Health Care Reform Spurs Growth in Pharmacy Services

Reduced reimbursements, Medicare Part D, and the Affordable Care Act have stimulated pharmacies to offer a broader palette of services.

Value-based payments are incentives for pharmacists to provide services that ensure cost savings to payers. In 2004, fewer than 10% of pharmacies provided medication therapy management (MTM) to patients. Since then, point-of-care testing, pharmacist vaccination, and other novel services have grown, raising questions about the current state of pharmacy services.

Now, an article published ahead of print in the Journal of the American Pharmacists Association indicates innovativeness, interprofessional collaboration, and technician staffing are associated with the provision of a wide variety of pharmacy services.

The authors reached community (independent, chain, mass merchandisers, and supermarkets) pharmacists across the United States through mail. The survey asked pharmacies to quantify the frequency of MTM, immunization, therapy adjustments, medication reconciliation, disease state management, health screening or coaching, complex nonsterile compounding, and point-of-care testing performed at their location.

Pharmacies near other pharmacies need to innovate to attract customers, whereas interprofessional collaboration improves patient care and increases revenues. For example, joining an accountable care organization to provide postdischarge medication reconciliation and MTM reduces readmissions and ensures patients use their pharmacy.

This study found that pharmacy chains and supermarkets provide a larger quantity of novel services than independent pharmacies and mass merchandisers, which indicates that chains are looking for ways to deliver community-based clinical services. A 2004 study found independent pharmacies provided the greatest variety of services, but chain pharmacies have strived to expand their offerings. More research is needed in this area.

A pharmacy with 3 or more pharmacists was more likely to provide novel services, but stores with 3 or more technicians were less likely. Technicians allow pharmacists to perform time-intensive nondispensing services (eg, immunizations), but increasing numbers of technicians seem to indicate that the pharmacy focuses on dispensing.

Lean healthcare reimbursement has spurred new services that improve care and use pharmacists’ professional expertise. Greater innovativeness, interprofessional collaboration, and lower technician staffing are predictive of greater pharmacy service variety.