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- Jun 12, 2012
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There is healthcare reform occurring globally. Some countries are seeing a fail for clinical pharmacists while others are seeing a win. Registered Nurses roles are expanding rapidly around the globe. Starting in 2026 RN's will be able to bill Medicaid for some services without working under a provider! The next generation of pharmacists are going to have to show VALUE and OUTCOMES beyond what others can do on the healthcare team. One podcast explains pharmacist role in the healthcare teams should be solving complicated drug related problems in patients with multiple disease states and to focus on changing services based on being able to bill for these services is a short term focus if it does not show VALUE to the team if a nurse practitioner, physician assistant or RN can do the same job for less. The payers in the near future do not want to pay pharmacist for dispensing. All healthcare workers must practice at the top off their license. All countries seem to be focusing on primary care and Patient Centered Medical Homes.
yourfinancialpharmacist.com
Highlight: Todd Sorensen: I’m a particular fan of pharmacists trying to achieve revenue through annual wellness visits in primary care settings. We can’t demonstrate a clear value in net value proposition in that role because again, a nurse practitioner or even a nurse can do that. So by adjusting your service line to try to take advantage of that payment opportunity is very much a short-term focus that is not building the capacity and the direction for the future where you can actually demonstrate value.
Highlight: Todd Sorensen: I have thought about it, and it’s a really important question. It gets back to the issue of bringing value into healthcare. We are in an environment where the practitioner or the individual that can produce an outcome at the lowest price is the one that’s going to get the business. And in many cases, pharmacists are the second most expensive person on a healthcare team. So we really have to think about what is it that we do uniquely, that nobody else can do as well as us, to be able to justify that price point and be able to demonstrate value. And there’s a couple of things that I think of. First of all, no one is trained. And nobody is as skilled as pharmacists in managing really complex medication-related problems. So that’s where we have to focus our team. For us to spend time on the majority of our time on things that are not very complicated, that our single disease-focused, others can do that. You mentioned nurse practitioners and physicians assistants. Honestly, RNs, at even a lower price point can manage essential hypertension on protocol. So we really have to be looking at where our unique knowledge and skills are different and can be leveraged in a way that exceeds that of others.
Highlight: Blair Thielemier: And a lot of times, it’s like, well I’m the medication expert. Well how does that really help anyone else, you know? That almost makes it sound like you’re the most important person in this scenario when really, it should be the person in front of you, so whoever you’re wanting to help and wanting to buy this service. And so that’s really what I’ve tried to shift the idea and rebrand pharmacy as like how can we actually add value? What are the quality metrics that physicians in primary care are being graded on now in the new pay-for-performance model? What are things that payers want in terms of preventative services for patients? What are things that patients want? You know, anti-aging and help with nutrition and weight management.
Highlight: Blair Thielemier: So you know, I said on last night’s webinar really, if we’re looking at pharmacy practice in September 2029, my vision is to have an embedded clinical pharmacist in every single primary care practice. So a few things that I have to work with is primary care is — they are having issues with medication-related quality metrics that pharmacists can help with. From a quality care coordinator standpoint, they are having to do medication reconciliations. They now have access to these pharmacogenomic tests with not really sure how to use them, how to integrate them into their practice. So they’re getting more and more data and more and more information, but being able to put it together and create a program that aligns with the quality metrics, that aligns with what the payers want to see as well in the new pay-for-performance thing, they don’t have a member on their team that can do that. And I think that’s where the pharmacist can really come in and a lot of value. So a lot of times, pharmacists in the hospital settings will be on the team that’s making sure that we’re meeting the quality metrics on the hospital team. So did the patient get an antibiotic started within two hours of admission with a diagnosis of pneumonia? That’s one of those things. Or on metoprolol after a STEMI. So looking at pharmacy from a quality standpoint, it’s like how can we add value for payers and physicians’ offices by focusing on quality? That’s where I think we can make the biggest impact.
Health Care Reform Australia
Health Care Reform Canada
Kenya
- YouTube
nurse.org
pubmed.ncbi.nlm.nih.gov
RN versus NP Prescribing
Nurse lead medication management as critical component of transitional care for preventing drug related problems
YFP 122: What Will Be the Future of Pharmacy Practice?
yourfinancialpharmacist.com
Highlight: Todd Sorensen: I’m a particular fan of pharmacists trying to achieve revenue through annual wellness visits in primary care settings. We can’t demonstrate a clear value in net value proposition in that role because again, a nurse practitioner or even a nurse can do that. So by adjusting your service line to try to take advantage of that payment opportunity is very much a short-term focus that is not building the capacity and the direction for the future where you can actually demonstrate value.
Highlight: Todd Sorensen: I have thought about it, and it’s a really important question. It gets back to the issue of bringing value into healthcare. We are in an environment where the practitioner or the individual that can produce an outcome at the lowest price is the one that’s going to get the business. And in many cases, pharmacists are the second most expensive person on a healthcare team. So we really have to think about what is it that we do uniquely, that nobody else can do as well as us, to be able to justify that price point and be able to demonstrate value. And there’s a couple of things that I think of. First of all, no one is trained. And nobody is as skilled as pharmacists in managing really complex medication-related problems. So that’s where we have to focus our team. For us to spend time on the majority of our time on things that are not very complicated, that our single disease-focused, others can do that. You mentioned nurse practitioners and physicians assistants. Honestly, RNs, at even a lower price point can manage essential hypertension on protocol. So we really have to be looking at where our unique knowledge and skills are different and can be leveraged in a way that exceeds that of others.
Highlight: Blair Thielemier: And a lot of times, it’s like, well I’m the medication expert. Well how does that really help anyone else, you know? That almost makes it sound like you’re the most important person in this scenario when really, it should be the person in front of you, so whoever you’re wanting to help and wanting to buy this service. And so that’s really what I’ve tried to shift the idea and rebrand pharmacy as like how can we actually add value? What are the quality metrics that physicians in primary care are being graded on now in the new pay-for-performance model? What are things that payers want in terms of preventative services for patients? What are things that patients want? You know, anti-aging and help with nutrition and weight management.
Highlight: Blair Thielemier: So you know, I said on last night’s webinar really, if we’re looking at pharmacy practice in September 2029, my vision is to have an embedded clinical pharmacist in every single primary care practice. So a few things that I have to work with is primary care is — they are having issues with medication-related quality metrics that pharmacists can help with. From a quality care coordinator standpoint, they are having to do medication reconciliations. They now have access to these pharmacogenomic tests with not really sure how to use them, how to integrate them into their practice. So they’re getting more and more data and more and more information, but being able to put it together and create a program that aligns with the quality metrics, that aligns with what the payers want to see as well in the new pay-for-performance thing, they don’t have a member on their team that can do that. And I think that’s where the pharmacist can really come in and a lot of value. So a lot of times, pharmacists in the hospital settings will be on the team that’s making sure that we’re meeting the quality metrics on the hospital team. So did the patient get an antibiotic started within two hours of admission with a diagnosis of pneumonia? That’s one of those things. Or on metoprolol after a STEMI. So looking at pharmacy from a quality standpoint, it’s like how can we add value for payers and physicians’ offices by focusing on quality? That’s where I think we can make the biggest impact.
Health Care Reform Australia
Health Care Reform Canada
Kenya
- YouTube
Nurses Can Now Bill Medicaid Directly—Oregon Just Made History
Oregon Pioneers Direct Medicaid Billing for Registered Nurses. Oregon Governor Tina Kotek signed House Bill 2789 into law on May 28, 2025
nurse.org
RN Prescribing: An Expanded Role for Nursing - PubMed
Considering unmet healthcare needs and patients' need for medication and medication education, we advocate for RN prescribing as expanded scope and role change for experienced RNs to practice to the highest level of their education.
pubmed.ncbi.nlm.nih.gov
RN versus NP Prescribing
Nurse lead medication management as critical component of transitional care for preventing drug related problems
