Ninety-two of North Carolina’s 100 counties include areas designated as “medically underserved.” Meanwhile, some 10,000 pharmacists are licensed in the Tar Heel state.
Wingate University School of Pharmacy (WUSOP) student Caleb Ramey says the numbers point to an obvious solution: change the law to allow pharmacists, who are already trained to perform many medical services, to offer those services under the umbrella of Medicare Part B.
President of the University’s chapter of the American Pharmacists Association (APhA) and a second-year pharmacy student, Ramey is among a growing number of those in the profession who are pushing for the passage of the Pharmacy and Medically Underserved Areas Enhancement Act.
The legislation, filed in the U.S. Congress as H.R. 592 and S. 109, would allow state-licensed pharmacists in medically underserved areas to be paid by Medicare when they give immunizations, conduct health-and-wellness testing, manage chronic diseases and medication therapy and partner with health systems in other ways to reduce hospital readmissions. The reimbursement rate would be 85 percent of the physician fee schedule.
“There’s already a lot of altruism in pharmacy, where pharmacists are taking time out to help the patient, going over their medications and talking with them about disease management,” Ramey says, explaining that the law would not expand the types of services that pharmacists are permitted to provide, but would simply allow them “provider” status under Medicare.
Ramey feels so strongly about it that he and WUSOP assistant professor Dr. Cortney Mospan took a trip to Washington, D.C., in July to meet with lawmakers. Part of a contingent that included representatives from three other North Carolina pharmacy schools, Ramey and Mospan met with the staffs of Sen. Richard Burr, who already supports the bill, and of Sen. Thom Tillis.
“This is not really about the money, but corporate may not want us, as pharmacists, to spend a lot of time with a patient to provide a service if that time is not something that can be billed for,” he says. “So the reimbursement would be an incentive for the corporation to let us offer the service we’re already trained to do.”
Ramey says that, if allowed, pharmacists can make a huge difference in healthcare delivery, helping patients stay out of the hospital and reducing costs, especially as Baby Boomers age and the doctor shortage intensifies.
“Doctors already have their time cut short with patients,” he says. “So if a patient is worried about their glucose, their blood pressure or their cholesterol – any of that point-of-care testing – they’d be able to see a pharmacist instead of having to wait for a doctor’s office appointment or go to an urgent care facility.”
Ramey says retail pharmacies located in medically underserved areas could incorporate the services inside their stores, a move that would create more jobs for pharmacists while making healthcare more accessible for their customers and cutting costs.
Studies show pharmacists’ counseling and adherence programs can save the healthcare system $164 per patient in the six months following the start of a new medication. Further, an average of $1,000 is saved per year per patient when pharmacists step in to help them manage their chronic conditions. Patients are three times more likely to stay out of the hospital when they take advantage of clinical services from a pharmacist after discharge.
Ramey says it felt good to relay those facts to Washington lawmakers.
“It was one of the most unique experiences I’ve had, doing a Capitol Hill visit as a student pharmacist, knowing that what I was doing could make a difference and that APhA supports me and trusts me to represent them,” Ramey says. “In both of the lawmakers’ offices we visited, the staff seemed to truly be looking to us as experts and seemed to appreciate our spending time to talk about the bill, to say ‘this is what it is and this is why we need it.’”
A native of Low Gap, North Carolina, near Mount Airy, Ramey is always willing and ready to help people better understand the pharmacy profession.
“People think pharmacists just stand there counting out pills and telling you to have a nice day,” Ramey says. “Many people don’t realize it’s a doctoral degree, so we are educated to know much more than just ‘is this the right pill to go in the bottle?’”
He says few people take advantage of all the ways they can benefit from getting to know their pharmacist and understanding his or her role on the healthcare team.
Although he knew he wanted to pursue pharmacy when he came to Wingate as an undergraduate, Ramey says he’s still learning the ins and outs of the profession and considering where he wants to start his career. As he leads the APhA chapter, he says, increasing the public’s awareness of pharmacists and their place in healthcare is one of his goals.
“If I didn’t know about all the things pharmacists do – and I want to be a pharmacist – how can I expect the general population to know unless we put that information out there?” Ramey says.
He’ll be among a group of about a half dozen members of Wingate’s APhA attending the group’s mid-year regional meeting in Charleston, South Carolina, next month. The chapter has roughly 70 members and meets three to four times a semester.
Until then, he’ll continue to talk up the proposed changes to the law during October, which is American Pharmacists Month.
Learn more about Wingate University’s pharmacy program.