Last week the U.S. Senate introduced bipartisan legislation which would provide patients better access to testing and treatment for common infections like respiratory syncytial virus, COVID-19, influenza, and strep throat. The bill would also make permanent authorities for pharmacy-based immunizations that were authorized under emergency action during the COVID-19 pandemic. The pharmacy profession often refers to these authorities as “provider status” legislation, referencing the inclusion of pharmacists under the Social Security Act for payment through the Medicare and Medicaid programs. But what this bill actually is is a public health infrastructure bill.
Long before the COVID-19 pandemic, pharmacists were filling significant gaps in public health services access in local communities. In the early 1990s, researchers at West Virginia University’s School of Pharmacy found that pharmacists advocating to patients for seasonal flu shots improved vaccination rates compared to places where pharmacists were not involved. During the H1N1 epidemic of 2009, CDC estimated that pharmacist involvement in vaccinating within local communities likely caused the epidemic to end several months earlier than it would have otherwise. As county and state public health departments have faced funding cuts and reduced staffing, and as shortages of primary care physicians have worsened, pharmacists have—time and time again—come to the rescue of their communities providing critical access to care. Nowhere is this more evident than in rural areas of the United States, where according to the University of Southern California’s Schaeffer Center there are dozens of counties with a staffed pharmacy but no physician. In these communities, pharmacists are caring for patients by monitoring blood pressure, providing diabetes management, and engaging in cardiovascular risk reduction efforts—vital services to the public health infrastructure. And many of these pharmacists are doing this without one cent in compensation.
This public health infrastructure aspect of our profession also extends far beyond community pharmacies. Community hospitals are in crisis. Reduced funding from Medicare and Medicaid, tightening reimbursement from private insurance, and increased numbers of under- or uninsured persons are straining the acute care system. The Center for Healthcare Quality and Payment Reform estimates that over 30% of all rural hospitals are at risk of closing in the near future without more sustained funding. Every one of these hospitals has a team of pharmacists ensuring appropriate medication use and optimal care from the emergency department to the critical care units and including outpatient clinics and pharmacies. When a community hospital closes, not only does the community lose an acute care facility, but it also loses the trusted care services of pharmacists providing acute and primary care through the hospital’s system.
As pharmacies have faced these struggles, many state Medicaid agencies have begun to realize the damage to our public health infrastructure and have filed and had approved plan amendments to compensate pharmacists for their care services. We’re also seeing isolated pockets of recognition with private health plans. This is not enough. The federal government is the largest payer in the health care industry in our nation, and Medicare continues to perpetuate a system of unequal access to care by denying patients coverage for the care services of their pharmacists. In a world where we hear rhetoric every day about access to care and addressing health disparities, the nation’s largest insurer claims they do not have the authority to provide coverage for pharmacist-provided services as part of the Medicare program. Congress must act and they must do so quickly. To help avert this crisis, we are calling on all members of the pharmacy profession to write to your members of Congress and demand the passage of H.R. 1770 in the House and S. 2477 in the Senate. The future of our public health infrastructure and the patients we serve depends on our profession taking a stand NOW. We cannot wait any longer.
To help make advocacy more convenient for you, APhA’s Advocacy Action Center allows you to write directly to your members of Congress on these issues – please use this helpful tool TODAY!