Healthcare Reform Blog > January 2012 > Is there a pharmacist in the house?

Fresh U.S. healthcare insights from expert analysts on Healthcare Reform, ACOs, Exchanges, Medicaid, Medicare, regional and national trends…and much more

Is there a pharmacist in the house?

Laura Beerman

Contributor: Laura Beerman
Topic: Pharmacists

When more people have access to healthcare coverage in 2014, the existing shortage of physicians could make a good doctor even harder to find. Waiting in the wings are other practitioners—including pharmacists—who can provide effective, patient-centered care.

Jon Roth, chief executive officer of the California Pharmacists Association, wants to see his members play a much larger role in patient care management than they currently enjoy.

“A big push for 2012 will be working to move pharmacists to a provider status role that is far beyond simply dispensing medication. By having pharmacists on the care team, you can lower costs, increase adherence and improve outcomes.”

CPhA may sponsor legislation in the coming year to define a role for pharmacists when it comes to ACOs and medical homes. They are also working with California’s health insurance exchange board to help define the role of pharmacists as the state designs its essential benefits plan.

Roth isn’t the only one who sees pharmacists taking a greater role. Cora Tellez, president and CEO of Sterling Health Savings Administration and the newly formed Sterling Self-Insurance Administration, agrees. Sterling’s PBM partner, Ventegra, offers a Medication Therapy Management Program that is a key component of her company’s SIA services.

“This concept reclaims a role for pharmacists that they haven’t had in a while,” says Tellez. “It puts them front and center when it comes to a role in patient management. It’s the next generation of PBM.”

Pharmacist involvement will likely also be part of next-gen innovations such as medical homes and accountable care organizations. Among big players in California, it already is. Pioneer ACO awardee Monarch HealthCare and San Diego market-share leader Scripps Health are among the providers putting pharmacists on their care teams.

Successful healthcare reform will require that all hands be on deck. Maybe it’s time to expand the role that pharmacists and other practitioners play in that effort.


Posted on: 1/19/2012 10:24:13 AM | with 2 comments

Tags: Pharmacists

Laura Beerman
Response: ACOs, payment bundling and other healthcare reform initiatives are going to increasingly use medication therapy management---the reconciling of regimens, avoiding duplication, preventing drug interactions and improving outcomes. Pharmacists are being looked to as important members of care teams to help physicians, hospitals and health plans control costs and deliver better care. To your point, they don’t just dispense drugs; they know these drugs inside and out, their side effects, etc. Additionally, alternative “providers” and sites of care will be needed to ensure that the mass influx of people gaining coverage under healthcare reform will actually have access to care. Even if the individual mandate is struck down, the nation is still dealing with a physician shortage that will only grow more critical as doctors retire or if they elect to treat fewer Medicare or Medicaid patients because of declining reimbursements. Of course, formal scope of practice for pharmacists is a separate issue—decided largely at the state level and not an easy thing to expand. But we think the examples above cite the important role pharmacists have to play.
5/21/2012 10:11:25 AM

Dispensing medication inquirer
I definitely agree with you that the more access people have to healthcare the greater our need will be for physicians to see them. What would you see pharmacists doing besides dispensing medication? I guess I just don't understand the extent of their training. I appreciate you bringing to light this topic that many of us are wondering about.
4/24/2012 5:29:49 PM

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