How Pharmacies Can Help Drive Health Equity

April Gill, a member of the Tabula Rasa Healthcare executive leadership team, argues that having pharmacists play a larger role in healthcare could close equity gaps.

We need to do a better job extending quality care to underserved populations, and pharmacy could provide an important bridge to better health outcomes.

Over 27 million people did not have health insurance at any point in 2021. According to the CDC, rural Americans are even less likely to have health insurance, and they have higher poverty rates and less access to healthcare.

Additionally, data from the Kaiser Family Foundation shows racial and ethnic disparities in healthcare among adults 18 to 64 years old. For example, 34% of Hispanic adults reported not having a personal healthcare provider compared with 16% of White adults.

While there have been a growing number of calls for health equity, we need to take a more strategic approach to truly succeed. The objective isn’t just about extending care to underserved populations. It’s about providing the right care — simplified, personalized care — where people already go.

In many cases that is their pharmacy.

Those who are uninsured or have limited access to healthcare might use an emergency room (ER) rather than seeing a primary care doctor. The problem is doctors in ER settings focus on the patient’s immediate need — and rightfully so. But without access to primary care teams and holistic coordinated care beyond the ER, these patients’ cost of care is inevitably higher.

ER visits are costly. Research shows that the average ER visit in 2017 cost nearly $1,400, an increase of 176% from 2008. We consider it an economic win when people use urgent care instead of the ER, but it’s not really a win if the person doesn’t have access to primary care and preventive services.

Low-income seniors are arguably a more impacted part of this underserved group. Low-income seniors may not see a primary care doctor for an entire calendar year, despite often havingcomplex and multispecialty care needs. They may also be limited in their care options. According to an AARP survey, over 75% of adults 50 and up want to stay in their homes as they age. But low-income seniors might not be able to access the resources needed to do so, which translates to changes in location as well as providers. These financial barriers increase the complexity of managing their needs.

While those in underserved populations may not see a primary care physician, it’s likely they will see a pharmacist. This is largely due to accessibility. According to a report in the Journal of the American Pharmacists Association, nearly 90% of U.S. residents live within five miles of a pharmacy. As noted by the American Association of Colleges of Pharmacy, pharmacists are accessible in every healthcare setting, including inpatient, ambulatory and community settings. Plus, a patient can often see their pharmacist at their convenience without an appointment.

Although it is now well-known that pharmacists can administer vaccines and other types of acute care, such as prescribing antibiotics for strep throat, they are in position to do much more. Specifically, pharmacists can further advocate for patients by asking targeted questions to direct patients to appropriate resources and having info handy on Medicare and Medicaid plans and other coverage options.

Pharmacies are also positioned to address food insecurity by packaging and delivering food, in addition to prescriptions, to people who might have limited mobility or access to food. Some organizations have food pharmacies. For example, Children’s Hospital of Philadelphia has a food pharmacy, where patient families experiencing food insecurity are provided with healthy food. In addition, Children’s National Hospital partnered with a food bank to launch a food pharmacy program. If similar programs become prevalent in pharmacies throughout the U.S., it would make healthy food even more accessible. It would also further help us identify and solve problems where people already regularly go – the pharmacy.

According to a report by the Centers for Medicare and Medicaid Services, national health spending is expected to reach almost $6.8 trillion by 2030. Meanwhile, people in need are outpacing resources. For example, data has estimated a potential physician shortfall between 37,800 and 124,000 by 2034. We have an opportunity to leverage a team-based model of care to address this issue. Having the pharmacist collaborate with a coordinated care team ensures patients have the necessary education and access to resources, and the pharmacy may be the only opportunity for some.

As costs increase and the number of people in need further outpaces resources, it becomes increasingly urgent to find ways to further extend services to the people who need them, when and where they need them.

April Gill is a member of the executive leadership team at Tabula Rasa HealthCare.