Pharmacists Look to Play a Bigger Role in Healthcare – and Be Compensated for It

Although pharmacy students are educated in subjects such as counseling and administering certain therapies, most find themselves in a retail pharmacy dispensing pills after graduation. According to an article in International Business Times, there are signs of change as pharmacists are slowly being given the authority to step-up and expand their role as a healthcare provider.

Washington Takes the Lead

One pharmacy in Washington State has expanded its services to include screenings for HIV and offering medication to prevent the disease.  What’s unique, aside from offering these services, is that soon the pharmacy will be able to bill insurers for them.

Washington has become the first state to require health insurers to classify pharmacists as healthcare providers. As such, beginning January, 2016, Washington pharmacists will be able to bill for services like physicians do, thanks to the implementation of the Every Category of Health Care Providers law.

This law requires insurance companies to cover at least one provider in each specialty, with pharmacists named as a specialty. As word about reimbursement associated with this law gets out, it’s expected that pharmacists in other states that have the Every Category of Health Care Providers law will push for similar rights.

Other States Follow Suit

Supporters for the expanded role believe that pharmacists should be allowed to prescribe medications which do not require a diagnosis, such as birth control pills, prophylactics and travel medicines. Legislation is now being put into place to make this happen. As of October 1, California will permit pharmacists to dispense birth control. Oregon will follow as of January 1 of next year. However, at this time, neither state will allow pharmacists to receive reimbursement for their services.

Who Benefits?

Ultimately, if states allow pharmacists to provide more services, patients will win. When pharmacists can bill for their services, patients will get much needed assistance to manage their medications via one-on-one consultations and follow-up calls.

The healthcare system can also benefit. According to a 2011 Surgeon General’s report, the system would receive four dollars for every dollar spent on pharmacists.

Opposition

Although there is support for pharmacists becoming more involved, not everyone is in agreement. Some doctors have expressed opposition due to worries that pharmacists will take away business that traditionally only physicians could provide. The American Medical Association (AMA) feels that pharmacists should remain in their traditional role as a member of the physician-led healthcare team who is not directly involved in patient care.

Additionally, others are concerned that pharmacists may abuse their billing power and charge insurance companies every time a senior comes in to pick up a prescription even if no other services are rendered.

Finally, insurance companies may not support reimbursing pharmacists since their bottom line will not benefit.

Potential Role in Readmissions

With the population aging and healthcare costs skyrocketing, it makes sense for pharmacists to step-in and play a more impactful role in patient care. Helping patients manage their medications and offering services such as consultations and screenings will aid in increasing medication adherence, keeping patients healthy and reducing hospital readmissions.

Related Articles:

American Pharmacists Association

PIT Journal

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