We know it, they know it, let’s get it done! Pharmacists must be formally included in public health efforts
The pharmacy community has fought for payment for pharmacists’ services under Medicare Part B—otherwise known as provider status—for years. Getting that message through to Congress has been painfully slow. Even though a huge and bipartisan number of federal legislators signed onto the Pharmacy and Medically Underserved Areas Enhancement Act (S. 109/H.R. 592), they didn’t push it across the finish line.
If only Congress had acted, the country would have much more rapidly fought back COVID-19. Although there are many ways our health care system was not optimally equipped to handle the pandemic, leaving pharmacists out of the equation is likely the most egregious. The government wasted its most accessible health care resource when people needed us the most. Nearly 90% of Americans live within 5 miles of a pharmacy. Where would we be if Congress had the foresight to activate pharmacists to test for COVID-19 right away? That’s our mantra, right? Pharmacists are easy to reach and ready to help. Although pharmacists are ready to help, they can’t be expected to do this for free. Physicians and hospitals are reimbursed to test, but not pharmacists.
We need that reimbursement under Medicare Part B because private payers often follow Medicare’s lead. Once pharmacists can bill both public and private payers, that’s when we’ll really see what pharmacists can do for patients and communities. This is especially crucial during the pandemic but will reap dividends even when we emerge from it.
Pharmacists aren’t the only ones singing this song. Last month APhA and the APhA Foundation signed on to a National Forum for Heart Disease & Stroke Prevention (National Forum) joint policy statement in support of the Forum’s Value & Access Initiative. Twenty other organizations signed on to the statement, including key allies like the American Heart Association, the American College of Cardiology, and WomenHeart.
The statement, titled “Joint Policy Statement on Expanding Access to Healthcare Every Day and During the COVID-19 Response,” states right off the bat that patient-centered, team-based care—with pharmacists as key members—improves patient outcomes and saves money. With mounting evidence that people with underlying conditions such as hypertension, heart disease, and diabetes are more likely to suffer severe COVID-19 illness, on top of the virus’s appalling disproportionate impact on communities of color, Congress really can’t afford to drag its feet on this.
The joint statement makes recommendations that jive with what APhA's been saying all along: Include the Pharmacy and Medically Underserved Areas Enhancement Act in must-pass emergency COVID-19 legislation; ensure restrictive state scopes of practice aren’t inhibiting patient access to evidence-based care; maintain patient access to telehealth; and establish the mechanisms that will allow pharmacists to bill for their services under Medicaid and Medicare, among others. Despite the U.S. Department of Health and Human Services (HHS) teeing pharmacists up to perform COVID-19 tests and associated services, the statement rightfully asserts that we still need Congress to include explicit language authorizing pharmacists to test and immunize for COVID-19 and flu in emergency legislation.
Health systems are also taking a stand for pharmacists and patients. Last week, APhA enlisted three health systems to send a letter to Senate and House leadership that’s consistent with the National Forum joint statement and APhA's ongoing messaging: Pay pharmacists, and fill the gaps in COVID-19 testing. I want to thank the University of Washington Health, the University of Maryland Medical System, and OhioHealth for taking this on.
APhA has other irons in the fire. We’re working with states to get payment for pharmacist testing. We’re continuing our dialogue with lawmakers on this and future pandemics—read a letter we sent to the Senate Health, Education, Labor, and Pensions committee in response to its chair Sen. Lamar Alexander’s (R-TN) call for input on preparing for future pandemics. And we’ve got some comments on the HHS second interim final rule going out today.
There is plenty of opportunity for grassroots action from members like you, too. Keep an eye on https://actioncenter.pharmacist.com, and we’ll let you know when your participation is most vital on APhA's Facebook and Twitter.
I’m extremely encouraged that the medical community is increasingly touting the value of pharmacists’ involvement in team-based care, during the pandemic and beyond. COVID-19 has injected our mission with the urgency that it’s always deserved, and we’re making progress more quickly than ever before. It won’t be easy making change, but we’re going to do it anyway.