Value-Based Care and Provider Status: A Winning Combination

The pharmacist’s role continues to evolve from a distribution focus toward an emphasis on value-based health care. As a result, pharmacists are becoming more active drug-therapy decision makers and an increasingly important part of team-based health care. By enhancing appropriate drug-therapy outcomes, pharmacists are ensuring the value of health care services.

Provider status also seems poised to propel pharmacy. The House of Representatives, and eventually the Senate, are expected to pass bill HR 592. Passage of the bill would allow immediate billing of medication therapy management (MTM) by pharmacists, prompting most medical practices to require MTM and, in turn, ensure better medication adherence and patient outcomes. The federal legislation supports having pharmacists recognized as providers by CMS, and it is hoped that commercial payers will also come on board.

Pharmacists should support grassroots activities that promote passage of HR 592 and any supportive state legislative bills. With the passage of these bills, pharmacists will have new opportunities to practice in current environments and in potential new practice areas. Provider status could also be an incentive for additional professional training, residencies, and board certifications.

Together, value-based care and provider status are looking like a winning combination for empowering pharmacy and individual pharmacists in terms of patient care, especially for treating chronic conditions such as respiratory disorders— the clinical focus of this issue. According to the Centers for Disease Control and Prevention, the proportion of Americans with asthma grew by nearly 15% in the past decade; more than 22 million Americans are now affected.¹ Another major respiratory issue is allergies, which are now the sixth leading cause of chronic illness in the United States. More than 50 million Americans suffer from allergies each year.² In addition, approximately 15 million Americans have been diagnosed with chronic obstructive pulmonary disease.³ The numbers are staggering, but advances in diagnosis and treatment continue. Pharmacists are doing their part to help, but we can only imagine the positive impact that they might have if empowered by provider status.

Now the good news: pharmacists are in a unique position to mitigate the physical and economic burdens of these diseases. To support pharmacists in their efforts to improve Americans’ respiratory health, this issue offers practical information that can be applied immediately. Topics include OTC intranasal steroid inhalers, cystic fibrosis, e-cigarettes, and allergen immunotherapy—plenty of information to help you and your patients breathe easier this spring.

Thank you for reading!

Mike Hennessy

Chairman and CEO

References

• Asthma. Centers for Disease Control and Prevention website. cdc.gov/asthma/faqs.htm. Accessed February 18, 2016.
• Allergies. Centers for Disease Control and Prevention website. cdc.gov/healthcommunication/ToolsTemplates/EntertainmentEd/Tips/Allergies.html. Accessed February 18, 2016.
• Chronic obstructive pulmonary disease (COPD). Centers for Disease Control and Prevention website. cdc.gov/copd/index.html. Accessed February 18, 2016.