California legislation would allow Medi-Cal to cover pharmacists’ services

Its Z

7+ Year Member
May 15, 2010
Yes, I'm very excited about it. In addition to the SB493, this is the opportunity we have waited for to create pharmacist providership. I do think there are market where this model can thrive, and there are market where this will not work.

For integrated delivery health systems (IDS), pharmacist providers are already active in patient care. And this is why Am-care/primary care pharmacy education is critical, if not in school, in PGY1 environment. There are many primary care clinics where pharmacist mid-level practitioners can be successful. We're at the cusp of evolving pharmacy practice. And the age old question is, who will pay for it? And if you have been following health care reimbursement closely, either you agree or not, the Affordable Care Act attempts to convert from fee for service to pay for performance - value based purchasing. That is an evolution of health care payment system where providers are taking on risk for patient care, partial and sometimes full in capitated reimbursement system that currently exists in Medicaid Managed Care (Medi-Cal in CA).

For Medi-Cal to cover pharmacist provider, it would still fall under the fee for service model, and I think it can work. And for primary care and clinic based settings, the fee for service model will remain for a while as our system transitions.

It's the nimble and innovative pharmacy leaders who must capitalize on this to move our profession forward. And trust me, there are many of us working on this right now.