From Payer Change to Pharmacy Opportunity: Turning CMR Policy Shifts into Revenue, Efficiency
Kevin Boesen, PharmD, delivers a session on turning Medicare policy shifts into tangible revenue and workflow efficiency for community pharmacies.
Community pharmacists are positioned to become the nation’s core primary care providers within the next 5 years, a transformation driven by persistent physician shortages and the rising burden of chronic illness.
Kevin Boesen, PharmD, chief commercial officer at Outcomes, recently detailed how this shift is being accelerated by massive Medicare policy changes and AI-driven workflow efficiencies at the Total Pharmacy Solutions Summit Summer 2026 event.
A critical turning point occurs in 2027, when comprehensive medication reviews (CMRs) return as a high-stakes star rating measure. With health plans aiming for a 90% engagement rate, annual CMR opportunities are projected to jump from 1 to 4 million. To manage this volume, Outcomes is leveraging MTM Intelligence, an AI-driven tool that automates medication reconciliation and pre-populates action plans to eliminate administrative pre-work.
Workflow innovations like automated data entry for e-prescriptions and portable pill-counting devices, which can increase throughput by 23%, are further freeing pharmacists to focus on direct patient care.
As the industry transitions toward medically billed services such as blood pressure and diabetes management, the pharmacy is evolving from a dispensing site into a true clinical hub. By utilizing technology to offload manual tasks, pharmacists can finally claim their place at the center of the health care ecosystem.
Explore more of our coverage from the Total Pharmacy Solutions Summit Summer 2026: Policy, People, and Profitability.
