Employers play an important role in addressing provider shortages

Scheduling an annual checkup or securing a more urgent appointment with a healthcare provider is far from routine these days. It is more likely we will be told there are no appointments available within a reasonable time frame. A survey from a physician search and consulting firm found that it takes 26 days on average to schedule a new patient physician appointment. This delay in care thwarts the ability to address and treat preventable conditions in a timely manner, leading to increased morbidity and mortality and ultimately higher costs of health and healthcare.

There are several reasons for today's provider shortage. On the heels of the COVID-19 pandemic, many healthcare workers are facing burnout, with one survey finding 20% of physicians likely to leave their current practice within two years and one-third planning to cut back on work hours. There is also an increase in unionization efforts: Recently, 75,000 providers and nurses at Kaiser Permanente participated in a three-day strike. This comes on the heels of Northwestern Medical Center facing a unionization vote from both their residents and fellows.

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The problem is much worse than just a scarcity of clinicians. The healthcare system is also grappling with a pharmacist shortage. The pharmacy benefit is the most used of employee healthcare benefits, and this shortage creates even greater access issues for the more than 50% of Americans who take medications for chronic conditions.

Like the primary care and specialty provider shortages and availability issues, the access problem with retail pharmacists is multi-causal. Interestingly, it's not just pharmacist pay that is the issue, but working conditions have degraded for retail pharmacists over the years. In many ways, the pandemic became a "tipping point" and only exacerbated this problem.

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Retail pharmacists became a crucial access point for testing, treating and vaccinating during the pandemic. This increased responsibility and workload intersected with the pharmacist shortage, creating an insufficient level of staffing. Shorter pharmacy hours — Walgreens decreased their retail pharmacy hours by an average of 12% — along with store closures resulted in less time for pharmacists to provide patient advice and longer wait times for filling medications. These factors contributed to the current environment and have resulted in diminished patient care and a spike in medication errors.

So, what can employers do on behalf of their employees and family members to reduce the impact of access and shortage issues? There are concrete steps to take, including:

• Be aware of the problem
• Have honest conversations with your carrier and PBM
• Focus on plan design attributes that address access, such as narrow networks of providers and pharmacies
• Ask for access metrics on an annual basis and require back-up plans
• Be creative, especially with primary care networks
• Consider direct contracting, virtual care options, urgent care programs and on-site and near site programs

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Lack of access to care is not just a nuisance, it is a health and healthcare emergency. The problem is not going away, and if nothing is done to address these systemic issues, it will only get worse. Employers, payers, hospital systems, provider groups, retail pharmacy organizations and private equity are all stakeholders who have the ability and responsibility to participate in finding solutions. If they don't, we all will suffer.