PBMs and Value-Based Care: A Pathway to Better Pharmacy Reimbursement

While some experts believe value-based care is a model of the future in pharmacy, others—like David Pope, PharmD, Chief Pharmacy Officer at XiFin—believe it’s how pharmacy has always operated. But amongst declining reimbursements and burnout in the workforce, pharmacists have had an evolving relationship with providing value-based care.

According to the Centers for Medicare & Medicaid Services, value-based care focuses on the quality and performance of a health care providers’ medical services, making the patient’s experience the forefront of how care is delivered.¹ Most pharmacists will say that their patients are always at the forefront of what they do. However, amidst pharmacy benefit manager (PBM) tactics that industry experts believe are taking away from the profits of pharmacies nationwide, value-based care is getting more difficult to facilitate.

In the most recent episode of Over the Counter, David Pope joined Drug Topics to discuss the idea of value-based care within pharmacies, where the pressure of PBMs comes into play, and how his company XiFin is working hand in hand with pharmacists across the country.

READ MORE: Q&A: Why Value-Based Care Can Lead to Increased Revenue in the Pharmacy

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Reference

1. Value-Based Care. CMS. 2024. Accessed October 14, 2024. https://www.cms.gov/priorities/innovation/key-concepts/value-based-care