Shawna Kraft, Pharm.D., BCOP, Clinical Pharmacist Specialist – Oncology, University of Michigan Comprehensive Cancer Center, MSHP Board of Directors
I believe in the idea that, if you know where to look for the answer, then you already have the answer. Knowing our resources is extremely important and necessary to successfully educate yourself and others on provider status. Sure, we are hearing about it, and some of you may even be saying, “enough already”, but do you really know about provider status, how it will impact you and how you can implement innovative services within your own practice? For most of us the answer is, “probably not.” In our February issue, Dana Staat touched on the essential education of ourselves, our patients and our provider partners (physicians, NPs, PAs, etc). If we do not fully educate ourselves, then it is very difficult and intimidating attempting to educate our non-pharmacy colleagues, legislators and patients.
What is this law I keep hearing about?
Pharmacy and Medically Underserved Areas Enhancement Act
But I don’t live in an underserved area, so this does not impact me.
Not true, as Jesse Hogue stated in January, even areas you may think are not underserved, actually qualify in the law. Additionally, as the FAQs from ASHP clarify, other healthcare professionals (e.g., nurse practitioners) were first recognized as providers in service in underserved communities. Additionally, this proposal would directly affect practitioners in ambulatory/community settings, and this recognition would expand to pharmacists in all settings by establishing a precedent. We need a starting point in order to prove how adept we are as official providers.
In your next daydream sequence, spend some time reflecting on your practice site. If I were to have provider status in my daily work, what more could I do for my patients? In our March issue, Frank Zaran discussed various examples and best practices for potential programs, thereby putting ideas into practice. Work to read other articles on the topic, and pay attention at conferences from the local, state and national levels for ideas. Network with other pharmacists (we all love doing this anyway) so that when you do decide to implement an idea, you have colleagues you can talk with. Next, ask yourself what obstacles at your site need to be overcome in order to put your idea into practice. Engage your managers and colleagues, early and often. Think about how you can utilize “free” or reduced cost resources such as students to leverage/overcome these obstacles.
Why not? This is the future of pharmacy; having appropriate structure in our practices will provide a smoother transition when provider status becomes a reality. If you have policies or processes that are due for updating, take advantage of the timing to restructure (if needed) in order to align with provider status goals. For example, when documenting patient care activities performed, scrutinize what you are documenting. Is it really all necessary? What components or data are essential for accrediting bodies and demonstrating value? Look at the requirements set forth by your specialized accreditation body/bodies and model your documentation after those needs. Leverage your technology for your documentation so when data is needed to prove your value, it is easily attainable in a report or dashboard. Even if you are not able to currently bill for your services, review what is currently required to obtain billing, so again, you can structure your approach to fit within a payment model. Even if your eventual payment model isn’t exactly the same, you are more likely to be ahead with your documentation had you not started at all. ASHP has wonderful, detailed resources in the ambulatory care resource center to guide you.
Ok, ok, this is important, I get it. So how do I know if my representative was a cosponsor/supporter of this bill, and what can I do to help?
Cosponsors for Michigan:
Rep. Miller, Candice S., District 10, 7/10/2015
Rep. Bishop, Mike, District 8, 7/22/2015
Rep. Walberg, Tim, District 7, 9/17/2015
Rep. Kildee, Daniel T., District 5, 10/1/2015
Rep. Dingell, Debbie, District 12, 10/27/2015
Sen. Stabenow, Debbie, 4/22/2015
Sen. Peters, Gary C., 7/28/2015
To check to see what district you are in, visit the Secretary of State’s district locator map. Sign up to keep updated with MSHP/MPA advocacy and contact your legislator.
I am certainly not an expert in provider status and the laws and regulations associated, but I would like to use this opportunity to encourage you to explore the issues, and if you have additional knowledge or helpful resources, speak up and out, even by posting online comments at the end of this article. I think we have much to learn from one another via collaboration and can use each other as best practice examples to model our practices and create new ideas.