Pharmacists: Value-Based Care & Patient Outcomes
- Pharmacists are encountering payment and reimbursement obstacles, potentially hindering pharmacy services.
- Mary Ann Kliethermes, director of medication safety and quality at the American Society of Health-System pharmacists Inc., emphasized the long-standing role of pharmacists in clinical therapeutics.
- Panelists shared various approaches to pharmacy reimbursement.
Pharmacists are indispensable healthcare providers,yet they face important reimbursement hurdles despite their expanding roles. News Directory 3 dives deep into the financial struggles impacting pharmacists, exploring how value-based care and legislative support can reshape the landscape. This article unpacks expert discussions on financial and reimbursement models, pinpointing strategies designed to help pharmacists thrive. Discover how innovative programs are enhancing patient outcomes while navigating complex healthcare economics. Read about the critical need for changes in pharmacy service reimbursement and how to better position pharmacists as essential healthcare providers.Explore the latest developments in this evolving field. Discover what’s next for pharmacists and patient care.
Pharmacists Face Reimbursement Hurdles Despite Expanded Health Care Roles
Updated June 5, 2025
Pharmacists are encountering payment and reimbursement obstacles, potentially hindering pharmacy services. experts at the National Academies of Sciences workshop highlighted the need for legislative action, standardized billing, value-based care approaches, and technology to address these barriers to pharmacist service reimbursement and recognition as key health care providers. The workshop, “Innovation in Pharmacy Training and Practice to Advance Patient Care,” explored enduring financial models for pharmacist-provided health care services.
Mary Ann Kliethermes, director of medication safety and quality at the American Society of Health-System pharmacists Inc., emphasized the long-standing role of pharmacists in clinical therapeutics. She noted the challenges of medication management amid a market of over 20,000 prescription medications and physician burnout.Kliethermes stressed the need for supportive laws and regulations, noting that while 44 states recognize pharmacists as health care providers, securing payment remains arduous. Securing adequate pharmacy reimbursement is key to expanding access to care.
Panelists shared various approaches to pharmacy reimbursement. Amanda Brummel, vice president of clinical pharmacy services at Fairview Pharmacy Solutions, described their comprehensive medication management program, which served over 25,000 patients and recorded over 57,000 encounters last year. The program saw a 33% reduction in readmissions for medication therapy management patients. Total annual health expenditures were reduced by an amount exceeding the cost of providing MTM services by more than 12 to 1. A patient satisfaction survey showed 96% would recommend the services. Brummel said Fairview needs to advance payment suitability, improve productivity, and optimize population health.
Adriene Zook, pharmacy manager at Geisinger health System, discussed ambulatory clinical pharmacy program models integrating pharmacists into care teams. These models included medication therapy disease management in primary and specialty care. Zook emphasized the importance of tracking clinical interventions and outcomes to drive legislative changes and optimize revenue while maintaining focus on patient outcomes. Medication therapy disease management is a key area for growth.
Laura Hanson, from Virginia Mason Franciscan Health medical Center, detailed their clinic pharmacy model, which generates nearly 32,000 visits and $7.5 million in revenue