cardinal Health also is bringing to market additional back-end services to help manage health provider relationships. “When you look at the movement of payment based on value, you have to have an ability to contract for that value,” Tice said. “That may be difficult for an individual pharmacist to do, but Cardinal Health can bring that whole system together.”



Cardinal Health RBC 2016 will take place in Chicago at McCormick Place West from July 20 to 23. Click here to register or explore this year’s agenda.