How Provider Status Will Change Health-System Pharmacist Roles

With active legislation in the US House and Senate, provider status is something that many pharmacists want, as it would open up many opportunities in a variety of health care settings.

For instance, health-system pharmacists would be able to take a more active role in medication management while a patient is in the hospital. Labs could be ordered to assess adherence and adjust accordingly prior to discharge for a variety of conditions.

Pharmacists could also see more opportunities with a greater demand for pharmacy specialties. Perhaps, managed care organizations could tap into the potential of having pharmacists manage medications in order to save companies money and improve public health.

In California, the Advanced Practice Pharmacist (APP) recognition gives pharmacists the authority to do the things that are already being done by many clinical hospitals across the nation, as well as the ability to bill for them. APPs must also complete 2 of 3 criteria to receive this designation: earn certification in a relevant area of practice, complete a postgraduate residency program, and/or provide clinical services to patients for 1 year under a collaborative practice agreement or protocol with a physician, APP pharmacist, CDTM pharmacist, or health system. California's provider status bill, SB 493, was also signed into law.

In North Carolina, there is Clinical Pharmacist Practitioner (CPP) designation. In this state, you must be a licensed pharmacist with an agreement with a physician. In addition, you must have:

• Completed board certification or geriatric certification, or the American Society of Health-System Pharmacists accredited residency program, and have 2 years clinical experience, or
• Earned a PharmD degree, have 3 years experience, and complete a Certificate Program, or
• Earned a BS degree, have 5 years experience, and have completed 2 certificate programs.

North Carolina defines CPP as a licensed pharmacist who is approved to provide drug therapy management, including controlled substances, under the direction or supervision of a licensed physician who has provided written instructions for a patient and disease-specific drug therapy which may include ordering, changing, substituting therapies or ordering tests. Only a pharmacist approved by the Pharmacy Board and the Medical Board may legally identify as a CPP.

New Mexico and Montana also have legislation to initiate some drug therapy.

Ambulatory care pharmacists could make headway with patient medication adherence. The US Centers for Medicare and Medicaid Services base many of its quality measures on adherence. Ambulatory care pharmacists could also be paid for services with immunizations and diabetes self-management education, along with home infusion and other areas of pharmacy practice.

What can a pharmacist do today to be prepared for the change that is on the horizon? First, get your board certification. Second, become involved in the movement. This designation will not only open doors for pharmacists, but also allow us to prove our place in the health care team and help improve public health.