How Pharmacy Provider Status Will Change Pharmacist Roles in Different Healthcare Settings
/Pharmacy provider status is a movement that many pharmacists want with active bills in the House in Senate. Pharmacy provider status would open up many opportunities for pharmacists in a variety of settings.
Hospital pharmacists will be able to take a more active role in medication management while a patient is in the hospital. Labs could be ordered to assess adherence and adjust accordingly prior to discharge for a variety of healthcare conditions. Pharmacists could also have more opportunities with a bigger demand for pharmacy specialties. Perhaps managed care organizations could tap into the potential of having pharmacists manage medications to save companies money and for better public health.
In California (who has always been cutting edge in healthcare), the (California created/named) Advanced Practice Pharmacist (APP) recognition gives pharmacists authority to do the things already being done by many clinical hospitals across the nation with the ability to bill. APPs must also complete two of three criteria to earn this designation: Earn certification in a relevant are of practice, complete a postgraduate residency program and/or provided clinical services to patient for one year under a collaborative practice agreement or protocol with a physician, APP pharmacist, CDTM pharmacist, or health system. SB 493 was also passed: Bridging the Provider Gap.
In North Carolina, there is a Clinical Pharmacist Practitioner (CPP) designation. In this state, you must be a licensed pharmacist with an agreement with a physician. In addition, you must have either: (1) have completed a BPS certification or geriatric certification, or the ASHP accredited residency program and have 2 years clinical experience OR (2) you must have earned a PharmD degree, have 3 years experience, and have completed a Certificate Program OR (3) you must have earned a BS degree, have 5 years experience, and have completed two certificate programs. North Carolina defines CPP as "Clinical Pharmacist Practitioner or CPP" means a licensed pharmacist who is approved to provide drug therapy management, including controlled substances, under the direction of, or under the supervision of a licensed physician who has provided written instructions for a patient and disease specific drug therapy which may include ordering, changing, substituting therapies or ordering tests. Only a pharmacist approved by the Pharmacy Board and the Medical Board may legally identify himself as a CPP.
New Mexico and Montana also have legislation to initiate some drug therapy.
Ambulatory care pharmacists could make headway with patient medication adherence. Centers for Medicare and Medicaid Services (CMS) base many of their quality measures on adherence. Ambulatory care pharmacists could also be paid for services with immunizations and diabetes self-management education along with home infusion and other areas of pharmacy practice.
What can a pharmacist do today to be prepared for the change that is on the horizon? First, get your board certification. Second, become involved in the movement. Not only will this designation open doors for all of us, we will also be able to show our place in the healthcare team and for better public health.