And How to Get Paid for Them
Estimates say that there will be a shortage of 17,800 to 48,000 primary care physicians in the United States by 2034, according to the Association of American Medical Colleges (AAMC).1
Pharmacists, taking on broader roles, are now identified as community-based practitioners. Their importance to public health has long been acknowledged and was highlighted during the height of the COVID-19 pandemic. But how can more pharmacies operate as primary care destinations?
Pharmacists as primary care providers facilitate the provision of an access point for their community that may be sorely lacking. Considering that nine out of ten individuals in the United States live within a five-mile radius of a pharmacy, visiting one could mean convenient parking, interacting with familiar pharmacists and other pharmacy team members, or accessing nearby healthcare options that were previously unavailable. A pharmacist’s role in primary care can include diagnosis and treatment for common ailments like strep throat and influenza, chronic disease management, immunizations, prevention and wellness programs, and comprehensive medication reviews.
What does it look like to offer primary care services?
Beyond their traditional role in medication management, pharmacists’ scope has expanded in many states to provide a variety of comprehensive primary care pharmacy services. This evolution allows them to play a crucial role in optimizing the health of their community members by attending to common ailments while monitoring and managing certain chronic conditions.
Primary care services in the pharmacy are not all created equal, and not all states afford the same advancement opportunities through provider status legislation. When a pharmacy evaluates the opportunities available in their state(s), there are multiple considerations for selecting clinical services that are right for your practice and your community. Some offerings do not require large changes to space or staffing while others may require infrastructure, equipment, and pharmacist time for robust clinical documentation.
At its core, providing primary care services changes the way patients experience pharmacies from merely buying items to receiving the comprehensive care that pharmacists are trained to offer. For the business, pharmacy owners focused on primary care are not only making health services more accessible to their patients but unlocking a new source of revenue.
What Types of Primary Care Services Are Best Suited for a Pharmacy?
Chronic Disease Management
Chronic diseases can be a huge physical and mental burden. Pharmacies providing primary care services can help patients manage these common conditions like diabetes, heart and other cardiovascular issues, and asthma to improve patients’ overall disease management and well-being without a big trip to a physician.
When closely collaborating with other providers, pharmacists can perform important tasks like assess patients, manage and interpret remote patient monitoring, and adjust necessary medications. Pharmacists can also serve in an important education role, holding individual and group teaching sessions on disease management. This may reduce hospital admissions or readmissions while reducing overall healthcare cost.
Minor Ailments and Common Conditions
Minor illnesses can also be treated by qualified pharmacists. Things like sore throats, the flu, skin conditions, and UTIs are a good place to start. Pharmacists in primary care can handle the stages from assessing symptoms to prescribing treatments.
Expanding this kind of primary care services to more pharmacies would empower community members to simply go to their nearest primary care pharmacy instead of having to experience long waits at urgent care or have an expensive visit at the hospital for non-emergency conditions.
Medication Management and Renewal
Naturally, another primary care service that makes sense for pharmacists is medication management. Through this primary care service, pharmacists regularly review a patient’s full prescription regimen and its impact from all angles. Pharmacists work with patients and other members of the care team to provide advice on medication use, adherence, storage, side effects, treatment burden, and more. They also can handle the timing of prescription refills and renewals, helping patients synchronize the timing to keep schedules aligned and prevent extra trips to the pharmacy. The goal of this service is to prevent medication errors, remove some of the unpleasantries of chronic medications, ensure patient and caregiver understanding, and promote safe use.
Vaccination
The COVID-19 pandemic sparked a change not only in COVID vaccination and PAXLOVID™ (nirmatrelvir tablets; ritonavir tablets) treatment but also in routine vaccinations. More routine vaccinations are now being given by pharmacists instead of physicians, flipping the trend of where patients receive their vaccinations.2 Pharmacy primary care providers also have the option to offer vaccinations for adults and children. This includes publicly funded vaccines and travel immunizations.
Wellness Programs
Instead of perpetuating the standard US health care system of sick care, pharmacies offering primary care services can be a hub for wellness. Welcome your healthy community members to maintain or enhance their nutrition, deliberate weight changes, hormone balance, and nutraceutical and supplement regimens with products, consultations, testing, and programs geared toward improving and maintaining a healthy lifestyle.
Preventive Care
Pharmacies can also offer screenings and health checks to detect conditions early. Many preventative care services can be offered with point-of-care testing supplies. Blood pressure screenings, bone density (DEXA) scans, cholesterol, and blood glucose/A1c testing can alert your patients and community members of serious health issues that may be present or developing.
Establishing a Collaborative Practice Agreement (CPA)
Pharmacists offering primary care are quietly revolutionizing the healthcare industry by making health services far more accessible. Consider the geographic advantage: pharmacies significantly outnumber hospitals and clinics, positioning them closer to a larger segment of the population. This proximity, combined with the generally lower costs compared to hospital services, positions primary care pharmacists as invaluable assets to their communities.
Each state has specific laws that outline the scope of practice for pharmacists. Many states require a collaborative practice agreement that allows a pharmacist to provide expanded clinical services.
Collaborative Practice Agreements represent structured partnerships between pharmacists and prescribers, often physicians, detailing the specific responsibilities the pharmacist can undertake with the prescriber’s oversight. Such responsibilities may encompass the initiation, adjustment, or cessation of medication therapy, as well as the authorization to order and analyze lab tests. Primary care pharmacists, under CPAs, frequently manage conditions like diabetes, hypertension, and high cholesterol.
A Collaborative Practice Agreement can significantly enhance the abilities of a pharmacist practicing in the community setting, enabling them to provide a higher level of patient care. Through a CPA, pharmacists are empowered to perform functions that traditionally fall within the purview of prescribers, such as initiating, modifying, or discontinuing medication therapies based on patient needs and clinical guidelines.
This expanded scope of practice allows the pharmacist role in primary care to also expand into the management of chronic diseases. Many studies have been published showing improved outcomes when pharmacists manage conditions such as diabetes, hypertension, and hyperlipidemia. By working closely with physicians and other healthcare providers, pharmacists can ensure a more integrated approach to personalized patient care, focusing on optimizing therapeutic outcomes, improving medication adherence, and contributing to the prevention and management of diseases.
Challenges of Primary Care Pharmacies
Running a pharmacy that provides primary health care or being a primary care pharmacist presents unique opportunities alongside certain challenges. Understanding these elements can help prepare you and your business for success. Below lists some key aspects to anticipate:
Financial Considerations and Workload & Service Expansion
Pharmacies expanding into primary care should first consider the workflow impact of additional services compared to the requirements of their current fill volumes. The media is filled with stories of pharmacies backed up for days on prescriptions while pumping out other types of services like vaccinations.
Primary care pharmacies face the challenge of expanding services. They must balance traditional dispensing roles with new responsibilities like health screenings and chronic disease management. In the beginning, adding this workload is definitely a challenging balance with team member expectations, potential labor cost additions, and time between service outlay and reimbursement.
Just as any other business offering new services, it’s very important to balance this expansion with maintaining quality.
Regulations
Regulatory requirements vary by state, but generally in the United States, pharmacists can offer primary care services under existing legal and regulatory conditions. For this purpose, you may need to complete certain continuing education requirements, hold professional liability insurance (which is highly recommended in general!), or complete and maintain certifications.
In addition, legal frameworks like Collaborative Practice Agreements are important to understand. They allow pharmacists to work with healthcare providers to deliver patient care services beyond traditional pharmacy roles.
Technological Advancements
New technology presents a huge opportunity for growth. But if you don’t adapt, then you might be doing more work than necessary. Becoming a primary care clinic pharmacy means utilizing the technology that identifies, captures, and bills primary care services. The training and investment in new technologies is an important beginning step.
Pharmacies must integrate new technologies like AI and digital tools like electronic health records to meet current service demands. Adapting to market shifts and evolving patient expectations is also crucial. Thus, pharmacies need to invest in digital infrastructure to keep up.
Elements for Setting up Primary Care Services in a Pharmacy
To set up your pharmacy for primary care services, you need the following elements:
Pharmacy Management Software
DocStation is a pharmacy management software that gives you all the tools you need to effortlessly turn your pharmacy into a primary care clinic pharmacy. With our powerful features, you can identify billable services automatically, handle medical claims billing, streamline your revenue cycle management (RCM), and schedule patient appointments.
Securely message patients while maintaining HIPAA compliance, manage health records, connect with payer programs, and more. Click here to learn more!
Facility Setup and Design
A pharmacist-led primary care type location must have adequate space for patient consultations. It should ensure privacy and comfort for patients. The layout must include areas for clinical assessments.
Space considerations are not just for evaluation and treatment areas. Consider where patients will browse or wait for your other primary care offerings and if this would interfere with drop off and pick-up locations. Additional computer terminals, storage for products, and counter space for form completion are other space considerations for a pharmacy offering primary care.
Staff Training and Qualifications
As we mentioned before, pharmacists may require specific training or certifications to offer certain primary care services. Staff may also benefit from training. For example, cultural competency training can assist in addressing vaccine hesitation, and training on care for certain age groups can avoid meltdowns from the stress of a test or needle.
Team members can learn about health coaching and counseling as well as effectively using the primary care pharmacy management software of choice.
Start Offering Primary Care Services Today
Your pharmacy can become a reliable health center for your community with the right plan. DocStation can be your partner in this journey. Our experts have helped dozens of pharmacies launch clinical services successfully, and we can help you do the same. With our guidance and software, you can boost your revenue for services you are already offering and consider other potential revenue sources by leaning on the expertise already in your toolbelt. Contact us today.
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