Building on the 2025 National Academies Pharmacy Workshop: health systems financially supported pharmacist roles.

Pharmacist services demonstrate a positive impact on healthcare delivery, patient outcomes, and cost of care. Translating this evidence into sustainable funding models demands significant change in healthcare policy and payment that accounts for institutional constraints, payment structures, and scalability requirements. Meanwhile, the gap grows between the positive impact of pharmacist services and reimbursement limited to narrowly defined services or drug product costs. Lack of federally designated provider status and payer-imposed cost containment strategies threaten the financial sustainability of pharmacist services. Future solutions include innovative value-based payment with quality-driven reimbursement, comprehensive medication and care management, and shared financial savings linked to outcomes. Priority funding areas using a shared-savings model include acute and chronic care service lines that cater to high-acuity patients who require high-cost medications and experience frequent care transitions. This model is based on reductions in medication costs, adverse drug-related outcomes, length of stay, and readmissions. A call to action is proposed, focused on policy changes in provider status, adequate payer reimbursement, improving current fee-for-service models and shifting payment models to value-based payment, and removing misaligned financial strategies.