Pharmacists Deserve A Raise For the “Extra”
Posted by: Gerald “Pharmacist Jerry” Finken, RPh, MS & Martha E. Morton, Contributor
In the book Cat’s Cradle, Kurt Vonnegut writes “In This World, You Get What You Pay For”. For pharmacists, this is a conundrum depending upon whether we are payer or patient-facing.
The 2017 Pharmacist Salary Guide reports that there are various factors that impact how much a pharmacist is paid annually. According to the guide, in 2017 the main contributing factors include: the area of residence, the specific employer, and the experience level of the pharmacist. According to recent Payscale survey findings, the median annual salary falls at $110,318. This amount does not reflect overall income, which could also include bonuses and profit sharing.
In 2017, pharmacists in the U.S. were paid an average salary of between $106,500 and $148,000 -with Puerto Rico being the lowest paying state on average and California being the highest. In regards to employment, pharmacists that serve in mass-merchant pharmacies make the biggest salary, at around $123,000 per year. As for the role of experience in salary calculations, the pharmacist’s years of experience usually aligns well with an increase in pay. This is exemplified by the average new pharmacist (0-5 years) making around $109,000 per year and someone who has been in the field for 20+ years earning approximately $121,000. This sounds like a wonderful salary, right? Of course, such salaries are wonderful. However, what we should be asking is: does such a salary, wonderful as it is, reflect the true value of the full range of present day services provided by the pharmacist. I say no. Let’s dig a bit deeper here.
For those of you who are tight-knit with a pharmacist, or even those of you who go to a pharmacy to pick up your medications, you may have noticed that the pharmacy field has been changing its focus quite dramatically lately from merely dispensing to a more clinical approach (even in the retail setting). By that, I mean that the pharmacist is not only a dispenser but also a patient-facing counselor, a medical expert, and an important member of the healthcare team. What sets pharmacists apart from other health care team members is their accessibility to the patient. With this accessibility, pharmacists have the opportunity to counsel, manage medications, and perform preventative care screenings for their patients. They even administer immunizations and assist patients in smoke cessation programs. Though dramatic, this change is necessary to provide the best care for each individual patient in hopes to improve their health outcomes and satisfaction.
This is a welcomed change and one that I endorse. However, I have one concern: there has been very little compensation and reimbursement for the value-added services for the professional salaries rightfully earned by pharmacists. Pharmacists know and do so much more than they did a few years ago yet their true value is being overlooked when it comes to being payer-facing. Both the Federal government and the PBMs seem to value only the service of dispensing the medication while placing very little value on the patient-facing role of the pharmacist as a healthcare professional.
That said, there are 15 states with laws that require Medicaid to compensate pharmacists for professional pharmacy services. The services most often covered are: smoke cessation, counseling, and other preventative actions. Of the states that do not provide such compensation, there are some that provide a form of reimbursement. For example, in Ohio, Medicaid does not directly reimburse the pharmacists, but a Medicaid managed care organization, CareSource, does. Though it is encouraging that reimbursement is being provided in multiple states, I believe that all pharmacists providing professional services should be compensated as a healthcare professional. As more responsibility is accepted and the role of pharmacist continues to change, so too should the associated laws of payment, compensation and reimbursement.
A great start would be to expand Medicare Part B and Part D to have the practice of pharmacy as its own practice setting with its own billing options and codes. If you think about it, who is better than the pharmacist to ensure patient safety and ensure that the correct “established” patient has received the right care. Paying pharmacists directly would pay for itself in that the nearly $290 billion medication non-adherence problem would finally be addressed. It is a known fact that when patients talk to their pharmacists and participate in MTM or Synchronization programs their adherence AND compliance improves significantly. Additionally, if pharmacist were paid for their extra services, inroads to the $60 billion lost to Medicare fraud (see April 2018 AARP Bulletin article here) could be addressed. Moreover, the pharmacist is indeed the best choice to confirm and verify that billed services are actually being provided to the right Medicare beneficiary during their conversations with the patient. Yes, the pharmacist is indeed doing extra – maybe more than a little extra. It should be acknowledged and compensated.
What do you think?