Community Pharmacy Partnerships That Close the Gaps

An uninsured patient in Baton Rouge, Louisiana, had an acute deep vein thrombosis and needed to begin taking apixaban (Eliquis) immediately. Their physician's office called St. Vincent de Paul Community Pharmacy, which supplies medications at no cost to eligible patients. The pharmacy had the drug and coordinated with the provider so treatment could begin without delay, reducing the risk of hospitalization and a life-threatening complication.

This real-life scenario demonstrates what a local partnership can accomplish when relationships and communication channels are already in place.

"Timely communication, collaboration, and a shared focus on patient care can make a meaningful difference, especially for uninsured or underserved patients who often face significant barriers to accessing essential medications," said Kellie Elisar, PharmD, director of health services at St. Vincent de Paul Community Pharmacy.

Today, community pharmacies are working with providers, public health departments, agencies that serve older adults, churches, libraries, payers, and social service organizations. The most effective partnerships do more than refer patients elsewhere: They position the pharmacy as a hub that identifies needs, connects patients with help, follows up, and documents whether the gap is closed.

READ MORE: Transforming Community Pharmacists Into Care Providers

From Referral Point to Community Hub

Jake Galdo, PharmD, MBA, BCPS, BCGP, managing network facilitator for CPESN Community Health and CEO of Seguridad Inc, said community partnerships can help with a host of unmet health and social needs.

"Many health care interventions overlook local realities," he said. "A health plan may arrange app-based transportation, but a ride-sharing service may not exist in a rural county. A patient may have a mobile phone but no smartphone or reliable internet access. Community pharmacy teams understand those realities because they work and often live in the same communities as their patients."

Galdo described a pharmacy technician cross-trained as a community health worker (CHW) who learned during a delivery that a patient was choosing between prescriptions and dog food. The technician found free pet food, allowing the patient to redirect that money toward medications. Elsewhere, a pharmacy and library helped reestablish bus service so residents could reach health care in a larger city.

Such interventions may fall beyond traditional pharmacy boundaries, but they can directly affect adherence and outcomes.

"Screening alone is insufficient if the pharmacy cannot act on what it learns," Galdo said. "Care coordination must follow the need through to resolution."

Giving Technicians a New Role

Missouri has been testing that approach by training pharmacy technicians as CHWs. The idea began when a pharmacist serving on a local health board heard a discussion about CHWs and recognized the similarity to what technicians were already doing, according to Annie Eisenbeis, PharmD, MBA, director of practice development at the Missouri Pharmacy Association.

The association helped develop pharmacy-specific CHW training that has since reached technicians nationwide, with at least 200 trained in Missouri. The state's 2024 Pharmacy Vaccine Gap Closure Program put a pharmacist and a CHW technician on every participating pharmacy team. Approximately 30 pharmacies participated in the 9-month program, submitting more than 100,000 interventions, Eisenbeis said.

The teams discussed vaccine hesitancy during routine encounters, conducted monthly follow-up, identified social barriers, scheduled appointments, arranged transportation, and confirmed whether patients received care. If a patient missed an appointment, the CHW could find out why and schedule another one. The framework could also be applied to mammograms, colorectal cancer screenings, and other preventive-care gaps.

"We're not doing colonoscopies at the pharmacy," Eisenbeis said, "but the pharmacy can remind a patient, help secure a referral, locate an in-network provider, resolve transportation problems, and continue following up between primary care visits."

CHW training gives pharmacies a vocabulary that other partners understand and makes a technician's role recognizable to clinics, public health agencies, community organizations, and payers. The designation alone, however, does not produce results.

"Prepare your workforce," Galdo said. "The second part is to let them get off the bench."

Protected time is essential. If a cross-trained technician remains tied exclusively to dispensing duties, Galdo said, that person cannot perform outreach, build referral pathways, pursue grant opportunities, or coordinate care.

Building a Sustainable Model

Partnerships are also becoming a business imperative. Wesley Nuffer, PharmD, BCPS, CDCES, BC-ADM, professor and assistant director of experiential programs at the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of Colorado Anschutz Medical Campus, noted that a pharmacy can absorb prescriptions from a nearby closure, double its workload, and still fail to improve its financial position.

Nuffer works with CPESN Colorado and an academic-community transformation initiative through which pharmacy faculty help community practices with skills such as medical billing. He said the strongest models bring together community pharmacies, schools of pharmacy, state pharmacy associations, and payers.

"Medication synchronization can provide an operational foundation," he said. "Once a patient's maintenance medications are aligned for one monthly pickup, the pharmacy can schedule 10 or 15 minutes for blood pressure measurement, medication review, vaccine assessment, adherence counseling, point-of-care testing, or chronic disease follow-up."

The encounter must then be documented and submitted as a medical claim.

"Pharmacists want to do this, and they're trained to do this," Nuffer said. "But until you can justify the fact that there's revenue behind this, it's never going to take off."

He compared chronic disease management and medical billing today with pharmacy vaccination 15 years ago, when it was unfamiliar to many patients and providers but could become routine if pharmacies proved their value and were paid. That proof requires measures such as care delivered, time spent, clinical results, and gaps closed, as well as bidirectional communication.

"Pharmacists have worked in silos for too long," Nuffer said. "We need to share that we have these services and that we're doing these services and collaborating with the local providers."

Data exchange remains a major obstacle. Pharmacies, health departments, and community organizations may use systems that were not designed to communicate with one another. Eisenbeis said documentation must be brief enough to fit a 5-minute encounter while still producing information that partners and payers can use. The Missouri Pharmacy Association is developing the System for Pharmacy Health Encounter Reporting and Evaluation, known as SPHERE, based on lessons from its vaccine initiative.

Start With Local Trust

No partnership begins with technology or a contract alone. Elisar's pharmacy receives referrals from hospitals, social workers, physician offices, Catholic Charities, and churches. Nursing homes donate eligible medications for lawful redistribution, the Council on Aging helps patients obtain durable medical equipment, and community support sustains operations. Those relationships helped the pharmacy provide more than $1 million in free medications last year, Elisar said.

The network also helps eligible patients obtain OTC medications, incontinence supplies, and other health-related necessities. When a prescribed drug is unavailable, the pharmacy communicates with the provider to identify an appropriate therapeutic alternative.

Eisenbeis advised pharmacists to become involved in organizations they already care about, whether a local health board, school committee, civic group, or youth sports team. Those settings create relationships with people who may later become partners.

"When I say local relationships, I literally mean local relationships," Eisenbeis said. "It was simply knowing somebody and having participated in something local with them."

The broader lesson is to begin with a shared patient need, clarify what each partner can contribute, and give the pharmacy team the time and authority to follow through. As Elisar put it, community collaboration can ensure that neighbors "do not have to choose between their health and their ability to afford their medications."