Provider Status for Pharmacists
Where We Stand:
AMCP supports the recognition of pharmacists as providers under the Social Security Act. When pharmacists are recognized as provider members of the health care team, patient outcomes improve, and patients report higher rates of satisfaction while overall health care costs are reduced. Recognized provider status would allow pharmacists to be reimbursed under the Medicare Part B benefit for providing health care services to patients.
With the high level of education and training licensed pharmacists receive and as the most patient-accessible member of the health care team, AMCP firmly supports recognizing pharmacists as providers as imperative and necessary. The education pharmacists receive provides the knowledge necessary to be experts in medication use and evidence‐based practices. Most states permit pharmacists to enter into collaborative practice agreements with prescribers, which grant pharmacists authority to manage a patient’s drug therapy. Years of published literature provides significant evidence of the benefits gained by allowing pharmacists to more fully utilize their expertise within clinical settings as part of the health care team. Pharmacists can play a vital role in promoting public health in that they act as immunizers, improve vaccine-related health literacy, and counter vaccine hesitancy.
These benefits include, but are not limited to, immunization delivery, reduction in overall health care costs, improved patient outcomes, decreased number of drug related adverse events, improved access to primary care services, and increased patient satisfaction. The pharmacist‐provided services supported by the current literature include preventative care services, wellness screenings, chronic disease management, medication therapy management, and others. Many of these services are currently covered under Medicare Part B if delivered by a recognized provider.
Even with years of research that has continuously shown positive outcomes for pharmacists providing direct patient care, pharmacist involvement in many clinical settings remains limited. Barriers to expanding pharmacists’ involvement within these settings are in part due to inconsistent reimbursement and lack of recognition of pharmacists’ capabilities within the Medicare program. Provider status for pharmacists under Medicare Part B would begin to improve both the availability of a consistent reimbursement source and demonstrate federal support for pharmacists’ clinical abilities beyond that provided under the Medicare Part D program.
Currently, the following providers are recognized in the Social Security Act: physicians, audiologists, certified nurse midwives, certified registered nurse practitioners, certified registered nurse anesthetists, physicians’ assistance, licensed clinical psychologists, licensed clinical social workers, physical and occupational therapists, and registered dieticians/nutrition professional.
It is AMCP’s stance that pharmacists’ recognition as providers is long overdue. Provider status will allow pharmacists to effectively work with physicians and other health care providers to optimize medication therapy and deliver ideal patient‐centered care. Through the delivery of direct patient care, pharmacists, in collaboration with physicians, nurses, patients, and other health care providers can offer ongoing, comprehensive assessment and management of drug therapy that is patient‐centered, improves quality of care, produces desired patient outcomes, and reduces overall costs of care.
AMCP strongly believes the inclusion of pharmacists as health care providers under the Social Security Act is critical to effectively work as part of health care teams to address primary health care needs of patients.
See also:
AMCP position statement on Collaborative Drug Therapy Management
AMCP Where We Stand series: https://www.amcp.org/policy-advocacy/policy-advocacy-focus-areas/where-we-stand-position-statements
Revised by AMCP Board of Directors, February 2022