Regional Variation in Pharmacist Perception of the Financial Impact of Medicare Part D

Khan, Shamima; Spooner, Joshua J.; Spotts, Harlan E.

doi:10.3390/pharmacy6030067

Cited by 1 publication

(1 citation statement)

References 29 publications

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“…In addition to pharmacy closures, that more than 1 in 6 pharmacies in small rural areas are not contracted with a Medicaid insurance plan and that nearly 80% of rural zip codes lack access to a Medicaid-contracted pharmacy, as shown in our study, generates increased concern about limited access to pharmacy services in many rural communities. The implementation of Medicare Part D and associated challenges with reimbursement, payment, and claims management have been implicated in reduced revenues for and closures of independently owned pharmacies, especially pharmacies in rural areas (7,(34)(35)(36). As a by-product of the challenges created by Medicare Part D expansion, Medicaid patients may face a lack of access to critical services.…”

Section: Discussionmentioning

confidence: 99%

Rural–Urban Disparities in Access to Medicaid-Contracted Pharmacies in Washington State, 2017

et al. 2020

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Introduction Community retail pharmacies offer multiple public health services to meet the health care needs of medically underserved rural communities. Many rural residents are enrolled in Medicaid insurance, and it is important that pharmacies contract with Medicaid to meet the health care needs of these people. The objective of this study was to evaluate disparities in access to Medicaid-contracted pharmacies across the rural–urban continuum in Washington State. Methods We linked data on licensed community retail pharmacies in Washington State in 2017 to lists of state Medicaid-contracted pharmacies. We classified pharmacies as being located in small rural, large rural, suburban, and urban areas by using rural–urban commuting area (RUCA) codes. We evaluated the likelihood of zip code–level access to at least 1 pharmacy that was contracted with a Medicaid insurance plan across the rural–urban continuum by using descriptive statistics and modified Poisson regression models, adjusted for zip code–level community characteristics. Results Of 1,145 pharmacies in our study sample, 8.4% (n = 96) were not contracted with a Medicaid plan. Compared with urban core zip codes, small rural zip codes (adjusted relative risk [ARR] = 0.64; 95% CI, 0.46–0.91) and large rural zip codes (ARR = 0.68; 95% CI, 0.49–0.95) were significantly less likely to have access to a Medicaid-contracted pharmacy. Suburban zip codes did not differ significantly from urban core areas in their access to Medicaid-contracted pharmacies. Conclusion In Washington State, the likelihood of access to a Medicaid-contracted pharmacy decreased significantly as rurality increased. Policy efforts should aim to improve access for Medicaid enrollees, especially those outside urban centers.

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Section: Discussionmentioning

confidence: 99%