Scaling Pharmacist-Delivered Care: From Fragmentation to Sustainable Impact
NCPDP joined the Total Pharmacy Solutions Summit event as the keynote session, addressing whether community pharmacy is facing a “Tower Records problem.”
When a once-efficient distribution model becomes structurally irrelevant due to shifting technology and consumer sentiment, this is known as a “Tower Records problem.”
Although prescription volume and revenue have risen over the last decade, the gross margin spread has collapsed from roughly 27% to 17%, essentially squeezing traditional dispensing businesses. To survive, pharmacists must pivot from being paid to put pills in bottles to leveraging their status as highly accessible clinical assets.
In the Total Pharmacy Solutions Summit Summer 2026 virtual event, Pooja Babbrah, executive vice president of strategy and industry alignment with NCPDP, and Seth Joseph, managing director with Summit Health, conducted the keynote session titled “Scaling Pharmacist-Delivered Care: From Fragmentation to Sustainable Impact.”
Despite 180 bills introduced in 2023 to expand scope of practice and provider status, scaling these services remains hindered by an issue where payers and pharmacies wait for the other to commit before investing in workflows. Joseph explained that clinical profitability follows an S-curve, remaining financially invisible until a pharmacy hits a volume threshold of approximately 250 services per month.
To overcome this, the speakers proposed PHARMS (Pharmacy Health Alliances for Reimbursable Medical Services), a model of regional alliances designed to standardize reimbursement, streamline credentialing, and establish shared technology infrastructure.
Success in this new era requires starting with fee-for-service medical billing rather than complex value-based care, focusing deeply on only 2 or 3 core services to build staff competency. By targeting regional health plans and utilizing existing clinical documentation tools, pharmacies can move clinical care from fragmented pilots to a sustainable, scalable impact that places the pharmacist at the center of the community health care ecosystem.
Check out these additional resources from the NCPDP Foundation:
NCPDP Foundation Research Summary A Business Model Framework to Scale Pharmacy-Delivered Clinical Services
Explore more of our coverage from the Total Pharmacy Solutions Summit Summer 2026: Policy, People, and Profitability.
