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Study: CLIA waivers can empower pharmacists to fill PCP care gap


FAIRFAX, Va. - Pharmacists and lab technicians are capable of absorbing the additional health management responsiblities currently being created by the reduction in primary care physicians, according to a new study published by the Mercatus Center at George Mason University. According to the Department of Health and Human Services, the physician shortage could reach as high as a shortage of 20,000 primary care physicians by 2020.

"Broadening the scope of practice for pharmacists may help alleviate the rising costs of providing health care in the United States," noted Edward Timmons, associate professor of economics, Saint Francis University. "Though nonphysician healthcare professionals may not be equipped to substitute for physicians in every capacity, a variety of professionals, including pharmacists, can help bring affordable health care to those who need it most," he continued. "States that currently make it onerous for pharmacists to obtain CLIA waivers (e.g., Nevada) should consider relaxing restrictions and allowing pharmacies to expand their role in the provision of healthcare services."

In a paper titled, "CLIA Waiver Pharmacy Growth," Timmons and Mercatus MA Fellow Conor Norris examine the impact of broadening pharmacist responsiblities using the  Clinical Laboratory Improvement Amendments of 1988 (CLIA) that grants pharmacies the ability to apply for a waiver to perform routine medical testing on patients without direct physician supervision.

"Significant variation in the protocol for obtaining a federal CLIA waiver has resulted in numerous differences across states with respect to the number of pharmacies able to obtain waivers," Timmons noted. "In 1999, nine states and the District of Columbia did not have a single pharmacy with a CLIA waiver," he added. "By 2014, Hawaii was the only state that had no pharmacies with CLIA waivers."

"Until recently, states that have large footprints of CLIA waivers have used blood glucose testing but have generally not taken advantage of other testing that could be performed (e.g., for strep throat)," Timmons wrote. "In states that present barriers to obtaining CLIA waivers, this growing potential may be stymied."

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