The Societal Case for Pharmacist Provider Status

Every profession advocates for itself—that’s to be expected. But when a profession seeks to address a significant societal problem, it stands a better chance of gaining favor. Such is the case today, as there is an opportunity for pharmacists to help address a significant and worsening societal problem of another profession—the physician shortage.

Using projected changes in population size and age, Xiaoming Zhang of the Cleveland Clinic Foundation and his fellow researchers developed demand and supply models to forecast the physician shortage or surplus by state, concluding that the United States will face a shortage of 139,160 physicians by 2030.¹

Similarly, a 2019 study commissioned by the Association of American Medical Colleges (AAMC) also factored in trends in health care delivery and the state of the health care workforce, such as data on physician work hours and retirement trends. That study projected that the United States could experience a physician shortfall of up to 139,000 by 2033.²

To put these projected figures in perspective, they are equivalent to approximately one-seventh of today’s total physician population. Moreover, the current primary care physician (PCP) shortage is widely estimated at 15,000 PCPs, and that number is projected to swell to as much as 55,000 by 2033, according to the AAMC-commissioned study.³

But the PCP shortage is even worse when you look at geographic distribution. Just as there are so-called “food deserts”—areas that have limited access to affordable and nutritious food, there are “PCP deserts”—places in which there is less than 1 PCP for every 3500 people, as defined by the Health Resources and Services Administration. Using that definition, 39% of the nation’s counties and 13% of the US population—44 million people, including some 10 million Medicare Part B enrollees—live in PCP-shortage areas.^4,5

The health care provider shortage issue has certainly not escaped the attention of Congress. It is mentioned in the framework for the Democrats’ human infrastructure budget resolution agreement. It also led to the introduction in both chambers of Congress of the Pharmacy and Medically Underserved Areas Enhancement Act (HR 2759 and S 1362) in late-April.

The bill—which has garnered growing bipartisan support in the House and Senate—would give pharmacists provider status, enabling them to get reimbursed for providing pharmacist services to Medicare Part B enrollees in health professional shortage areas, medically underserved areas, and medically underserved populations. Pharmacist services include medication management, immunizations, point-of-care testing, and chronic disease management.

Granting provider status to pharmacists would open many opportunities. For health systems, there would be a significant financial incentive to deploy pharmacists in higher-value, clinical, and patient-focused tasks in outpatient/clinic settings.

For retail pharmacy clinics, there could be greater use of the estimated 250-300 retail clinics already located in medically underserved areas, as well as an incentive to establish more of them. And of course, provider status would enable pharmacists to practice at the top of their license, be more patient-focused, and derive greater satisfaction from their work.

Most importantly, a March 2021 Harvard Medical School study concluded that if the primary care shortage in medically underserved areas was fully addressed, more than 7000 lives would be saved annually, and the average life expectancy of Americans would lengthen by an average of 56 days.⁶

Thus, beyond the benefits to the pharmacist profession, granting provider status to pharmacists addresses the larger societal problem of the physician shortage, improving access to primary care for millions of people, and actually save lives.

About the Author

Ken Perez, VP of Healthcare Policy and Government Affairs, Omnicell

References

1. Zhang, Xiaoming, et al., “Physician workforce in the United States of America: forecasting nationwide shortages,” Human Resources for Health, https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-020-0448-3, Feb. 6, 2020.
2. Association of American Medical Colleges, “New AAMC Report Confirms Growing Physician Shortage,” https://www.aamc.org/news-insights/press-releases/new-aamc-report-confirms-growing-physician-shortage, June 26, 2020.
3. Ibid.
4. Norton, Amy, “Shortage of Primary Care Doctors Is Costing American Lives,” U.S. News & World Report, https://www.usnews.com/news/health-news/articles/2021-03-23/shortage-of-primary-care-doctors-is-costing-american-lives, March 23, 2021.
5. LaPointe, Jacqueline, “13% of People Live in an Area with a Primary Care Physician Shortage,” RevCycleIntelligence, https://revcycleintelligence.com/news/13-of-people-live-in-an-area-with-a-primary-care-physician-shortage, Sept. 17, 2018.
6. Harvard Medical School, “More primary care physicians could mean gains in life expectancy, fewer deaths,” https://www.eurekalert.org/news-releases/488443, March 22, 2021.