How Will the Healthcare Reform (Affordable Care Act) Affect Pharmacists?

Ever since early discussions of how a healthcare reform could affect pharmacists, the overall predictions were that it would be favorable for pharmacy practice. This is because pharmacists are considered valuable in a healthcare model that values cost-savings.  For example, the American Pharmacists Association, National Community Pharmacists Association, and the National Association of Chain Drug Stores are working on encouraging payment structures that allow pharmacists to receive provider status.  Pharmacists would receive reimbursement for MTM and alternative patient care models such as medical homes.

Although that sounds good, there is a problem. Currently the pharmacy practice acts in the 50 states are not all in line with making expanded reimbursable pharmacy services possible.  What is allowed under collaborative practice agreements differ in each state.  Collaborative practice agreements allow pharmacists to work collaboratively with a physician through a defined protocol and provide patient assessments; choose appropriate medication, order related lab tests; administer drugs; start, continue, and stop medications.

According to an article by Krstalyn Weaver, PharmD written for APhA, as of earlier this year, 33 states plus the District of Columbia allow for pharmacists to initiate drug therapy; many allow for discontinuation; and nearly all allow for modification of drug therapy.  In 8 states, collaborative practice agreements are restricted to certain practice sites only—and they all exclude community pharmacies.  31 states allow for pharmacists to order and interpret laboratory tests.

Some laws place extra requirements on which pharmacists are authorized to enter into a collaborative practice agreement. This varies.  For example, in California, a clinical residency is required, whereas in Arkansas, a PharmD is considered a minimum requirement.

What can we do as pharmacists so that we can actually take advantage of being reimbursed for our services? One thing you can do is join your state’s pharmacy association.  With proper funding, voice, and lobbying, there can be more favorable laws for pharmacists that allow us to appropriately get reimbursed for our clinical services.  Encouraging collaborative practice  agreements in our states that support our pharmacy practice is one aspect.  Don’t underestimate your power–each pharmacist’s membership and voice counts.

No matter what practice setting you’re in (whether you own a pharmacy or work for the federal government), giving our profession a voice can contribute to our own job security.  As a pharmacist to another pharmacist, join your state’s association now.

What do you think about all this?  Comment below on how you think the healthcare reform will affect your practice.

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