NEW YORK For years now, pharmacy leaders at the state and national level have waged a long lobbying campaign to educate policymakers about the damage wrought to community pharmacies by ill-conceived Medicaid cost-cutting programs.
Efforts to balance state and federal budgets by cutting Medicaid reimbursement rates to pharmacies, these pharmacy leaders tell lawmakers and their staffs, force a bitter choice on the retail pharmacy industry: to either dispense prescriptions to low-income Medicaid beneficiaries at a loss, or give up that end of the pharmacy business entirely. Filling scripts for those patients for the lowball payment levels offered in states like Washington means losing money with every prescription dispensed, pharmacy advocates tell policymakers. Not filling them means throwing impoverished and low-income patients out of the pharmacy without their needed medications.
It’s an untenable choice. Drug retailers have had to threaten cutting off service to Medicaid patients in states like Washington – where Walgreens recently threatened to suspend pharmacy services for those patients unless the state rescinded its latest round of cuts – or scrap their standard business model.
Leaders like NACDS president and CEO Steven Anderson and Bruce Roberts, EVP and CEO of the National Community Pharmacists Association, have argued repeatedly for a fresh approach by state legislatures to saving money. They assert that state Medicaid programs could save big dollars without cutting pharmacy dispensing rates. How? By partnering with pharmacies on cost-effective, long-term programs to effectively manage patients’ outcomes, educate those patients on prevention and wellness options, and keep them out of high-cost urgent-care centers through better medication therapy management.
Too often, those appeals have fallen on deaf ears. Thus, it’s no surprise that Anderson, along with Jeff Rochon, CEO of the Washington State Pharmacy Association, would take their case directly to the consumers themselves. Using the forum provided by The Seattle Times, the two warned Puget Sound residents that they could lose both vital health resources and businesses that contribute to the local economy if the proposed cuts aren’t replaced with other cost-saving options for the state’s cash-strapped Medicaid program.
Those options are available, NCPA asserted earlier this week in its latest salvo on reimbursement cuts. The independent pharmacy group urged the Congress and the White House to totally reform the Medicaid payment system, preserving a workable profit margin for community pharmacies, encouraging instead of discouraging the dispensing of lower-cost generics, and paying for cost-effective prevention and early-intervention programs by pharmacists for patients with diabetes and other conditions.
The urgency of the appeal from Anderson and Rochon reflects the ongoing battle over Medicaid reimbursement cuts at both the federal and state levels. As states like California, Michigan, Georgia and Texas cope with falling tax revenues and rising spending for public health programs, the battle over Medicaid pharmacy payment cuts in Washington State and at the Dept. of Health & Human Services are being waged in state legislatures across the United States.
Reporting on the surging costs of Medicaid earlier this year, The New York Times noted that the recession and job losses had driven enrollment rates by 5% to 10% in many states in 2008, adding new pressure to already strained state budgets.