California Pharmacist Spring 2025 - Flipbook - Page 43
entrepreneurial pharm tech
Expanding Pharmacy Services With Community
Health Workers
Amantha Bagdon
We can all relate to the following
scenario. The phone rings incessantly
as you scramble to fill prescriptions,
answer patient questions, and coordinate insurance approvals. It is
just another day at the pharmacy. A
visibly exhausted patient approached
the counter, clutching a handful of
papers. They complain about being in
and out of multiple healthcare facilities, trying to find help for their aging
father, who has diabetes, hypertension,
and early signs of dementia. They are
clearly overwhelmed, frustrated, and
exhausted from the maze of healthcare
navigation.
I find myself thinking about all the patients who struggle daily—not just with
their prescriptions but with the underlying factors that impact their health:
housing insecurity, food access, social
isolation, and financial stress. Many in
our profession find our possible roles
in pharmacy to be so much bigger.
What if we weren’t just dispensers of
medications? After all, we are often the
most accessible healthcare professionals in our communities. What if we
could do more to bridge the gaps our
patients face?
What Are Community Health
Workers?
CHWs are trained, nonlicensed
professionals who provide crucial
preventive health services to improve
patient outcomes, reduce healthcare
disparities, and address social determinants of health (SDOH). In California, the Department of Health Care
Services (DHCS) recognized the value
of CHWs by adding CHW services as
a Medi-Cal benefit that began July 1,
2022. On July 26, 2024, DHCS received
federal approval to include CHW
services as a benefit under Medi-Cal
Dental, effective December 1, 2024.
CHWs help address a variety of health
concerns, including the following:
• Chronic disease management (diabetes, hypertension, asthma)
• Behavioral health support (mental
health education, substance use
navigation)
• Preventive health education (smoking cessation, vaccinations, nutrition
counseling)
• Maternal and perinatal health (supporting expecting and new mothers)
The concept of community health
workers (CHWs) first made it onto
my radar when I attended McKesson's
Ideashare in 2023. I haven’t been able
to stop thinking about how pharmacies
are uniquely positioned to incorporate
these services as both a revenue stream
and a value-add for communities. I
have to take a moment to shout out
the deep admiration and respect I have
for a fellow pharmacy technician, who
executed this strategy for their pharmacy, Rachel Miller! Indeed, pharmacy
technicians are a natural fit to serve in
CHW roles in the pharmacy.
The Entrepreneurial Pharm
Tech column is coordinated
by Amantha Bagdon, Founder
and CEO, RxPost, Los Angeles,
California. amantha@rx-post.com
• Violence and injury prevention
(community violence intervention,
domestic abuse resources)
• Health navigation (helping patients
access resources, schedule appointments, understand insurance
options)
Why Pharmacies Are the Perfect
Fit for CHW Services
Pharmacies already serve as community healthcare hubs. Patients visit more
frequently than they do primary care
providers, making pharmacies a natural fit for CHWs. Here’s why pharmacies should integrate CHW services:
1. Pharmacies Have Trusted Relationships
Patients already trust their local
pharmacists and pharmacy technicians. By incorporating CHWs,
pharmacies can build on this trust
and offer holistic patient care.
2. Additional Revenue Stream
Effective October 1, 2024, pharmacies can bill for CHW services using
CPT codes 98960, 98961, and 98962.
Pharmacies that integrate CHWs
can receive reimbursement from
Medi-Cal and managed care plans
(MCPs), increasing revenue while
providing valuable services.
Social Determinants of Health
Photo credit: Centers for Disease Control and Prevention
California Pharmacist | vol. 72, no. 1
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