Research Reports

Medicaid Pharmacy in Focus: Opportunities to Improve Texans’ Health and Access to Care

Medicaid Pharmacy in Focus: Opportunities to Improve Texans’ Health and Access to Care

Pharmacists are trained to test, treat and immunize for many infectious diseases and by practicing their full scope of practice within their training and license can alleviate pressure on the health care system. Along with dispensing prescription medications and offering expertise in the safe use of prescriptions, pharmacists play an important role in enhancing public health and increasing access to care.

Currently, enrollees in Medicaid, CHIP, and the Healthy Texas Women program have good access to pharmacy providers, with nearly 90% of the state’s 5,120 community pharmacies participating. A majority (58%) of Texas pharmacies will deliver filled prescriptions to their patients’ homes, 78% administer immunizations, and a few have started administering infusions in-store (0.3%). During the COVID pandemic, the majority of immunizations were administered by pharmacies and the public health emergency provisions also authorized pharmacists to both test and treat their patients for COVID. Pharmacists demonstrated their abilities, and the public experienced the benefits of their role as advanced healthcare professionals.

Pharmaceutical care has historically been delivered and managed very distinctly from medical care. Existing policies, processes, systems, and workflows of pharmacy providers and payers are tuned for optimal delivery of medications, not for the delivery of services currently provided by other healthcare providers. Therefore, making the adjustments to add pharmacies as providers of those services will require collaboration and intentional efforts by all stakeholders, beginning with education on what is already available. Focusing those efforts on specific targets, such as increasing immunization rates and testing and treating streptococcus, Influenza, and COVID may yield relatively quicker results with long-term benefits for Medicaid enrollees.