Pharmacy Transformation: Unpacking Clinical Care in Pharmacies

Pharmacies are redefining their role in healthcare by establishing themselves as community health hubs that provide comprehensive clinical care. This shift is driven by increasing healthcare demands, the need for accessible community-based care, and the growing recognition of pharmacists as integral healthcare providers.

Our 2025 Pharmacy Transformation Outlook survey gathered insights from over 350 pharmacy professionals, and the data shows that 73% of pharmacies reported that a greater focus as a health and wellness destination is a top opportunity going forward. Chief Pharmacy Officer David Pope and Vice President of Product & Partner Marketing Sandra Greefkes discussed the survey results at our Drug Store News-hosted webinar, 2025 Pharmacy Transformation Outlook: Unlocking Insights to Drive Innovation & Revenue.

“We’re witnessing a paradigm shift where pharmacies are becoming community health hubs, providing essential clinical services that enhance patient care beyond prescription dispensing,” explained Pope. “Pharmacists are at the frontline of healthcare accessibility, offering convenient, patient-centered solutions that meet the evolving needs of our communities.”

Today’s pharmacy landscape clearly demonstrates that the future of pharmacy hinges on the ability to integrate clinical care services effectively.

The Current State of Clinical Care in Pharmacies

Pharmacies are rapidly evolving to meet patient needs and capture new revenue streams by expanding their clinical services. Survey participants revealed that:

• 70% of pharmacies now offer immunizations
• 29% provide specialty pharmacy services
• 21% are involved in clinical trials and pharmacy studies
• 16% offer digital therapeutics support
• 10% offer mental health services

“Pharmacies are navigating a new landscape where clinical care is at the forefront. This isn’t just about adding more services; it’s about building a sustainable model of care that integrates with the broader healthcare ecosystem,” Greefkes said. “Pharmacies are a perfect destination to provide continuity of care, which is crucial for chronic disease management and preventive health.”

As pharmacies transition to healthcare hubs, many are investing in medication therapy management (MTM) and chronic care management to enhance patient outcomes. The survey highlighted that more than 60% and nearly 70% of pharmacies are interested in expanding chronic care management and MTM services, respectively. This reflects a growing focus on holistic patient care.

“Pharmacies are uniquely positioned to bridge care gaps and provide essential clinical services that enhance patient outcomes,” Pope stated. “This is about transforming the pharmacy from a transaction-based model to a value-based care hub.”

The Top Five Challenges in Expanding Clinical Care

While expanding clinical care in pharmacies presents significant opportunities, it also brings substantial challenges. Survey data shows that reimbursement, staff limitations, and time constraints are the top three barriers to clinical care expansion, highlighting the need for more advanced systems to support pharmacy teams and the complex workflows they now face.

“Pharmacies are dealing with a fragmented payment landscape that requires advanced billing solutions that support their teams,” explained Pope. “Pharmacies need systems that can seamlessly navigate both pharmacy and medical benefit landscapes to reduce administrative burdens that can take away from time spent with patients,” he added.

Payor contracting and the complexity of credentialing round out the top five biggest barriers to expanding clinical services, reflecting the difficulties of gaining payor approval and securing favorable reimbursement rates.

“Credentialing isn’t just about getting on a payor’s network—it’s about navigating intricate payor requirements and ensuring sustainable reimbursement contracts,” Greefkes said. “This is a new frontier for many pharmacies, and it requires a strategic, data-driven approach. Pharmacies must leverage data to negotiate effectively and demonstrate the value of their clinical services to payers.”

Regulatory Issues Continue. With federal bills like Equitable Community Access to Pharmacists Services (ECAPS) and pharmacist authority varying from state to state, efforts to champion pharmacy change must continue.

“The regulatory landscape is incredibly fragmented,” said Pope. “Pharmacies are facing different rules in each state, which makes scaling clinical services a logistical challenge. Advocacy and policy reform are crucial for enabling pharmacists to practice at the top of their license.”

The Future of Clinical Care in Pharmacies: Leveraging AI to Impact Community Health

Artificial intelligence (AI) is emerging as a transformative force in pharmacy, with its role expanding beyond clinical applications into operational, administrative, and financial workflows. Responses from the Pharmacy Transformation Survey indicate enhancing pharmacy technology and automation through AI, machine learning (ML), analytics, or cloud computing to improve operational efficiency presents one of the biggest opportunities for pharmacies to expand clinical care.

The survey questioned participants about emerging opportunities and identified the top 10. AI-assisted pharmacy management was the only technology-specific opportunity to make it to the top ten list, ranking fifth overall.

Survey participants also provided ideas and suggestions for how pharmacy can evolve and adapt to changing healthcare landscapes through free-form responses related to top predictions about the future of pharmacy. More specifically, survey participants indicated that they see AI-assisted therapy management as a way for pharmacies to evolve and adapt to the changing healthcare landscape.

“Those who master AI and advanced billing will set the standard for clinical care efficiency and financial success.” Greefkes explained, “Investing in cutting-edge technology is not just about staying competitive—it’s about leading the next wave of healthcare transformation.”

Transform Your Pharmacy by Expanding Your Clinical Services Offering

Expanding clinical services in your pharmacy is crucial for sustaining growth, impacting community health outcomes, and maximizing revenue.

“Pharmacies are at the forefront of healthcare transformation, and those that strategically navigate clinical care expansion will be the industry leaders,” Pope concluded. Greefkes added, “Success requires investment in technology, strategic partnerships, and a forward-thinking approach to clinical care delivery.”

Next Steps for Pharmacies

• Invest in Advanced Clinical Systems: Integrated systems are essential for managing clinical workflows, billing, and patient engagement
• Enhance Credentialing and Contracting Strategies: Develop strategic payor negotiations and effective credentialing processes to secure favorable reimbursement
• Expand Clinical Services Strategically: Align service offerings with patient needs and payor reimbursement policies to capture new revenue streams
• Educate and Train Staff: Develop specialized expertise in clinical care delivery and medical billing to navigate complex coding requirements and payer policies
• Leverage AI and Automation: Utilize AI for accurate patient out-of-pocket expense estimation, real-time eligibility verification, denials prevention, and appeals management

Watch the on-demand webinar, 2025 Pharmacy Transformation Outlook: Unlocking Insights to Drive Innovation & Revenue, to equip your team with the knowledge needed to innovate, optimize, and grow your pharmacy.