Newswise — The American Society of Health-System Pharmacists (ASHP) is outraged that the Centers for Medicare & Medicaid Services (CMS) has refused to restore funding for residency programs that provide vital post-graduate training for pharmacists in specialized areas of health care.
In a proposal announced this week, the agency failed to reinstate reasonable-cost, pass-through funding for these programs despite significant evidence provided by ASHP demonstrating that the residencies meet the conditions for funding originally set by the agency two years ago.
"Inexplicably, CMS has chosen to continue a scenario that may seriously jeopardize the health of more than 40 million Medicare beneficiaries," said Henri R. Manasse, Jr., Sc.D., Ph.D., ASHP executive vice president and CEO. "This failure to act flies in the face of common sense. CMS's own regulations for the new Medicare prescription drug benefit—which includes medication therapy management services, some of which depend on pharmacists with this level of training. Unless funding is restored immediately, this decision could have ramifications for years to come because it will cut off the pipeline of pharmacists who are best able to provide these essential specialized services."
The announcement comes despite a nearly two-year effort by the Society that fulfilled CMS's requirement to show that an "industry norm" exists for hospitals to require completion of a specialty residency program before beginning work in a specialty.
ASHP conducted a survey in 2004, which found that 82 percent of hospitals that employ clinical pharmacy specialists require specialized pharmacy residency training for those practitioners. Among these hospitals, nearly one-fifth will not fill a specialized clinical pharmacy position with someone who has not completed such a residency; the remainder will do so only if a specialty-residency trained candidate is not available.
CMS defined "industry norm" as "mean that more than 50 percent of hospitals in a random, statistically valid sample require the completion of a particular training program before an individual may be employed in a specialty." ASHP submitted these survey results to CMS in July 2004 and again in March 2005. Both times the agency failed to address the Society's request to reinstate funding for pharmacy residency programs in its regulations.
"ASHP has repeatedly tried to meet with CMS officials to solve this problem but have been rebuffed over and over again," Manasse said. "This blatant disregard for the effects this decision will have on Medicare beneficiaries is very disturbing and inexplicable."
ASHP estimates show that restoring the $8 million funding for these programs is a small investment in assuring that pharmacists are trained to provide patient care services to high-risk Medicare beneficiaries. "This is minimal as compared to the more than $8 billion allocated for post-graduate medical education in the Medicare Program. Pharmacy specialty residency training costs 1000 times less than what is spent for similar training for physicians," said Manasse. "The value of this training cannot be overstated. It is an absolute necessity for providing the best care to patients."
A number of institutions have informed the Society that they have either postponed or tabled plans to increase specialized pharmacy residency programs. Several have even been forced to eliminate specialized pharmacy residency positions altogether because of the lack of funding. ASHP is resolute in its conviction that funding for second-year, specialized pharmacy residency programs should be reinstated and has issued an Action Alert asking its 30,000 members to voice their condemnation of the agency's action.
For more than 60 years, ASHP has helped pharmacists who practice in hospitals and health systems improve medication use and enhance patient safety. The Society's 30,000 members include pharmacists and pharmacy technicians who practice in inpatient, outpatient, home-care, and long-term-care settings, as well as pharmacy students. For more information about the wide array of ASHP activities and the many ways in which pharmacists help people make the best use of medicines, visit ASHP's Web site, http://www.ashp.org, or its consumer Web site, http://www.SafeMedication.com.
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