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APhA2013: Your voice, your profession, our legacy

2013; Elsevier BV; Volume: 19; Issue: 2 Linguagem: Inglês

10.1016/s1042-0991(15)31510-3

2773-0735

L. Michael Posey,

Pharmaceutical Practices and Patient Outcomes

As pharmacists have shifted from products to services, we have been recognized in many ways and many forums for our ability to improve patient care while holding costs down. Beginning with nursing homes in 1974 and continuing with Medicaid recipients in 1990, and with Medicare Part D in 2003, federal statutes and regulations have called on members of our profession to use their special set of knowledge and skills to help patients, many of them on the margins of American society As pharmacists have shifted from products to services, we have been recognized in many ways and many forums for our ability to improve patient care while holding costs down. Beginning with nursing homes in 1974 and continuing with Medicaid recipients in 1990, and with Medicare Part D in 2003, federal statutes and regulations have called on members of our profession to use their special set of knowledge and skills to help patients, many of them on the margins of American society One thing has been missing from these mandates: a payment mechanism. As long-time federal pharmacist Sam Kidder pointed out in a 2005 article in The Consultant Pharmacist, the lack of defined reimbursement mechanism for drug-regimen review (DRR) in skilled nursing facilities “turned DRR into a superficial, fragmented exercise.” Kidder, whose obituary was in the December 2012 issue of TCP, wrote that this is an important lesson for pharmacists as we move forward with medication therapy management and other clinical practice models.When APhA2013 opens in Los Angeles on March 1–4, an energized group of members will begin speaking out in a concerted effort to rectify this problem. As noted in the editorial by APhA CEO Tom Menighan on page 12 and the Hub on Policy and Advocacy on pages 53 and 54, APhA is committing $1.5 million of strategic reserves to a push to achieve provider status for pharmacists. This will be an uphill battle, this amount is just the beginning figure, and success is not ensured. Expansion of our critically needed clinical services is stifled, and access by beneficiaries limited without coverage and recognition. Many physicians have become used to their patients getting our services for free in residency and other training settings, and they don’t fully understand why we can’t expand those services. We can be a major source of medication management services in the health care system if, and only if, we are allowed to be part of the team as recognized by payers.Senior Assistant Editor Diana Yap notes in the Hub column that provider status will literally require an act of Congress. When Medicare was created in the mid-1960s, the idea that pharmacists would practice in clinical roles existed mainly in the minds of a few creative folks such as Eugene White in Berryville, VA, and a handful of visionaries who were starting the Ninth Floor Project at the University of California, San Francisco. There was no reason for pharmacists to be reimbursed under Part B, as they provided no services covered there.Today, the situation is fundamentally and radically different. Pharmacists across the country work in a diverse array of clinical roles in practice settings of all types. Whenever and wherever pharmacists are involved, quality of care goes up and costs go down. People need the clinical services that only pharmacists can provide, but we can’t routinely and regularly provide the services without a mechanism for those costs being covered.The theme for our Los Angeles meeting is Your Voice, Your Profession, Our Legacy. Those ideas match very well the concepts that need to drive the profession’s efforts to achieve provider status. It will take each of our voices, amplified to the max, to get the attention of Congress. The entire profession must speak as one; divisiveness on the Hill will mean an early death for the effort. And if we’re successful, pharmacists of this era will share a legacy of finally figuring out a payment mechanism for clinical pharmacy, pharmaceutical care, medication therapy management, and other types of care that patients need pharmacists to provide.Enjoy Los Angeles, find your voice, and enjoy your February Today!View Large Image Figure ViewerDownload Hi-res image Download (PPT) One thing has been missing from these mandates: a payment mechanism. As long-time federal pharmacist Sam Kidder pointed out in a 2005 article in The Consultant Pharmacist, the lack of defined reimbursement mechanism for drug-regimen review (DRR) in skilled nursing facilities “turned DRR into a superficial, fragmented exercise.” Kidder, whose obituary was in the December 2012 issue of TCP, wrote that this is an important lesson for pharmacists as we move forward with medication therapy management and other clinical practice models. When APhA2013 opens in Los Angeles on March 1–4, an energized group of members will begin speaking out in a concerted effort to rectify this problem. As noted in the editorial by APhA CEO Tom Menighan on page 12 and the Hub on Policy and Advocacy on pages 53 and 54, APhA is committing $1.5 million of strategic reserves to a push to achieve provider status for pharmacists. This will be an uphill battle, this amount is just the beginning figure, and success is not ensured. Expansion of our critically needed clinical services is stifled, and access by beneficiaries limited without coverage and recognition. Many physicians have become used to their patients getting our services for free in residency and other training settings, and they don’t fully understand why we can’t expand those services. We can be a major source of medication management services in the health care system if, and only if, we are allowed to be part of the team as recognized by payers. Senior Assistant Editor Diana Yap notes in the Hub column that provider status will literally require an act of Congress. When Medicare was created in the mid-1960s, the idea that pharmacists would practice in clinical roles existed mainly in the minds of a few creative folks such as Eugene White in Berryville, VA, and a handful of visionaries who were starting the Ninth Floor Project at the University of California, San Francisco. There was no reason for pharmacists to be reimbursed under Part B, as they provided no services covered there. Today, the situation is fundamentally and radically different. Pharmacists across the country work in a diverse array of clinical roles in practice settings of all types. Whenever and wherever pharmacists are involved, quality of care goes up and costs go down. People need the clinical services that only pharmacists can provide, but we can’t routinely and regularly provide the services without a mechanism for those costs being covered. The theme for our Los Angeles meeting is Your Voice, Your Profession, Our Legacy. Those ideas match very well the concepts that need to drive the profession’s efforts to achieve provider status. It will take each of our voices, amplified to the max, to get the attention of Congress. The entire profession must speak as one; divisiveness on the Hill will mean an early death for the effort. And if we’re successful, pharmacists of this era will share a legacy of finally figuring out a payment mechanism for clinical pharmacy, pharmaceutical care, medication therapy management, and other types of care that patients need pharmacists to provide. Enjoy Los Angeles, find your voice, and enjoy your February Today!