As the trade association for America's community pharmacies, NACDS faced a significant challenge in helping its' members respond to the demands of a changing marketplace. The organization asked Marcia Comstock and Jon Comola to work with them to develop elements of an effective long-term strategy for the industry that would garner support for an expanded role for community pharmacy.

As a start, they focused on evaluating new options for reimbursement of pharmacists for medication management, counseling, and other cognitive services. A literature search was conducted and a careful external and internal environmental scan performed. Information was assembled on current pilot programs in pharmaceutical care services in the public and private sectors. They interviewed key leaders in the various sectors of community pharmacy to assess the potential impact on pharmacy operations in different settings, and gauge their willingness to champion new payment models. Their ability to quickly garner respect and generate trust was instrumental in ensuring an accurate assessment of the industry's position.

They next facilitated leadership meetings to discuss and debate the merits of different reimbursement mechanisms and strategies for gaining support from other stakeholders. The industry leaders engaged in productive dialogue relative to drivers of change, leverage points and barriers, issues for different industry segments (chain vs supermarkets vs mass retailers) and "friends and foes."

A detailed report summarizing the research, interviews, meetings and recommended reimbursement model was prepared for the NACDS board.

Marcia and Jon also worked with a professor from the Wharton School of Business on a "white paper" on community pharmacy. The paper argues cogently for the cost-effectiveness of an expanded role for pharmacists, given the impending demands of an aging population more dependent on medication therapies. It persuasively urges policy-makers and payers to consider the need to modify reimbursement mechanisms to align incentives with growing needs and demands.

As a result of this work, a foundation was created upon which to build a successful campaign to broaden the role of America’s pharmacists. This project reflected in a specific industry the challenges of the coming changes in our healthcare system, as well as the opportunities. Jon and Marcia helped outline a proactive strategy for positioning this industry to benefit from these changes.

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