With economic stress mounting on long-term care (LTC) pharmacies, uninterrupted access to prescription drugs for nursing home and assisted living patients is under threat.
The average nursing home resident takes eight to nine prescriptions daily, and these medications are essential to their well-being. The midst of a pandemic is the wrong moment to risk ongoing access. The U.S. Department of Health and Human Services (HHS) should expedite distributing some of the $175 billion Congress has appropriated for emergency relief to LTC pharmacies.
The dramatic drop in admissions to nursing facilities and assisted living communities means a dramatic drop in prescription volume. In March alone, revenues fell 15%. This trend has worsened in April and will continue into May. On the other side of the ledger, the COVID-19 response increased costs 6 percent in March, worsening a difficult situation. These trends point to business failures – and disruptions in the flow of prescription drugs to LTC facility patients.
As enrolled Medicaid providers, LTC pharmacies are entitled and eligible for emergency CARES Act relief funds — and deserve to be on the priority list commensurate with their vital role in protecting the health and well-being of the very seniors most susceptible to contracting COVID-19.
One of our primary concerns is that HHS may not even know that LTC pharmacies should receive relief because states do not tell HHS which providers enroll in Medicaid. While Medicare pays for most LTC pharmacy services, this payment passes through Prescription Drug Plans under Part D and Skilled Nursing Facilities under Part A. HHS does not know that LTC pharmacies are enrolled in Medicaid or, lacking direct HHS payment, that Medicare accounts for most LTC pharmacy revenues.
But HHS must provide relief to LTC pharmacies now and must use a formula that recognizes the financial realities of LTC pharmacy revenues. The Department could quickly develop a process to distribute funds to LTC pharmacies based on an easily calculated metric, such as net patient revenues, and we have communicated this vital point. HHS is already using a similar approach in the second phase of disbursements from the emergency fund.
LTC pharmacies, and the consulting pharmacists they employ, provide an essential lifeline of medications and clinical services to residents in LTC facilities. Widespread business failures, likely in the coming months if current trends continue, will dramatically worsen an already overwhelming frontline care crisis. The residents in nursing homes and other LTC facilities, and the pharmacies that serve them, deserve better.
We believe the public-at-large strongly supports more help for vulnerable nursing home patients, and uninterrupted access to essential medications is an important element of that help, especially during this public health emergency.
Alan G. Rosenbloom is president and CEO of the Senior Care Pharmacy Coalition.