Avalere report supports pharmacists as health care providers

Provider status legislation among factors that would facilitate broader coverage of pharmacists’ services

In a new report, the health care advisory company Avalere Health highlights the important role pharmacists play in improving patient outcomes through appropriate and effective medication use in addition to providing more patient care service. The report looks at the current delivery and payment landscape in health care to identify factors that will influence reimbursement for pharmacists’ services in the future.

“With a greater focus on improving the value of care, especially within new payment models, opportunities for pharmacists to provide a variety of direct patient services will continue to evolve as incentives for reimbursement of these services are established,” wrote the authors of the report, which was published in October and funded by the National Association of Chain Drug Stores (NACDS).

The report points out all the ways pharmacists are providing patient care services—immunizations, wellness and prevention screenings, medication therapy management, and more. Coverage of these services remains limited, however.

According to the report, factors that would facilitate broader reimbursement of pharmacists’ services include passage of federal provider status—the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/S. 314)—which recognizes pharmacists and their services in Medicare Part B; improvements in health information technology that would drive improved coordination between pharmacists and the patient’s health care team; standardization of billing methods from a federal and state perspective within scope of practice regulations; and integration of pharmacists into new payment and delivery models that are bent on reducing overall costs while improving outcomes.

“We are pleased that the findings in the Avalere study further support pharmacists as health care providers under Medicare Part B, within state scope of practice laws, as key to facilitating needed access to pharmacists’ services,” said Chrissy Kopple, Vice President of Media Relations for NACDS.