J Am Pharm Assoc (2003). 2021 Nov-Dec;61(6):651-660.e1. doi: 10.1016/j.japh.2021.08.021. Epub 2021 Aug 27.
Payment reform for pharmacists is both an important and urgent issue that needs to be addressed.
OBJECTIVE(S): The purpose of this paper is to assess the use of medically underserved areas, medically underserved populations, and primary care health professional shortage areas in The Pharmacy and Medically Underserved Areas Enhancement Act; and provide policy recommendations for national pharmacy associations to achieve provider status.
Pharmacy location addresses were determined using public domain data from the National Plan & Provider Enumeration System (NPPES) National Provider Identifier (NPI) Registry. Medically Underserved Areas/Populations (MUAs/MUPs) and Health Professional Shortage Areas (HPSAs) were gathered through public data provided by the Health Resources and Services Administration as Keyhole Markup Language (KML) files. Addresses and KML files were analyzed and mapped using the geographic information software, QGIS. A series of maps depicting the location of all MUAs/MUPs, HPSAs, HPSA facility locations, and community pharmacy locations in the U.S. were then created. These maps were overlayed, and geoprocessing tools were used to create the analysis.
After analyzing all community pharmacy locations in the United States, we found that only 56% are located within a current MUA/MUP or HPSA. The percentage of pharmacies in healthcare underserved areas differs widely between states from the lowest in New Jersey of 18.26% of pharmacies to the highest of Guam, the Northern Mariana Islands and the Virgin Islands with 100% of pharmacies.
Aligning the pharmacist business model to be comparable to other health care professionals will ensure patients receive access to pharmacist-provided cognitive patient care services, which have higher value than product-centered services. Future attempts to recognize pharmacists as providers and allow for their reimbursement under Medicare Part B should consider strategies to increase the number of pharmacists that are eligible to participate in order to exemplify value to the public and elected leaders.
药剂师薪酬改革是一个亟待解决的重要问题。
本文旨在评估《药学和医疗资源匮乏地区加强法案》中医疗服务不足地区、医疗服务不足人群和初级保健卫生专业短缺地区的使用情况，并为全国性药学协会提供实现供应商地位的政策建议。
使用国家计划和供应商名录系统（NPPES）国家供应商标识符（NPI）注册中心的公共领域数据确定药房位置地址。通过卫生资源和服务管理局提供的关键标记语言（KML）文件获取医疗服务不足地区/人群（MUA/MUP）和卫生专业人员短缺地区（HPSA）。使用地理信息软件 QGIS 对地址和 KML 文件进行分析和映射。然后创建一系列地图，描绘美国所有 MUA/MUP、HPSA、HPSA 设施位置和社区药房位置的位置。然后将这些地图叠加，并使用地理处理工具进行分析。
分析全美所有社区药房位置后发现，仅有 56%位于当前 MUA/MUP 或 HPSA 范围内。医疗服务不足地区的药房比例在各州之间差异很大，最低的新泽西州为 18.26%，最高的关岛、北马里亚纳群岛和维尔京群岛为 100%。
使药剂师商业模式与其他医疗保健专业人员相匹配，将确保患者能够获得药剂师提供的认知患者护理服务，这些服务比以产品为中心的服务具有更高的价值。未来尝试将药剂师确认为提供者并允许其在医疗保险 B 部分下报销时，应考虑增加有资格参与的药剂师数量的策略，以向公众和当选领导人展示价值。
