Unprecedented Coalition Supporting Pharmacist Provider Status

At a town hall event at the ASHP Summer Meeting in Minneapolis, CEO Paul Abramowitz updated the membership on the movement to attain pharmacist provider status.

The movement to win health care provider status for pharmacists has been growing since the beginning of 2013. Among the leaders of the cause has been American Society of Health-System Pharmacists (ASHP) CEO Paul Abramowitz, PharmD, FASHP, who wrote in a blog entry on the second day of the year that attaining provider status was one of the association’s “top strategic priorities.” At a town hall event held at the ASHP Summer Meeting in Minneapolis on June 3, 2013, Dr. Abramowitz provided an update on how the campaign is going.

“Pharmacists are patient care providers now, and we all know that,” said Dr. Abramowitz. “But we’ve got some work ahead of us to fix some antiquated federal laws that place unnecessary limits on patients’ having the access to care that we believe they need to have.”

The current goal is to have Congress update the Social Security Act so pharmacists are defined as patient-care providers eligible for reimbursement under Medicare. However, Dr. Abramowitz pointed out that the end result may not involve pharmacists being paid for providing specific services.

“We’re in the era of ACOs [accountable care organizations], an era where whoever is providing health care is going to need to take responsibility for outcomes and costs across the spectrum of care,” said Dr. Abramowitz. “We’re still placing great emphasis on the fact that we need the recognition as providers so the health care system supports us financially, but that support may or may not be in terms of paying for a specific part of that service.”

Dr. Abramowitz noted that the breadth of the coalition that has formed to help attain pharmacist provider status is unprecedented. In addition to ASHP, it includes the National Community Pharmacists Association, the National Association of Chain Drug Stores, the American Pharmacists Association, the American Association of Colleges of Pharmacy, the American College of Clinical Pharmacy, the Academy of Managed Care Pharmacy, and some of the large pharmacy chains. “I’ve never seen such cohesion in pharmacy as I see around provider status,” he said.

There are, however, a number of issues that need to be ironed out among the members of the coalition. Dr. Abramowitz explained that the organizations’ executives and staff members have held a series of meetings and that a primary focus is on who should be considered a provider and what services they should be reimbursed for. One possible approach, he noted, is a “privileging process” such as that used by the Department of Veterans Affairs, in which a health care organization would determine which credentials are necessary to be considered a provider.

Once the pharmacy associations agree on their strategy, the coalition will reach out to organizations representing other health care providers, such as doctors and nurses, to try to enlist their support, then possibly to consumer and patient organizations such as AARP as well. Finally, it will look into employing consultants and lobbyists and develop a grassroots organizing effort involving state pharmacy organizations and colleges of pharmacy.

Kasey Thompson, PharmD, ASHP’s vice president for policy, planning, and communication, emphasized the role that individual pharmacists and patients will need to play in helping to win legislative support. “It’s going to have to be on you telling your legislators what you do for your patients, and in a lot of cases patients telling legislators on the Hill how a pharmacist helped them,” he said.

The key to winning provider status, Dr. Thompson explained, is that pharmacists are perfectly positioned to address the current needs of the health care system. “This isn’t so much about helping pharmacists, this is about helping patients,” he said. “The principles that we’ve developed at a high level focus on quality, access, and the big C-word, cost, which is the overriding issue that is plaguing our health system and everyone is looking for a solution. Pharmacists can make a difference in all those domains, and patients can benefit from that.”

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