Amid access and cost challenges, U.S. health system turns to pharmacy

It’s time.

With the nation struggling to pay its massive health bill, medical schools turning out fewer and fewer primary care doctors, 10,000 boomers a day turning 65 years old and putting new stress on Medicare and health services, the Affordable Care Act demanding new cost-saving solutions to front-line care, and chronic diseases reaching epidemic proportions, it’s clearly time to fully engage the nation’s nearly 180,000 community pharmacists in the urgent campaign for a more effective, more accessible and less costly healthcare system.



The pharmacy profession — and the industry it drives — is up to the challenge. Armed with a doctorate in pharmacy and advanced training in pharmacology, population health, clinical care and patient counseling, today’s community pharmacists are ready and able to do more to help relieve the stress on the nation’s vast, overburdened and staggeringly expensive healthcare system.



Indeed, they’ve already stepped up as frontline providers of vital services like immunizations, medication therapy management, disease prevention, health screenings and healthy lifestyle counseling. And with a fairer and more rational payment system for pharmacy services in place, they could do much more to improve Americans’ overall wellness and curb the rising health cost spiral.



“Retail community pharmacists provide high quality, cost-efficient care and services, especially for patients with chronic conditions,” noted Steve Anderson, president and CEO of the National Association of Chain Drug Stores. “However, the lack of pharmacist recognition as a provider by third-party payers, including Medicare and Medicaid, has limited the number and types of services pharmacists can provide, even though fully qualified to do so.”



“Pharmacists play an increasingly important role in the delivery of services, including key roles in new models of care beyond the traditional fee-for-service structure,” Anderson added. “Pharmacists are engaging with other professionals and participating in models of care based on quality of services and outcomes, such as ACOs (accountable care organizations). They’re also partnering with healthcare providers working in nearby health systems and hospitals, serving as part of care teams to help improve patient health and outcomes.”



NACDS calls pharmacists “the face of neighborhood healthcare — the final link in a chain of care that extends from health providers to patients, and unquestionably the nation’s most accessible health professional.”



‘We need to make changes’ 



The growing reliance on pharmacists as fully engaged and clinically capable members of the modern patient-care team couldn’t come at a better time. Costs of acute care services and hospitalizations have skyrocketed. And the nation’s growing shortage of primary care physicians — traditionally the first line of care for most Americans — is reaching critical levels.



This growing squeeze on the number of primary care physicians has made access to affordable healthcare a hot-button issue. And it comes even as the U.S. health system is in the midst of a “back to basics” movement that’s “making primary care once again the critical touchpoint,” according to PriceWaterhouseCoopers’ Health Research Institute. “Besides elevating the role of primary care physicians, that movement is also elevating the critical importance of pharmacists, retail clinicians and other health professionals who extend and supplement the role played by family-practice doctors in a team-based, more collaborative network of frontline care,” PwC reported recently.



“America’s population is living longer than ever before; however, the number of people suffering from chronic disease is at an all-time high and growing,” noted Dr. Harry Leider, chief medical officer at Walgreens, in a report for the Congressional newspaper The Hill. “Almost half of U.S. adults — approximately 117 million people — have at least one chronic disease, resulting in three-quarters of our nation’s annual healthcare expenditures going toward costs for treatment and management of these conditions.

“We’re also challenged with a primary care physician shortage that’s only supposed to worsen, with the Association of American Medical Colleges predicting that in five years there will be nearly 100,000 fewer doctors than the number needed,” Leider added. “And, of course, there is the influx of newly insured individuals into the healthcare system as a result of the Patient Protection and Affordable Care Act.”



“Against this backdrop, it’s clear we need to make changes to our system to counter these trends that will only continue to hinder patient access,” he noted. “One viable solution is to promote the important role that community pharmacists can play in providing patient care, in the same manner as other non-physician providers like nurse practitioners and physician assistants.”



Many of the stakeholders who will determine the future direction of health care in America are beginning to heed that advice. Government and privately run health plan payers, hospital-based health systems and time-pressed family physicians are turning to pharmacies nationwide to provide more cost-effective and accessible frontline healthcare services.



“It’s often said that pharmacists are the most underutilized healthcare professional in the healthcare system,” said Anne Burns, VP of professional affairs at the American Pharmacists Association. “That’s changing as policy-makers, media outlets, healthcare administrators, and physicians and other members of the healthcare team highlight the value that pharmacists can bring to improving patients’ health and medication outcomes.”

To see the full report, click here.