Reimbursement for Clincal Services

Discussion in 'Pharmacy' started by tropical1, Dec 5, 2002.

  1. tropical1

    tropical1 Junior Member

    Joined:
    Oct 29, 2002
    Messages:
    7
    Likes Received:
    0
    For those who have practiced pharmacy or are currently practicing pharamcy, in your estimation what is the probability that medicare or hmo's will reimburse for pharmacists clinical interventions. Most of the journal articles I have read provide evidence that pharmacists interventions are economically beneficial but the studies have not been very well designed. Also, the ACP is supportive of furthering the role of the pharmacis but only with additional empircal evidence that it is justfied. It seems in the world of managed care this is central to the future of the profession. It also seems with polypharmacy among the elderly and the rapid advancements in the field that pharmacists interventions would have both positive economic and clinical outcomes.
     
  2. Thread continues after this sponsor message. SDN Members do not see this ad.

  3. INevrLearn

    INevrLearn GoldMember

    Joined:
    Nov 21, 2002
    Messages:
    138
    Likes Received:
    0
    I have no literature to back this.... I have no scientific studies or financial analysis.... only my own jaded .02

    what is the probability that medicare or hmo's will reimburse for pharmacists clinical interventions?

    zero.... unless public view of pharmacy is changed. Pharmacy has always, is currently, and probably will be for some time viewed as a dispensing service. As most of us well know, our cognitive abilities/services aren't widely recognized by our patients, other provders, or 3rd party payors. (and we are, at least in part, to blame.) This profession is definitely changing. I don't think anyone is quite sure how the final picture will look. Until that is decided, public view will not be changed and our cognitive servicies and abilities won't be fully recognized or reimbursed.

    (And that is about as good as it gets at 1:30AM.)
     
  4. tlh908

    tlh908 Senior Member

    Joined:
    Jan 13, 2002
    Messages:
    175
    Likes Received:
    19
    Status:
    Pharmacist
    From what I understand, in PA the law concerning pharmacists was just changed to allow for the billing of clinical services. At one time pharamacists were considered only merchants by the state but now that role has been increased by the state. The problem is going to be able to get third parties to pay for the service.

    But as has been stated already, the public perception of pharmacy needs to change. When people have questions about disease/drugs, the expert seems to be the physician. I think over time the public will begin to see the professional services that pharmacists can offer. But that could take almost a generation in my opinion......
     
  5. LSUMED2006

    LSUMED2006 Senior Member

    Joined:
    Sep 7, 2002
    Messages:
    170
    Likes Received:
    0
    The difficulty will lie in convincing people the information they had been recieving in the past or could walk into most pharmacies now and recieve would no longer be FREE. This is a VERY tough sale. Insurance companies are not the only ones who would have to pay for these services. People call or consult pharmacies very, very often, at least in my experience, for drug information. They also expect counseling services at the pharmacy. I am aware of other group teaching services (eg diabetes counseling or drug regimin reviews) that pharmacists are seeking reimbursement for, but the that if pharmacists begin seeing sizeable reimbursement for these services, there will be a rush to bill for every possible service. Even if there is no rush, those without insurance or with high copays will have to be convinced to pay. Those without insurance will be caught in the middle. In fact, one of my pharmacy professors spent a great deal of time going over her thoughts on how to convince patients to pay for services that were once free and customers have come to expect.

    >But as has been stated already, the public perception of pharmacy needs to change. When people have questions about disease/drugs, the expert seems to be the physician.

    The physicians are the disease experts and should be viewed as such, period. We can argue about the drug issue, and my opinion is clear, only strengthened as I proceed through med school. However, I would say, because they are more available, that pharmacists are consulted much more often by patients than physicians about medications, so that is not really the problem.


    >I think over time the public will begin to see the professional services that pharmacists can offer.

    It goes beyond knowing about these services, but convincing patients that what used to be free in the past will no longer be so.

    Jason
     
  6. Megas

    Joined:
    Jun 10, 2008
    Messages:
    242
    Likes Received:
    0
    Status:
    Pharmacist
    So, was this the very first general pharmacy thread ever on SDN? What ever happened to tropical1? Are they talking about what we now call MTM?
    Yup, I'm taking a break from studying for the boards. It was either this or you tube...........
     
  7. njac

    njac Senior Member

    Joined:
    Mar 20, 2005
    Messages:
    11,570
    Likes Received:
    5,909
    Status:
    Pharmacist
    in the hospitals I've rotated in thus far, there is software where you can log your interventions. Some of them allow you to go into great detail on the intervention and record how much time was invested. Hopefully these can eventually lead to reimbursement for clinical services.
     

Share This Page