The concept of a network of high-performing pharmacies not new, but [Ryan Frerichs, PharmD] said what's different this time around is that payers are interested in contracting with them.

"The market is scrambling for market-based solutions, and that's exactly what we are," said Frerichs. "Payers are very interested in what we can provide."

Community pharmacists see a need to position themselves as players in value-based care models. Aggregating as a network can make them more attractive to payers.

"One of our goals is to be a community-based pharmacy network that can work with the local health care team to improve health outcomes," said Trista Pfeiffenberger, PharmD, MS, director of network pharmacy programs at Community Care of North Carolina (CCNC).

Just as it's challenging to measure health care quality and outcomes for patients receiving care in a small physician practice, it similarly can be difficult for a single pharmacy to move quality and utilization metrics substantially enough to show value to a payer. "It's hard for one pharmacy to have a sufficient number of patients covered by one payer to be able to see a strong effect on measures like emergency department use or hospitalizations, so part of the value of the network is aggregating these high-performing, community-based pharmacies in the hopes of being able to demonstrate a significant effect on quality and health outcomes," said Pfeiffenberger.

Networks of pharmacies can help payers manage health outcomes as well as costs. In addition, quality metrics that certain plans or providers must meet are being tied directly to the pharmacy because pharmacies can be held jointly accountable for measures influenced by appropriate medications use.