New legislation would grant provider status

The introduction in January of bipartisan legislation that would grant retail pharmacists provider status for Medicare patients in “underserved” communities certainly sounds like a step in the right direction.

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But it’s more than that. A lot more than that.



First, as of Jan. 1, there are 6,086 Health Professional Shortage Areas — regions where the ratio of primary care physicians to people is 1:3,500 — according to the Health Resources and Services Administration’s Information Data Warehouse. Geographically speaking, there appears to be more underserved areas in the United States than there are “adequately served” areas, at least when you look at HRSA’s map delineating which areas are where.



Second, the escalating physician shortage is only going to create more HPSAs. And in those areas already designated as an HPSA, it will make the lack of access to medical care more critical. According to the Association of American Medical Colleges, by 2020, the United States will have 91,000 fewer physicians than what will be needed to meet anticipated demand.



Meanwhile, the number of Americans seeking to become pharmacists is on the rise. The U.S. Bureau of Labor Statistics indicates that about 286,000 pharmacists were employed in 2012, and projects that number to increase by 14%, to more than 325,000, by 2022. Currently, about 60% of pharmacists are employed in retail establishments, according to the USBLS.



For many Americans, the pharmacy is their most accessible form of health care. Approximately 67,000 pharmacies operate in the United States today, and nearly 90% of the population lives within five miles of a pharmacy, according to Pharmacists Care, a multi-stakeholder and interdisciplinary initiative comprised of organizations representing patients, pharmacists and pharmacies.



While pharmacists cannot fill the entirety of this immense gap, enabling pharmacists to practice to the full extent of their licenses and training must be seen as part of this solution, Pharmacists Care notes.



“Pharmacists are highly trained healthcare professionals who, in coordination and collaboration with other healthcare providers, can help to deliver improved patient outcomes,” said Rep. G.K. Butterfield, D-N.C., one of the sponsors of the provider status bill being processed in the House. “Allowing these qualified medical professionals to operate in underserved areas and receive payment for their services is a practical way to address the basic healthcare needs of vulnerable communities and the shortage in the delivery of care in those areas.”



“In a rural district like mine, healthcare accessibility is a major concern. Pharmacists play an important role in rural health care, providing important services like blood-pressure screenings, immunizations and routine checkups,” said Rep. Ron Kind, D-Wis. “By providing Medicare coverage for these services in medically-underserved communities, we improve access to these services in rural areas and allow pharmacists to practice to the full extent of their training.”



In addition to what the politicians are saying, voters are on board with granting provider status to pharmacists, too. According to a 2013 survey conducted by Clarus Research Group on behalf of the American Pharmacists Association, 83% of voters agree that pharmacists have the education and professional training to do more for patients than just fill prescriptions, and 81% agree that pharmacists should be considered a part of each patient’s overall healthcare team. Two-thirds of voters already think of pharmacists as “healthcare providers,” though that doesn’t necessarily help pharmacists process any Medicare claims as such.



The current healthcare mandate to improve health outcomes may be another clamoring factor for provider status for pharmacists. As many as 73% of voters nationwide agree if pharmacists were included as members of healthcare teams, it would improve healthcare quality. And 72% agree that pharmacists working more closely with doctors would reduce overall healthcare system costs.