The Missing Link in Healthcare Access: Expanding Public Access to Community Pharmacy Services Beyond the COVID-19 Pandemic, Part 1
The following is part 1 of 6 in a series of articles titled, "Expanding Public Access to Community Pharmacy Services Beyond the COVID-19 Pandemic" by Jason Ausili, PharmD, MSLS, Head of Pharmacy Transformation for EnlivenHealth.
The COVID-19 pandemic has dramatically impacted lives on a global scale. There have been few times in history when public health and access to healthcare have been such an ominous and far-reaching concern.
According to the Centers for Disease Control and Prevention (CDC), COVID-19 was the third leading cause of death in 2021, just behind heart disease and cancer. Among the population, overall death rates were elevated for non-Hispanic American Indian/Alaskan Native and non-Hispanic Black or African American People. A recent brief by the Kaiser Family Foundation Health System Tracker reports that, "about 234,000 COVID-19 deaths since June 2021 could have been prevented with vaccines. " Of the nearly 1 million COVID-19 related deaths as of mid-April 2022, vaccines could have prevented about 60 percent of all adult deaths since June of last year, when safe and effective vaccines became widely available to the U.S. population.
Pharmacists Enter the Fight
Pharmacists are the most accessible healthcare provider in the U.S. By the end of 2021, there were over 57,000 independent, retail chain, supermarket, and mass merchant pharmacies located in communities across the United States. To leverage the distinctive availability of these valuable resources, the Department of Health and Human Services (HHS) brought forth guidance documents and amendments to the Public Readiness and Preparedness (PREP) Act to give authority to pharmacists to help combat the COVID-19 pandemic on multiple fronts, including vaccinations, testing, and therapeutics.
The Public Health Emergency & Provider Status
Despite being uniquely prepared through education, skills, knowledge, and experience, the privileges granted to pharmacists by HHS are set to expire once the public health emergency (PHE) declaration ends. Lawmakers need to take immediate action to ensure that these scope of practice enhancements are not lost to ensure public access to care remains.
Why is such a talented and accessible group of healthcare resources not formally recognized as providers at the federal level? Without this recognition, pharmacists do not qualify for payment and reimbursement by the Centers for Medicaid and Medicare Services (CMS) for services rendered. The COVID-19 pandemic helped the nation realize that pharmacists are the missing link in population access to high quality public health services, and urgent action is needed to solidify pharmacists' long-term capabilities on this front.
Legislative Changes Needed
The Equitable Community Access to Pharmacist Services (ECAPS) Act, H.R. 7213, is a bipartisan bill introduced to the House of Representatives on March 24, 2022. If enacted, this bill would amend Title XVIII of the Social Security Act and provide a reimbursement mechanism under Medicare Part B to cover pandemic-related services provided by a pharmacist.
Public access to testing, vaccinations, and treatment for COVID-19 has been dramatically improved by the inclusion of community pharmacy and the corresponding privileges granted by HHS. Why would these privileges not expand versus expire once the Public Health Emergency ends, further improving care access to medically underserved and rural communities, reducing the overall burden of rising healthcare costs, and advancing health equity?
In this series, I will discuss policy recommendations that aim to influence legislative reform, create long-term adoption of the privileges granted during the pandemic, and impact expansion to similar public health services that are equally fit for the most accessible healthcare provider in the nation.