I was impressed and energized recently by the stellar initiative by ASHP member Sandra Leal to create an online petition calling on our elected leaders to amend the Social Security Act (SSA) to include pharmacists as practitioners who are eligible to provide and bill for covered services under Medicare Part B (a.k.a. Provider Status).
Sandra, like many other pharmacists who care for patients in ambulatory settings, would be able to do so much more to improve safety, outcomes, and reduce healthcare costs if they were eligible under Medicare Part B to provide and bill for covered services. ASHP members created professional policy in 2001 calling for changes to the SSA. Since then, ASHP has worked tirelessly to convince Congress that the additional costs to the Medicare program to pay pharmacists would be offset by the savings gained through improved outcomes, fewer errors, decreased hospital stays, and numerous other outcomes. Members of Congress agree, and on a few occasions legislation was introduced to amend Section 1861 of the SSA. Various other changes to public law have been enacted since 2001,including the Medicare Modernization Act (MMA) and the Affordable Care Act (ACA). On one side these laws caused disinterest by lawmakers to support changes to the SSA to include pharmacists, but on the other side MMA and ACA created numerous opportunities for pharmacists to change their practice models and to show their value under new payment and delivery systems such as value-based purchasing, medical homes, accountable care organizations, and payment bundling. However opportune these new payment systems are, Sandra is right: the SSA still needs to be amended to include pharmacists among the healthcare practitioners eligible to participate in many of these new and emerging payment and delivery systems.
Sandra Leal's activism is a great example of grassroots advocacy at it finest. Getting provider status enacted nationally is going to require a groundswell of sustained activism at the grassroots level by pharmacy practitioners. Professional pharmacy organizations are a great and necessary support mechanism for practitioners, but the battle to attain provider status will only happen through motivated and energized practitioner leaders like Sandra who can show the people they elect to represent them in Congress the benefits they bring to patients in their states, districts, and communities.
Achieving provider status is foundational to realizing the full potential of the ASHP Pharmacy Practice Model Initiative. ASHP looks forward to continuing to work with leaders like Sandra and many others to help bring these vital and fundamental changes to reality. A good start would be for everyone to sign Sandra's petition.
Kasey K. Thompson, Pharm.D.
Vice President
Office of Policy, Planning and Communications
American Society of Health-System Pharmacists
Bethesda, Maryland