Pharmacies Navigate Barriers for Clinical Services

Independent pharmacies play a pivotal role on the front lines of health care, serving as accessible points of care for millions of patients across the nation. In recent years, these pharmacies have been called upon to provide a growing array of clinical services, including medication therapy management, chronic disease monitoring, and patient counseling. However, as the industry shifts toward delivering more care beyond the traditional dispensing model, pharmacy owners and health care stakeholders are increasingly confronted by a host of non-pharmacy benefit manager (PBM) barriers that make fair reimbursement for clinical services an ongoing challenge.

In this panel discussion, experts came together to share their experiences and concerns regarding these operational and regulatory obstacles. One of the most daunting issues cited was the intricate web of credentialing and registration processes required by both state and payer organizations. These hurdles must be surmounted before pharmacies can even begin providing advanced clinical services. Even after being recognized as providers, they often face the additional challenge of mastering separate software systems and workflow adaptations, which can delay or derail implementation. Pharmacy closures, workforce shortages, and the struggle to recruit and retain skilled staff—especially in a competitive labor market—further exacerbate the pressure on pharmacy operations.

State-level disparities add another layer of complexity, as some states lack provider status recognition, rendering reimbursement and operational consistency elusive. Innovative payer programs, while promising, often deliver one-off opportunities rather than systemic solutions, and persistent PBM involvement can undermine the business case for offering certain clinical services.

Despite these challenges, the panelists remain committed to navigating these obstacles in pursuit of better patient care and fair compensation. By collaborating on workflow innovations, advocating for policy reform, and seeking greater standardization, independent pharmacies are striving to transform barriers into pathways for growth and improved service delivery.