Pharmacy leaders across major health systems say one set of changes would do more than anything else to expand pharmacy’s role in care delivery: Remove the regulatory and reimbursement barriers that prevent pharmacists from practicing at the top of their training. According to them, today’s rules often lag behind what pharmacists are clinically trained to do.
The changes leaders are calling for — provider status, prescribing authority, reimbursement reform and regulatory modernization — are not new ideas. But as health systems face ongoing provider shortages, rising demand and increasing complexity in care delivery, pharmacy leaders say the urgency is growing.
At the top of many leaders’ lists is formal provider recognition.
“Achieving pharmacist provider status at the state and federal levels would be the most meaningful scope-of-practice change,” said Bonnie Levin, PharmD, vice president of pharmacy services at MedStar Health in Columbia, Md. She emphasized that recognition would allow pharmacists to more fully integrate into care teams and sustainably deliver clinical services across settings, from hospitals to ambulatory and population health.
John Armitstead, vice president of pharmacy services at Lee Health in Fort Myers, Fla., echoed that point more bluntly.
“Advocate for recognition of pharmacists as patient care providers across all healthcare insurers and payers,” he said.
Without that designation, leaders say one of the biggest constraints remains reimbursement. Even when pharmacists are already providing clinical services — managing medications, adjusting therapies or supporting chronic disease care — payment structures often do not support scaling that work.
“Ensuring equitable reimbursement for the clinical services they deliver would be the most impactful change,” Dawn Moore, PharmD, vice president and chief pharmacy officer at Community Health Network in Indianapolis said. “This would enable pharmacists to practice at the top of their license, expand access to care, and more fully support patient outcomes across the healthcare continuum.”
But recognition alone is not enough. Several leaders pointed to the need for expanded clinical authority, particularly around prescribing.
Stephanie Goldman, PharmD, vice president of pharmacy operations at Tower Health in West Reading, Pa., said allowing pharmacists to independently prescribe medications, particularly in states like Pennsylvania, would significantly improve access and efficiency.
“Pharmacists are uniquely educated as medication and pharmacotherapy experts,” she said, adding that expanded prescriptive authority could help address provider shortages while improving chronic disease management and reducing overall costs.
Others framed this expansion through team-based care models already in place.
Ryan Haumschild, PharmD, director of pharmacy at Emory Healthcare in Atlanta, pointed to collaborative practice agreements and clinical pharmacy practitioner roles as key levers.
“Allowing pharmacists to practice under [these models] would enable our teams to deliver greater clinical value while meeting patients where care is most needed,” he said, noting the impact on chronic care management and specialty disease programs.
Still, some leaders argue the issue goes beyond any single policy change.
Kim Zammit, PharmD, executive director for clinical pharmacy services at Mount Sinai Health System in New York City, called for a broader modernization of the regulatory framework, shifting away from rigid, task-based rules toward a standard-of-care model.
“Such a framework would remove many of the restrictive and prescriptive barriers that currently limit pharmacists’ ability to deliver timely, high-quality and efficient patient care,” she said. “This concept is not novel or radical. It reflects the regulatory approach long applied to other healthcare professions.”
Some leaders also pointed to more targeted regulatory changes that could improve operational efficiency and patient access.
Dorinda Segovia, PharmD, vice president and chief pharmacy officer at Memorial Healthcare System in Hollywood, Fla., said greater flexibility around compounding regulations could help health systems deliver care more efficiently.
She added that aligning state regulations with FDA anticipatory compounding guidance could reduce delays in therapy initiation and improve consistency across sites of care.
In the meantime, more immediate operational barriers continue to shape day-to-day care, particularly prior authorization requirements.
Lisa Mulloy, vice president and chief pharmacy officer at Northwell Health in New Hyde Park, N.Y., said reducing those administrative hurdles would have a direct impact on patient care.
“Allowing this autonomy, free from the bureaucratic bottlenecks of prolonged prior authorization, isn’t just about efficiency; it’s about delivering superior responsive care,” she said, emphasizing the importance of timely, tailored treatment decisions.
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