POCP Blog

By Tony Schueth

Pharmacists are increasingly called on to work with other healthcare professionals to increase their participation in care services. Studies and experience have shown that pharmacists add value to patient care—whether, for example, it is through counseling in the pharmacy, conducting medication reconciliation, assisting in disease management or working as part of a patient care team in a patient-centered medical home or accountable care organization. There is an ever-expanding list of services and venues in which pharmacists’ participation can be a definite value-add in terms of decreasing medication errors, reducing overall healthcare costs and improving the quality of patient care.

So what’s not to like? The answer is that payers have been reluctant to reimburse pharmacists for such services.  Medicare—the 800 lb. gorilla in the policy room—has so far been the biggest holdout. And as we all know, private payers tend to follow Medicare’s reimbursement lead.

That could be changing soon.  A coalition of pharmacy stakeholders–the Patient Access to Pharmacists Care Coalition (PAPCC)—has garnered Congressional support to introduce legislation that will enable patient access to, and payment for, Medicare Part B services by state-licensed pharmacists in medically underserved communities. Details are in HR 4190, and PAPCC hopes a Senate bipartisan introduction can be carried out in the near future.

We at Point-of-Care-Partners believe this certainly is a step in the right direction. It is evidence that the healthcare system is beginning to officially recognize the value of pharmacists in patient care, acknowledge the expansion of their roles in an evolving healthcare system and pay them their due. 

We also applaud PAPCC for creating Congressional traction on this important issue.

Such efforts will help the profession become even more relevant as value-based payment and integrated delivery models take hold. It also can be an effective strategy to nibble away at reimbursement policy.  Policymakers often find it easier to digest small Medicare reimbursement changes than try and create a force-feeding of sweeping reimbursement policies.

While we’re at it, we’d like to give POCP’s own Jeanette Nelson a pat on the back for her participation as an APhA Provider Status volunteer in support of PAPCC. We hope to see more results from the group and we’ll keep you posted.

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