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THE PHARMACIST AS A HEALTH CARE PROVIDER

In the process of providing patient care, pharmacists provide direct medication-related care for the purpose of achieving definite and positive outcomes that improve a patient’s quality of life. To accomplish this, pharmacists establish one-on-one relationships with patients to ensure the appropriateness of medication therapy and patients’ understanding of their therapy. In addition, pharmacists identify and help patients overcome barriers to adherence, assist in the coordination of medical care, and ensure the continuity of patient care. To optimize therapy, pharmacists monitor the effects of patients’ medications and make recommendations and changes to medication therapy when appropriate.

As a member of the healthcare team, pharmacists work in concert with physicians, nurses, and other health professionals to ensure the expected outcomes of medication therapy.

Pharmacists often participate in collaborative drug therapy management in which pharmacists enter into agreements with physicians who authorize pharmacists to select appropriate medication therapies and adjust doses based on patient characteristics, diagnosis, and response to treatment. Additionally, pharmacists have already gained recognition as health care providers in certain states through various medication therapy management (MTM) programs. This is one of many services pharmacists can provide as health care providers.

Historically, recognition as a healthcare provider under the Social Security Act has been inextricably tied to direct financial compensation for services delivered. Currently, physicians, nurse practitioners, nurse midwives, physician assistants, dietitians, and clinical social workers are recognized as healthcare providers under this act. At present, pharmacists are primarily financially compensated for providing patient care services incident to physician services or as a result of dispensing medications. 

The Illinois Council of Health-System Pharmacists (ICHP) supports the recognition of pharmacists as healthcare providers under the Social Security Act and by health insurance providers.

Background

There are a few bills aimed at targeting provider status for pharmacist:

The Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/S. 312) would allow for pharmacist-provided ambulatory-based patient care services to be reimbursable under Medicare Part B

The Improving Public Health with Pharmacists Provided Immunization Care (HB3627) would allow pharmacist-administration of vaccinations to all patients 10 years and older

The Improving Patient’s Access to Pharmacists and Increasing Transparency in Prescription Health Plan Costs (HB4079) would expand access to care services within the pharmacist scope of practice.


Revised 10/2015