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    Medicaid Expansions Mean New Roles for Pharmacists

    Pharmacists will be the most frequent point of contact for new Medicaid patients.

    Expansion of Medicaid brought in many people with new needs for education, counseling, ad intervention from pharmacists.

    Pharmacists may need to increase their education, counseling, and intervention efforts to better serve the patients who now have health insurance through the Medicaid expansions.

    As a result of health reform, more Americans have medical and pharmacy benefits. According to the Henry J. Kaiser Family Foundation, the number of uninsured nonelderly Americans went down from 44 million in 2013 to 28 million in 2016.

    Many who became eligible for Medicaid through expansions under the Affordable Care Act (ACA) may never have had health insurance before. They have a distinct set of needs and often require a more hands-on approach from pharmacy. Pharmacists will be the most frequent point of contact for new Medicaid patients within the health-care system, which gives both community and hospital pharmacists opportunities to play a greater role in improving patient outcomes.

    Medicaid ExpansionPharmacists can adopt new strategies that lower overall drug spending or that put the patient in a better position to improve their health, whether by creating comprehensive medication lists, improving adherence, or collaborating with physicians.

    “This could be a great opportunity for pharmacists to demonstrate their value as a patient-care provider,” said Joseph Hill, Director of the Government Relations Division for ASHP.

    States that chose to expand Medicaid as part of health-care reform are seeing more significant jumps in coverage, but this increased coverage comes with increased responsibility for health-care providers.

    “The good news is more people are covered under Medicaid, the bad news is we don’t have enough money to pay for everybody to get everything, so we have to ration health care for Medicaid recipients,” said Perry Cohen, PharmD, CEO of The Pharmacy Group. “Pharmacists have to manage the cost like never before and not just be passive dispensers blaming the third party for the cost.”

    Growing in Numbers

    After the ACA (Obamacare) went into effect, 32 states plus the District of Columbia chose to expand Medicaid.

    The Henry J. Kaiser Family Foundation released a brief in September summarizing the findings of 153 studies that examined the impact of the Medicaid expansions. 

    The expansions resulted in significant gains in coverage and reductions in the uninsured rates in those states, according to the brief. For example, according to a 2017 report from the Louisiana Department of Health, the state of Louisiana provided coverage for more than 433,000 residents who previously had lacked it.

    Jill Sederstrom
    Jill Sederstrom is a Contributing Editor

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