Expanding Clinical Services in Community Pharmacies: Overcoming Barriers in 2025

Community pharmacies have long been a cornerstone of the healthcare system, providing essential services like dispensing medications and offering over-the-counter products. However, as the landscape of healthcare evolves, there is a significant opportunity for pharmacies to expand their clinical services and enhance their role in patient care. By leveraging their accessibility and expertise, pharmacies can be pivotal in managing chronic conditions, offering preventive care, and supporting patient wellness. This transformation is not without its challenges, but with the right strategies in place, community pharmacies can overcome these barriers and seize the opportunity to expand their clinical services.

Let’s explore the various clinical service opportunities in community pharmacies. We will discuss common barriers to implementation and how to overcome them, explore collaboration with healthcare providers and payers, highlight the financial and operational benefits of offering clinical services, and consider the future of clinical services in pharmacies.

“Pharmacies have an untapped potential to contribute more significantly to patient care. By expanding clinical services, pharmacies can become a central point in the healthcare delivery system.”

– NCPA 2024

Overview of Clinical Service Opportunities in Pharmacies

Pharmacies have the opportunity to expand beyond traditional dispensing duties to offer a wide range of clinical services that can directly improve patient outcomes. Some of the key clinical service opportunities include:

1. Chronic Disease Management

Pharmacists are well-positioned to assist with the management of chronic conditions—diabetes, hypertension, and asthma. By offering services such as medication therapy management (MTM), blood pressure monitoring, and diabetes education, pharmacies can play an active role in supporting patients with chronic diseases.

2. Durable Medical Equipment

Pharmacies can expand their services by offering durable medical equipment (DME) such as walkers, canes, braces, and home monitoring devices. This provides patients with convenient access to essential medical supplies while allowing pharmacists to offer personalized guidance on equipment selection, fitting, and usage. DME services are particularly valuable for elderly patients, those recovering from surgery, and individuals with chronic conditions, further positioning the pharmacy as a comprehensive healthcare destination.

3. Immunizations

Pharmacies can provide a range of vaccinations, including flu shots, COVID-19 vaccines, and other recommended immunizations. This service not only improves public health but also enhances the pharmacy’s role in preventive care.

4. Point-of-Care Testing

With the advancement of diagnostic technology, pharmacies can offer point-of-care testing for conditions like strep throat, COVID-19, and cholesterol levels. This provides patients with quick results and allows pharmacists to offer timely advice and treatment.

5. Medication Therapy Management (MTM)

MTM services involve reviewing patients’ medications to ensure they are appropriate, effective, and safe. Pharmacists can educate patients on medication adherence and prevent potential drug interactions. This service is particularly beneficial for patients on complex medication regimens.

6. Tobacco Cessation Programs

Pharmacies can offer counseling and support programs to help patients quit smoking. This may involve offering nicotine replacement therapy (NRT), behavioral counseling, and continuous support.

7. Mental Health Services

Pharmacists can play a key role in supporting patients with mental health conditions. While pharmacists are not licensed therapists, they can offer support by providing MTM services for psychiatric medications, offering counseling, and collaborating with healthcare providers to ensure comprehensive care.

These services are just the beginning of what pharmacies can offer. Expanding these clinical services requires overcoming several key barriers—from regulatory limitations to workflow disruption.

Common Barriers to Implementation and How to Overcome Them

Despite the potential benefits, several barriers hinder the expansion of clinical services in community pharmacies. Overcoming these barriers is essential to unlock the full potential of pharmacy-based care.

1. Regulatory and Scope-of-Practice Limitations

One of the biggest challenges is the regulation of pharmacists’ roles. Some states have restrictive laws that limit pharmacists’ ability to provide certain clinical services, such as prescribing medications or ordering lab tests.

Solution:

Advocating for policy changes at the state and federal levels can expand pharmacists’ scope of practice. Collaborative Practice Agreements (CPAs) are one way to address this challenge. These agreements allow pharmacists to collaborate with physicians to provide services like medication adjustments and disease management.

2. Uncertain Levels of Reimbursement

It is best to be sure that the clinical services you are offering are reimbursed by insurance providers or government programs like Medicare and Medicaid. A lack of reimbursement can make it difficult for pharmacies to justify the cost of implementing new services.

Solution:

Collaborating with a knowledgeable software platform like DocStation is essential. Confirming the patient’s insurance coverage is active and if the service provided will be reimbursable by the payer can help provide insight into the available reimbursement opportunity. Familiarizing yourself with the reimbursement policies for payers you are interested in billing can help with understanding reimbursement rates. Pharmacies can also explore alternative revenue models, such as charging for consultation services or participating in value-based payment programs. .

3. Workforce and Training Challenges

Pharmacies may face a shortage of staff with the necessary training and expertise to provide clinical services. Implementing new clinical services requires staff members who are not only trained in pharmacy operations but also in patient care.

Solution:

DocStation offers a comprehensive platform that streamlines medical billing for clinical pharmacy services into one integrated solution.. DocStation’s intuitive workflow tools eliminate redundant documentation, automate billing processes, and provide integration capabilities with pharmacy management systems, allowing pharmacists to focus on patient care rather than administrative tasks. This all-in-one platform helps pharmacies transform their clinical service offerings while maintaining operational efficiency.

4. Workflow Integration

Integrating clinical services into an already busy pharmacy workflow can be challenging. Pharmacies must balance traditional dispensing duties with new clinical tasks, which can cause operational inefficiencies, staff burnout, and service delays.

Solution:

Implementing streamlined workflows and utilizing technology is key to overcoming this barrier. DocStation’s ability to integrate with pharmacy management systems can help automate administrative tasks, such as billing, scheduling, and patient data management, allowing pharmacists to focus on clinical services.

5. Patient Cost Share Responsibility

Patients may often have out-of-pocket expenses when receiving clinical services, such as immunizations, MTM, or point-of-care testing. Clearly defining the patient’s cost-share responsibility is essential to avoiding confusion and ensuring payment for services.

Solution:

Pharmacies must educate patients about their financial responsibilities and work with them to minimize out-of-pocket costs. Clear communication regarding costs and insurance coverage is essential to improve service utilization.

Collaboration with Healthcare Providers and Payers

Collaboration with healthcare providers and payers is essential to the success of expanding clinical services in community pharmacies. By working together, pharmacies can integrate their services into the broader healthcare system and ensure that they are reimbursed for the services they provide.

Collaborative Practice Agreements (CPAs)

CPAs allow for the creation of a formal practice agreement between a pharmacist and a healthcare provider. It outlines the scope of services that a pharmacist can provide allowing for expanded clinical services by the pharmacist. Under a CPA, pharmacists commonly provide services such as initiating, modifying, or discontinuing medication therapy, administering immunizations, and ordering and interpreting laboratory tests. .. By collaborating with healthcare providers , through a CPA pharmacists can increase patient access to care, optimize medication regimens, and help improve disease state management leading to reduced healthcare costs..

Benefits of CPAs:

• • Enable pharmacists to adjust medication regimens based on clinical outcomes.
  • Allow for collaborative disease management and preventive care.

Expand pharmacies’ ability to provide comprehensive care beyond medication dispensing.

States with the most restrictive CPA requirements include:

• Alabama
• Delaware
• Georgia
• Illinois
• Michigan
• New York
• Pennsylvania
• South Carolina
• Texas

States with more permissive models that allow broader pharmacist scope through CPAs include:

• California
• Idaho
• Montana
• New Mexico
• North Dakota
• Oregon
• Washington

Restrictive CPA Scope vs. Broader CPA Scope

Restrictive CPA Scope: States with restrictive collaborative practice agreements typically limit pharmacists in several ways. They often require physician oversight for specific patients rather than populations, mandate frequent protocol reviews, limit the types of medications pharmacists can manage, restrict services to specific disease states, require physical proximity to collaborating physicians, and involve complex approval processes. In these states, pharmacists may only be allowed to modify existing prescriptions rather than initiate new therapies, and they often face geographic limitations on where they can practice under a CPA.

Broader CPA Scope: States with broader CPA scope grant pharmacists more clinical autonomy. These states allow pharmacists to manage medications for patient populations rather than requiring individual patient approvals, permit initiating new drug therapies (not just modifying existing ones), include a wider range of disease states and medications, simplify the CPA establishment process, and often don’t require direct supervision or physical proximity to physicians. Some progressive states even authorize pharmacists to order and interpret lab tests, diagnose common conditions, and prescribe certain categories of medications independently.

The trend across the country is toward expanding pharmacist scope of practice, with many states moving from restrictive models toward broader authorization, particularly in areas with physician shortages and for services that improve public health access.

Financial and Operational Benefits of Clinical Services

Expanding clinical services in community pharmacies can lead to both financial and operational benefits.

1. Increased Revenue

Clinical services such as immunizations, MTM, and point-of-care testing can generate significant revenue for pharmacies. By diversifying their service offerings, pharmacies can create new income streams, which can help offset declining reimbursements for traditional dispensing services.

2. Improved Operational Efficiency

By integrating clinical services into their workflows, pharmacies can improve overall efficiency. Automation tools and integrated clinical management systems, such as those offered by DocStation, help streamline administrative tasks and reduce the workload on pharmacy staff.

3. Enhanced Patient Loyalty

Pharmacies that offer a wide range of clinical services are more likely to retain patients. By building strong relationships with patients through personalized care and services, pharmacies can increase patient loyalty and satisfaction.

To enjoy all these benefits pharmacies must actively market their clinical services to patients. This can be done through in-store promotions, social media campaigns, and educational materials. By educating patients about the benefits of clinical services, pharmacies can increase patient engagement and encourage the utilization of new services.

The Future of Clinical Services in Community Pharmacies

The future of clinical services in community pharmacies is promising. As the healthcare system continues to shift towards value-based care, pharmacies will play an increasingly important role in improving patient outcomes.

Emerging Trends:

• Telehealth Integration: Pharmacies may offer telehealth services in collaboration with physicians to provide remote consultations and care.
• Data-Driven Care: Using patient data to offer personalized services and track clinical outcomes will become a key aspect of pharmacy-based care.
• Expanded Roles for Pharmacists: As healthcare regulations evolve, pharmacists are uniquely positioned to widen their clinical role in services such as: expanded chronic disease management, point-of-care testing and prescribing, and broader immunization authority.

A New Era for Community Pharmacies

Expanding clinical services in community pharmacies presents a tremendous opportunity to enhance patient care and create new revenue streams. By overcoming barriers such as regulatory limitations, reimbursement challenges, and workflow disruptions, pharmacies can take on a more significant role in healthcare. With the support of tools like DocStation’s medical billing platform pharmacies can seamlessly integrate clinical services into their operations and achieve long-term success.

Are you ready to expand your pharmacy’s clinical services? DocStation’s comprehensive pharmacy management solutions provide the tools you need to streamline workflows, improve patient outcomes, and increase profitability. Contact us today to learn more and schedule a demo.