Physician Shortage Provides Opportunity for Pharmacists to Step Up

From administrative burdens and burnout to health care consolidation and a Medicare system in need of reform, it’s perhaps not surprising that there is a nationwide primary care shortage.¹ Nearly two-thirds of counties in the US have 1 primary care provider per 1500 individuals, said Melanie Marcus, but pharmacists could step in and help close that gap.

“We’ve got to create teams of providers who can sell each other on the care that’s provided, whether that’s Food is Medicine, test and treat, or immunizations in the pharmacy,” explained Marcus, the Chief Marketing and Customer Experience Officer at Surescripts. She sat down with Drug Topics at the 2024 National Association of Chain Drug Stores Total Store Expo, held August 17 to August 19 in Boston, Massachusetts. “Pharmacists have a big role there.”

As pharmacists continue to take on clinical tasks—such as vaccination and chronic disease management, an expanded scope of practice which allow them to practice at the top of their license—there has been a simultaneous push to have pharmacists receive financial reimbursement for the services they are providing. Currently, pharmacists are not recognized as providers under Medicare Part B, limiting their ability to directly bill for the clinical services they provide. Collaborations with other health care providers, state insurers, and health systems have allowed pharmacists to “implement more sustainable clinical programs into their practices,” the American Pharmacists Association noted.²

READ MORE: Partnerships Key to Making Sustainable Pharmacy Care Models Work

In 2023, the Equitable Community Access to Pharmacist Services (ECAPS) Act (HR 1770/S 2477) was introduced with bipartisan support. The goal of the legislation is to ensure patients are able to “maintain access to essential pharmacist services”³ as well as strengthen the country’s public health preparedness through pharmacist-provided patient care services such as testing, vaccination, and prophylaxis administration. In early 2024, Representative Earl “Buddy” Carter (R, Georgia) urged the Congressional Budget Office to review the bill.⁴

While ECAPS moves through federal channels, some states have already begun to recognize pharmacists as providers. Most recently, Pennsylvania Medicaid now allows pharmacists to enroll as providers and bill for pharmacy services effective March 1, 2024.⁵ Meanwhile, the American Medical Association (AMA) has vocally opposed scope of practice expansion for pharmacists, with AMA Immediate Past President Jesse M. Ehrenfeld, MD, MPH, writing earlier this year that “the independent practice of medicine by pharmacists puts patient health and safety at risk.”⁶

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References

1. AMA president sounds alarm on national physician shortage. News release. American Medical Association. October 25, 2023. Accessed August 21, 2024. https://www.ama-assn.org/press-center/press-releases/ama-president-sounds-alarm-national-physician-shortage

2. Billing & payment. American Pharmacists Association. Accessed August 21, 2024. https://www.pharmacist.com/Practice/Practice-Resources/Billing-Payment-Center

3. Pharmacy care. Academy of Managed Care Pharmacy. Accessed August 21, 2024. https://www.amcp.org/policy-advocacy/legislative-regulatory-issues/pharmacy-care

4. Breaking news: Congress presses budget office on provider status. News release. American Society of Health-System Pharmacists. January 31, 2024. Accessed August 21, 2024. https://news.ashp.org/news/ashp-news/2024/01/31/breaking-news-congress-presses-budget-office-on-provider-status

5. Pennsylvania Medicaid to allow pharmacists to enroll as providers and bill for pharmacy services. News release. National Alliance of State Pharmacy Associations. February 12, 2024. Accessed August 21, 2024. https://naspa.us/wp-content/uploads/2024/02/PA-Medicaid-Enrollment-Announcement_Final.pdf

6. Ehrenfeld JM. Expanding test-to-treat policies is a harmful prescription. American Medical Association. June 10, 2024. Accessed August 21, 2024. https://www.ama-assn.org/about/leadership/expanding-test-treat-policies-harmful-prescription