Script Health CEO James Lott speaks on policy panel at MedCity INVEST
At MedCity News’ INVEST conference in Chicago last week, James Lott, CEO of health tech company Script Health, was asked what he would put on his policy wish list if he had a magic wand: pharmacist offerings When it comes to identity, he speaks loudly and clearly.
The term is Controversial and confusing But basically it means that pharmacists should be reimbursed for the type of services they provide.
In fact, bill and bipartisan support Already introduced, this will allow pharmacists in underserved areas to bill Medicare Part B for services within the pharmacist’s state practice. Care must also be provided to Medicare Part B beneficiaries who live in an underserved area to be eligible for reimbursement. According to the American Society of Health-System Pharmacists, if it becomes law, pharmacists will be paid 85% of the doctor’s fee schedule.
This is especially notable given the greater challenges facing rural health care, already under financial stress, with many facilities closed. At this. “Medical Desert” is a pharmacist trying to pick up the slack and become a trusted source for the community.
Lott, a public policy expert and PharmD, gushed about the litany of ways pharmacists have actually provided vital care during the pandemic, from vaccinations to testing.
“Recent data shows that pharmacists have administered more than 235 million doses of the Covid-19 vaccine nationwide. They have performed more than 100 million Covid tests,” Lott told the INVEST audience on Wednesday. “And I think if pharmacists are unable to vaccinate patients across the U.S., many of us will still be waiting in line for our first dose,” he said.
He added that because pharmacists are not providers, and because pharmacy benefits are separate and distinct from medical benefits, pharmacists have had to jump through hoops to provide the service.
“Pharmacists are reimbursed completely differently for these services,” Lott explained. “A lot of it was assigned by pharmacy benefit managers, and that created a lot of problems.”
Lott’s company, Script Health, is trying to bridge that gap.
“We’re seeing some pharmacies wanting to work with us because we have access to physician partners who can make agreements with those pharmacies and oversee their clinical services, like vaccine programs,” he said. “But if you’re in a small town in rural America, let’s say you’re in a medical desert, there’s no doctor within 50 miles.”
That’s where the federal legislation that the pharmacy community is pushing for comes into play.
“So, provider status is very necessary for pharmacists. I’m partly optimistic. My wish list is partly on the way because … a bill will be introduced in the House so that pharmacists can treat strep throat flu, greed and other diseases to be tested and treated, and the bill under Medicare Part B,” he said. “So we are taking a step in the right direction, but we have a long way to go. If I have any friends from the AMA [American Medical Association] Here, we can discuss this issue later. “
One doesn’t even have to imagine that this debate will intensify.
The American Medical Association is adamantly against moves to make pharmacies more accountable. The latest news was on March 4th:
- President Joe Biden’s “Test and Treat Covid-19 Plan” would allow pharmacy clinics to test people and prescribe antiviral drugs as soon as they test positive. This may be convenient for people who can be tested and prescribed in the same location. However, the AMA perceives that primary care services may be violated, clearly states: This approach, while well-intentioned as it seeks to increase patients’ access to care without a primary care physician, oversimplifies by ignoring knowledge of the patient’s medical history, the complexities of drug interactions, and managing possible negative reactions challenging prescribing decisions.
In other words, pharmacists simply do not have the medical resources to provide this service to their patients on their own. However, the problem appears to be supply and demand. Most people live near a pharmacy, and in rural areas, the pharmacist may be the first on the patient care team, not the doctor.
“[In these rural areas] The only provider or non-provider is the pharmacist. This is where your care comes from. Whether you’re able to get a vaccine or a Covid test or something, it’s going to be up to that pharmacist,” Lott continued. “If the pharmacist doesn’t have a relationship with the doctor because of a lot of state and federal laws, they can’t help the whole 2, 3, 4, 5,000 people in towns were given the vaccine. [People] Having to drive 50 miles to do this is problematic. “
compare it to this other statistics: About nine in 10 Americans live within 5 miles of a community pharmacy, according to the American Chain Pharmacy Association. That’s one reason Lott wants pharmacists to provide more care, such as field tests, blood pressure checks, and more.
“If you could democratize health care in the physical realm, it would look like allowing pharmacists to do more,” he said. “Trust me again, my friends at the AMA, pharmacists don’t want your job. They just want to be able to help their patients with the little things, keep them healthy, and then divert them to where they should be.”
Lott joined the INVEST panel, moderated by Cristal Gary, chief advocacy officer at Amita Health, and AJ Loiacono, CEO at upstart pharmacy benefits manager Capital Rx, whose own comments on drug pricing will be fodder for different positions.
Photo: Walter Lin
