Toward a model for reimbursing professional services in community pharmacy practice

Over the last thirty years increasing numbers of patients have been insured by benefit plans that include prepayment of prescription medications as part of their health care coverage. This has occurred at the same time that the focus of pharmacist has shifted from an emphasis on compounding and dispensing medications to one in which the assume responsibility for insuring the optimal use of drugs in patients. However, reimbursement mechanisms still rely upon product based payment rather than a service based payment method that remunerates pharmacists for professional services. This thesis explores the history and contest of community pharmacy practice in the United Stats. The characteristics of prescription drug insurance and examines the flaw associated with current reimbursement mechanism are examined. Reimbursement models used by other professions are described in order to arrive at a new payment mechanism. The information presented in the analysis is used to propose a model in which pharmacist in community practice would be reimburse on the basis of professional service they perform rather than only in association with the product they dispense.