Building on the 2025 national academies pharmacy workshop: ensuring access to community pharmacist care

Abstract Growing medication use, chronic disease burden, and primary care provider shortages have intensified the need for additional models of care delivery in the United States. Community pharmacists are uniquely positioned to help address these challenges through medication management, chronic disease management, and timely access to care. Evidence demonstrates that pharmacist services improve medication use and therapeutic outcomes while lowering overall health care costs. Despite these benefits, pharmacists remain underutilized as patient care providers, largely due to inconsistent reimbursement and business models that continue to prioritize product dispensing over patient care. Building on the 2025 National Academies of Sciences, Engineering, and Medicine workshop, Innovations in Pharmacy Training and Practice to Advance Patient Care, this paper examines existing and proposed state and federal payment policies and how their design influences implementation and scalability in community pharmacy practice. Recommendations include broad medical benefit reimbursement across payers, broad patient and service eligibility, and deference to state-defined scope of practice. Additional reforms are needed to address implementation barriers related to electronic health record access and credentialing. Together, these reforms can support sustainable, scalable community pharmacist-provided care and improve care access, quality, and affordability.