The term pharmaceutical care was introduced by Hepler and Strand in 1990, beginning an evolution from pharmacists focus on a product-driven service to a focus on delivery of patient-centered care.
Since then, pharmacists have provided disease and medication management for patients with diabetes, hypertension, and heart failure, for example, with a positive impact on clinical and economic outcomes. Health care reform over the last 10 years sparked further opportunities for pharmacists to practice at the top of their license.
The Medicare Modernization Act of 2003 mandated the provision of medication therapy management (MTM) to high-risk beneficiaries and explicitly highlighted pharmacists as potential MTM providers.
In 2010, the Affordable Care Act (ACA) expanded opportunities for pharmacists to be engaged in team-based care models including patient-centered medical homes and accountable care organizations (ACOs) as well as prevention and wellness services.
The ACA expanded access to insurance for uninsured or underinsured Americans, which has placed pressures on the primary care workforce to keep up with demand. There has also been an increasing emphasis on team-based care and incentive-based pay-for-performance to improve quality and efficiency of care.