The National Governors Association (NGA) recently released a report to encourage states that are looking to increase their primary care capacity to change legislation to allow pharmacists from doing work they are qualified to do. The report identifies several barriers including “restrictive laws and regulations governing collaborative practice agreements,” a “lack of provider recognition in federal and state law governing compensation of pharmacist to provide direct patient care services,” and “limitations on pharmacists ability to access health information systems.”
The report, released in January 2015, titled The Expanding Role of Pharmacists in a Transformed Health Care System, uses case studies, research, policy reports, federal and state information, as well as other sources of data about pharmacy practice. The report says pharmacists are capable of providing a more care related to medication therapy management, health and wellness counseling, disease prevention services, and even general primary care.
The report encourages states to maximize pharmacist services by declaring them health care providers within the state insurance code, state employee health plans, health information exchanges, and Medicaid. It also encourages private insurers to make the same designation.
NGA Executive Director Dan Crippen says, “I think there’s an increased understanding of the important role not only that pharmacists can play but have played. And so a paper like this helps, I think, promote the debate on allowing pharmacists to provide more services and make sure that they are reimbursed for them appropriately.”
Senior director at ASHP’s section of pharmacy practice managers, David Chen, says data used in the report helps to demonstrate “the impact and frequency of medication use in the United States, and the role effective medication management can have on supporting the health systems quality and financial goals.” Chan encourages pharmacy leaders share the findings with their hospital senior executives, as well as government affairs staff.
This report is a part of a series that takes a look at how states can better use the skills of non-physician health care providers–specifically pharmacists, dental hygienists, nurse practitioners, and physician assistants–to meet the needs of primary care services. The reports, funded through a grant from the Health Resources and Services Administration (HRSA), agreed that the available supply of primary care providers could easily be supplemented by allowing these professions to practice all that they are trained and licensed to practice.
Crippen noted that of the four professions they examined, most states have placed some limitation on the scope of work for at least one of them. Federal health reform efforts place major focus on primary care, including the payment models that in the size coordinated care, and reimbursement on the basis of health outcomes rather than the volume of services provided.
In 2013, the HRSA said the demand for primary care services is slated to outgrow the national availability of primary care doctors in the United States by an estimated 20,400 full-time physicians by 2020. This change in supply and demand is mainly a result population growth and aging. Retiring baby boomers and doctors in that age group will strain the nation’s health care capacity, so employing the use of pharmacists and other healthcare providers at the top of their licenses will help to ease that strain.