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    Provider status

    Keep the pressure on lawmakers and push for payment

     

    Two access models

    From APhA’s perspective, provider status means improved patient access to healthcare services provided by pharmacists and payment for pharmacists who provide that care. Results from a 2015 survey of pharmacist-provided services describe two distinct pathways to access.

    The community pharmacy pathway represents the tens of thousands of community pharmacists working in independent, mass merchandiser, chain, and supermarket pharmacies. These pharmacists and pharmacies serve geographically defined communities.

    Services are generally available without an appointment, are aligned with the provision of prescription drugs, and are focused around a pharmacist working in the community.

    Pharmacists in these community settings are central to the medication-use process and are the healthcare professionals most often seen by many patients. About 95% of the U.S. population lives within five miles of a pharmacy. In many rural and urban settings, a pharmacist may be the only healthcare professional within reach.

    Community pharmacists provide the opportunity to teach and coordinate self-care behaviors that support prescribed therapies, including over-the-counter products and nutritional supplements. For patients seeing multiple prescribers, community pharmacy can strengthen the continuity and coordination across providers and settings that will improve the safety, effectiveness, and quality of chronic care.

    The integrated health organization pathway represents acute care, inpatient hospital, ambulatory care clinic, health system and outpatients, long-term care, integrated delivery systems, and physician office populations with very targeted needs. These integrated care systems often embed pharmacists in office practice settings as part of a team-based care model. Integrated organizations typically align provider behavior with payer goals for quality metrics and pay-for-performance targets.

    Pharmacists in these integrated settings are central to appropriate medication use in circumstances involving acute care, disease management, and targeted outcomes. Integrated care pharmacists help optimize resource use and provide medication-centered expertise, as well as facilitate continuous quality improvement efforts.

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