A bipartisan bill in Congress would allow pharmacies to get reimbursement via Medicare B for services related to Covid-19 and other infectious diseases after the health emergency declaration expires in January 2023. (Photo illustration, WEAR, 2016)

The Covid-19 pandemic inflicted tremendous pain on rural communities, where patients already lacked sufficient access to care.

As health care facilities closed or were suddenly overburdened by the pandemic, rural Americans struggled to receive essential care and services to protect themselves from the virus.

Pharmacists, often the most accessible source of care in rural areas, filled this gap and mobilized rapidly to provide testing, vaccination, and treatment initiation for Covid-19 for those in rural America.

However, pharmacists have been providing these services under a temporary authority that will expire when federal health officials end the Covid-19 public health emergency (currently scheduled to expire January 27, 2023). Unless Congress acts, seniors in rural America could lose access to essential pharmacist services they desperately need to manage their health. 

Rural areas constitute 72% of the nation’s land area and are home to 46 million Americans. Rural communities face higher rates of poverty, unemployment, underemployment, and significant health challenges. Nearly one in five individuals who live in a rural setting are 65 years or older, compared to just 13% of urban residents. One in three adults in rural America is in poor health, with nearly half managing at least one chronic condition, such as obesity, hypertension, or diabetes. 

Rural Americans also face persistent health care capacity challenges, including health care workforce shortages and hospital closures. While 15% of the U.S. population lives in rural areas, less than 10% of physicians practice in these communities. Sixty-one percent of primary care shortage areas are in rural communities, and 101 hospitals in rural areas closed from January 2013 through February 2020. When hospitals close, the median distance rural Americans travel to access common health care services increases by about 20 miles. This disproportionately impacts rural Americans, particularly the 50% of seniors who experience transportation problems and the 68% of seniors who live alone.

As the most accessible health care provider, pharmacists are essential in bridging gaps in rural care for these communities. Pharmacists partner with their communities to identify and help solve health problems and conduct primary prevention through health education.

Rural patients rely on pharmacists to access essential services – including testing, vaccination, and treatment for Covid-19 and other infectious diseases – and manage their health. Nine in ten Americans live within five miles of a pharmacy, and patients visit pharmacists twice as often as any other health care provider. Pharmacists have delivered many of the 25 million Covid-19 vaccines received by rural Americans.

Unfortunately, pharmacists are providing critical services for Covid-19 under the fragile framework of a temporary health emergency declaration. When government officials end the public health emergency, rural and other vulnerable communities could lose access to the essential services they rely on for Covid-19 and other infectious diseases.

To close any such gap, bipartisan members of Congress introduced federal legislation to ensure Medicare beneficiaries maintain access to essential care and services provided by pharmacists beyond Covid-19 and during any future public health emergency.

The bipartisan legislation would create Medicare Part B reimbursement for pharmacist services related to Covid-19 and other infectious diseases, including flu, strep throat, and RSV. H.R. 7213 would also ensure pharmacists are compensated for these services after the public health emergency and during future health emergencies.

According to a national survey, four in five older Americans want access to testing, vaccination, and treatment at the pharmacy.

The Covid-19 pandemic showed that Americans need accessible health care and that too many communities still struggle to receive equitable access to the services they need to stay healthy and well. Congress should act on H.R. 7213 to preserve patient access to essential services provided by pharmacists in rural America and beyond.

Brock Slabach, MPH, FACHE, is the chief operations officer of the National Rural Health Association.

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