Provider Status Would Enable Retail Clinics to Help Fill the Void in Seniors’ Access to Patient Care
By Ken Perez, VP of Healthcare Policy and Government Affairs, Omnicell
It has been said that the coronavirus pandemic has exposed the fissures in our healthcare system and highlighted disparities, especially regarding access to patient care. For years, the United States has experienced a primary care physician (PCP) shortage. Currently, it’s widely estimated at 15,000 PCPs, and that number is projected to increase to as much as 55,000 by 2033, according to a 2019 study commissioned by the Association of American Medical Colleges.1
Worse yet, the PCP shortage is unevenly distributed geographically. For decades, the Appalachian Region has suffered from a shortage of physicians. But the problem is much more widespread. Just as there are so-called “food deserts”—areas where people have limited access to affordable or good-quality fresh food, there are PCP deserts, where there is less than one PCP for every 3,500 people. This represents a shortage as defined by the Health Resources and Services Administration. It is estimated that 1,200 of the nation’s 3,100 counties and 13% of the United States population—44 million people, including some 10 million Medicare Part B enrollees—live in PCP-shortage areas.2, 3
In recognition of this worsening societal problem as well as the positive contributions of pharmacists in the administration of COVID-19 vaccines, in late-April the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 2759 and S. 1362) was introduced with bipartisan sponsorship in both chambers of Congress. As of this writing, the House bill has garnered 50 cosponsors, split equally between Democrats and Republicans, and the Senate bill has 10 cosponsors, five Democrats and five Republicans. Notably, these cosponsors represent the entire political spectrum.
The bill 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 be a boon to the estimated 250-300 retail clinics that are located in medically underserved areas, where, as previously mentioned, some 10 million Medicare Part B enrollees live. In addition, there would be an incentive to create more clinics and broaden the range of healthcare services in stores.
Such initiatives would be well received by the public. Research has shown that many patients find community-based pharmacists more accessible, and these pharmacists can improve patient outcomes. For example, the Michigan Medicine Hypertension Pharmacists’ Program, which featured a partnership with Meijer, a regional supermarket with retail pharmacy, improved blood pressure management among program participants and supported the health system in achieving quality benchmarks.4
J.D. Power’s 2021 U.S. Pharmacy Study reported that 51% of customers at retail pharmacies are using health and wellness services, up from 48% the year before and 43% in the 2019 report. James Beam, managing director of healthcare intelligence at J.D. Power, articulated the reasons for this increase in consumer preference for retail pharmacies: “It’s really around cost and convenience, and there’s a perception of quality now that’s new. I think the models are starting to evolve to be more clinically driven, and any time that’s the case, the consumers put their trust in the quality and clinical guidance.”5
In addition, it almost goes without saying that provider status would enable pharmacists to practice at the top of their license, be more patient-focused, and derive greater satisfaction from their work. Having this status and being able to bill for high-value clinical services will also enable pharmacies to increase their business results.
Most importantly, provider status and the ensuing greater use and expansion of retail clinics would benefit society by increasing access to patient care. A March 2021 Harvard Medical School study concluded that if the primary care shortage in medically underserved areas was fully addressed, more than 7,000 lives would be saved annually, and the average life expectancy of Americans would lengthen by an average of 56 days.6
Thus, granting provider status to pharmacists would leverage these retail healthcare destinations and help close one of the serious gaps in our healthcare system, improving access to primary care for millions of patients. The result would be better health outcomes for patients across the country.
- 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.
- 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.
- 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.
- Centers for Disease Control and Prevention, “The Pharmacists’ Patient Care Process Approach: An Implementation,” U.S. Department of Health and Human Services, https://www.cdc.gov/dhdsp/pubs/docs/PPCP_Guide_June2021-508.pdf, 2021.
- Minemyer, Paige, “J.D. Power: Number of patients seeking health, wellness services at pharmacies on the rise,” Fierce Healthcare, https://www.fiercehealthcare.com/payer/j-d-power-number-patients-seeking-health-wellness-services-at-pharmacies-rise, July 28, 2021.
- 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.