More On Pharmacists Providing Primary Care AND GETTING PAID DIRECTLY

Jp Enlarged

From Broncofan.  This is important stuff.  You should be all over this.  On the phone.  Telegrams.   If you do not get this handled, CVS will be getting the money, not you.  Do you want Primary Care to go the way of Flu and Shingles Shots?

How fucked up will it be when you diagnose, monitor, follow up, prescribe drugs and and are known around town as Doc Bronco and Rite-Aid gets paid and you get nothing more than your RPh wage?

40 Million Brand New Insured Americans getting adequate health care for the first time and NO new doctors.  Pharmacists WILL be providing Primary Care.  You will be the Family Doctor.  You can bet that they are talking his over up in the MBA Masters of the Universe long able meeting room up in Illinois.  WAG is always slow and methodical.  The moves are well thought out.  The only problem is that  there is a battle going on at WAG.  The Throw-Money-Gift-Card-For-Transfer Dinosaurs are fighting behind the doors with the Provide-High-Quality-Professional-Services-And-The-Cream-Will-Rise-to-the-top guerrillas.  Who will win?  You know who I would fight battles with.  Pharmacists as Family Docs is going to be huge.  Start the dialogue NOW or you will be fucked.  So.. Bend Over or get going………  Jay Pee

Goose, Peon, Steve, Pharmacy Gal, what say you guys.

Hello Jim,I was just made aware of this today...sorry for the short notice. Exposure on your blog may do some good. 

Got a second to help with provider status? Call your senator right now!

December 12, 2013

It is an exciting time here at 2215 Constitution on this cold but bright Thursday morning. Later today, we hope pharmacists in America will be plugged into providing patients team-based care in greater numbers than we’ve been able to achieve without recognition as providers at the federal level. You can help in getting pharmacists recognized as providers in accountable care organizations (ACOs) – but you have to act fast!

At 10 a.m. this morning Eastern time, the Senate Finance Committee is scheduled to mark up its sustainable growth rate formula (SGR) legislation—the “doc fix” bill. This is the last step before the committee votes on the legislation and sends it to the floor of the full Senate. More than 100 amendments, a number of which affect pharmacy, have been proposed to the Chairman’s Mark, including an amendment by Senators Grassley (R–IA) and Carper (D–DE) titled “Inclusion of Pharmacists as Providers in Medicare ACOs.”

Check the Senate website and see if either of your Senators is one of the 24 members on the Finance Committee.Many of the most populous states are represented—New York, New Jersey, Pennsylvania, Ohio, Michigan, North Carolina, Georgia, Florida, Texas, Washington—along with Maryland, Delaware, West Virginia, South Dakota, Iowa, Kansas, Wyoming, Colorado, Utah, Oregon, Idaho, and Montana (home of Finance Chairman Max Baucus). If so, contact him or her this morning to express your support of the Grassley–Carper amendment being voted in committee today.

We are so grateful to the Senate Finance Committee and its staff, and in particular these senators, for their concerns with medication use and for their ability to see the benefits of having pharmacists on the ACO health care team! Thanks to our APhA Government Affairs team members for their work as resources to the Senate Finance staff as this language was developed.

Just to “calibrate” folks, this legislative step forward for the pharmacy profession comes in large part because the Senators wanted to help their constituents’ medication use with access to pharmacists’ services. Importantly, this applies to services provided on a team within an ACO. In addition to work needed to get this amendment through the Senate, and through the House and/or conference committee, we’ll continue working on the larger proposal to get pharmacists more broadly recognized as providers in Medicare.

We appreciate all of pharmacy for everything you do to advance our profession! Thank you in advance for sharing with members of the committee the importance of the Grassley–Carper amendment.

Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA
APhA Executive Vice President and CEO

Jay Pee 12/17/13

I just read the comments and my knees started to shake, like a little puppy, I was so excited.  The more I sit with the idea of pharmacists gaining provider status, the more it sinks in.  As AJ wrote, “It really is GAME ON”.  I agree with AJ that this is a terrific reason for visiting the U.S. Small Business Administration for a low interest loan to get the lights on in your own store.  When young, energetic, motivated, well-educated Pharm Ds open stores with well built spaces like the Take Care Clinics at Walgreens, It will truly be game on, AJ.  Particularly if you are a nice, caring person with what people call a good personality you will be driving a stake in Dracula’s Big Evil heart.  If you are near a Big Stupid.. Oh my Gawd, what fun that would be.. calling ten times a day for transfers.  Immunizations would be a significant part of your practice.   I know about a neighborhood in Washington State where the MDs only keep the rudimentary vaccines.  Pediatric patients are sent to the local pharmacy for all immunizations.  Just one niche business.

It will not be long and there will be another pharmacist shortage.  The shortage will be of smart, competent, experienced pharmacist/merchants.  The Chains, Big Box & Grocers would be smart to be proactive or they will end up with rudimentary dispensaries staffed with marginal robo-dispensers.  Come on, the Jay Pee visitors look fondly at Broncofan.  He will gladly share his winning formula.  Imagine competing with a Rite-Aid  where the PIC is a first year out of Touro who has never even worked in a pharmacy other than a rotation in what they label a Professional Pharmacy that serves nursing homes.  Poor bastard.  What will he do the first time an obese woman asks about the rash under her heavy breasts and pulls up her tee shirt and shows him?  Probably send her to you.  What about the tough guy who comes in after a fist fight and asks the Touro kid to help him pull the other guy’s teeth out of his fist.  Dramatic and rare examples of why you are gonna kick some Big Stupid ass.  

I honestly believe that the employers of pharmacists who treat you badly will have to start throwing money at you again.  Suddenly, out of nowhere, the Affordable Care Act starts treating pharmacists with respect.  Suddenly, guys like AJ will turn in the CVS keys and open their own shops.  

You know, CVS has been treating pharmacists so badly that I don’t know if throwing money will help.  Possibly the money and iron-clad employment contracts might get guys like AJ  to hang around awhile.  I’d love to be 42, 52 even instead of 72 with legs like spaghetti.  It would take me about a minute to make the call.  

Click here: or Call 1-800-827-5722



  1. pharmaciststeve  •  Dec 13, 2013 @6:40 pm

    I have several thoughts.. One .. I believe that the ACO’s will be able to grant authority to do certain things.. like the Indian Health Service and VA already does. The ACO’s will be working under capitation and the various licensing entities will basically turn a “blind eye” as to what is going on within the ACO.

    Two – this will provide a larger wedge between the PharmD and BSPharm as far as employment opportunities. BSPharm’s will be relegated to more of a dispensing function.. supervising and being responsible for dozens of techs and untold amount of automated systems.. in such a large facility that there is no way that all parts/functions will be able to be under really direct supervision.

    The PharmD’s will be placed in more office/clinical settings. Where people are use to paying for medical advice.. unlike the Rx counter where the idea of charging for medical advice may never be accepted.

    Three.. TODAY.. RPH’s can work within a prescriber practice and help the practice generate more revenue.. so that the RPH’s salary can be affordable.

    The ability to do the billing & procedures is really not rocket science..

  2. MSDEMEANOR  •  Dec 14, 2013 @5:44 am

    fuck Washington.

  3. AJ  •  Dec 14, 2013 @4:02 pm

    ACO’s can save the pharmacy profession. Pharmacy has to move on and untie itself from reimbursement based on dispensing a product.

  4. pharmaciststeve  •  Dec 14, 2013 @4:51 pm

    @AJ.. I agree with you.. but… I don’t think that the current – or any variation there of .. the typical Rx dept layout is not going to be the place where it happens. If anyone has bothered to notice most all of these nurse-in-a-box that has been put in their chain stores.. have a waiting room and an exam office. Getting RPH’s to do vaccinations, BP, glucose and the like.. they are probably lucky to get a couple of chairs and maybe a table in at best a makeshift former closet, small storage area or just the Rx waiting area. A “professional environment” if I ever saw one !

  5. CathyJ  •  Dec 15, 2013 @10:36 am

    Yes, I have been at Meijer now for 10 months.(my new job since being canned from Wal-Mart)
    I am currently taking courses from U of Pitt (provided by Meijer) to become a Diabetes Expert/Educator in the Meijer stores. Technicians and RPh’s Do the Lab Tests right there in the waiting area. HBA1C, BG, BP, cholesterol, liver function tests, Flu Tests, Strep Tests, Immunizations, right there in the Waiting area. all we have for privacy is a trifold privacy screen.
    We Do Outcomes and Mirixa CMR’s too. Meijer is really jumping on this band wagon to provide clinical services.
    I have a BS Degree and no Pharm-D. I see the stores are being paid for all of these services while I get paid a straight pharmacist salary.
    I just thought I would share what is happening in the Meijer chain.
    Any advice as to how We RPh’s can get a piece of this pie? Do we need to own our own pharmacies?
    Do I NEED to get my Pharm D? I found one on line through the University of Florida. It is expensive and will take about 3 years. Its a Program especially for working Pharmacists to obtain their Pharm-D’s.

  6. AJ  •  Dec 15, 2013 @8:21 pm

    This is a turning point in our profession. If pharmacists are given provider status in Accountable Care Organizations it’s game on!
    Owning an independent pharmacy is the only way individual pharmacists will financially benefit from it. The big chains will follow the same game plan they used for immunizations. They will work you to death and force you to do 20 things at once to increase the companies profit. All the while you bring home to same pay check week after week.
    Cathy, I firmly believe the first step is to own your own pharmacy. The revenue stream provider status will create will make independent pharmacy a viable, profitable business once again. The second step is to become politically active and make your voice heard. This has to pass in order for pharmacy to survive.

  7. Peon  •  Dec 20, 2013 @12:10 pm

    I so no prospects of chain pharmacists, even with a provider status, with the major chains, of receiving reimbursement for services provided. As with flu and shingles vaccinations, the pharmacists receive no extra reimbursement. And, as Pharmacist Steve mentioned, pharmacists are not likely to get any extra accommodations for any new status. Wal-Mart pharmacists are doing a bit of MTM for the insurance companies. Wal-Mart receives a small fee for this service. Do you think the pharmacist gets paid anything extra for this extra function? If you believe it, then I have a bridge to sell you.

  8. AJ  •  Dec 21, 2013 @8:40 pm

    Peon…think outside of the box. How as a pharmacist will you be able to profit from this? Screw the chains! They’ve been screwing us for years!

Leave a Reply

Allowed tags: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>