I recently returned from a packed and thought-provoking week in Scottsdale, Arizona, where I attended the NCPDP Work Group meetings, NCPDP Foundation Board meetings, and the Annual Conference. While I’ve participated in NCPDP events for years, this one stood out. The strong turnout and energy were noteworthy, but the depth of conversation about the future of pharmacy—and a shared urgency around the need to evolve- was profound

A central thread running through nearly every session and hallway exchange was this: how can we modernize the pharmacy business model to enable pharmacists to work at the top of their license and be fairly compensated for the clinical value they provide? It’s not a new question, but the stakes feel higher than ever.

That broader conversation about redefining the pharmacy business model was also reflected in the NCPDP Work Group meetings. In Work Group 20, much of the focus was on Pharmacy Technology Innovation (PTI)—specifically, how disruptive technologies and emerging services could help free up pharmacists' time to support more value-based care. There was particular interest in the potential of AI to reduce repetitive tasks and shift pharmacist efforts toward more clinically meaningful activities. Meanwhile, Work Group 1’s Pharmacy Billing Task Group shared updates on the S1 transaction, which supports billing for pharmacist-provided care services. They walked through real-world business cases and examined how the upcoming shift from version D.0 to F6 could affect the use of the S1, especially in the context of evolving care models.

At Point-of-Care Partners (POCP), we’re digging into pharmacy business model evolution head-on through an NCPDP Foundation-funded initiative in collaboration with Summit Health Advisors. The project is focused on assessing the current situation, including the current landscape and existing business models, and determining barriers to scaling them. Through interviews with industry leaders and lessons from past efforts, we aim to uncover what’s working and what’s not, and how we can build sustainable models that serve patients and communities.

Examples are more plentiful than one might think. One effort cited at NCPDP was the trailblazing model of CPESN USA and Carolina Complete Health, where pharmacists already demonstrate their value through outcomes-based services and quality programs.

That focus on innovation was echoed throughout the event. Dr. Vin Gupta delivered the keynote and spoke about the importance of experimentation and progress over perfection. While his remarks focused broadly on health innovation, NCPDP ensured the message came back to pharmacy. The rest of the agenda was full of informative pharmacy-focused sessions, such as a panel and several sessions on AI in pharmacy, digital pharmacy, advances in Immunization tracking, and legal and regulatory updates.

One particularly engaging session came from Bruce Wilkinson of Benmedica. Bruce took on the often-overlooked topic of the role of formulary & benefit in accurate real-time benefit tools (RTBT), making it not only digestible but actually fun. He wove in an entertaining video segment that framed the content through a character he called "Formulary Guy," giving the audience a break from bullet points while still driving home how formulary data combined with RTBT can improve decision-making and reduce both patient and plan costs.

Other standout topics included:

• The evolution of pharmacy prior authorization (PA): Speakers shared that 70–80% of pharmacy PAs are now processed electronically. Both Surescripts and Agadia discussed their “no-touch” workflows, showing how far the industry has come.
• NCPDP Universal Patient Identifier Initiative:  NCPDP is advancing its Universal Patient Identifier (UPI) initiative, designed to improve patient safety and data accuracy across pharmacy and broader healthcare settings. Unlike a national patient ID, the UPI leverages existing industry identifiers and standardized data elements to create a unique, non-duplicative, and privacy-protective ID. The goal is to enable accurate patient matching across systems without relying on sensitive personal information
• STChealth’s National Facilitator Model Pilot Project: STChealth shared progress on its innovative approach to pharmacy data exchange, which aims to streamline interoperability between pharmacies and public health systems. The recently completed second phase of their National Facilitator Model pilot demonstrated the ability to connect multiple pharmacy chains to state immunization information systems through a single integration point. This work highlights a scalable, nationwide infrastructure for pharmacy-driven public health engagement

One of the most meaningful experiences of the week was accepting the Charles Pulido RPh Excellence Award on behalf of Point-of-Care Partners. The award recognized POCP’s leadership in driving interoperability, streamlining pharmacy workflows, and championing health IT solutions that improve care delivery. Our white paper, Pharmacy Interoperability: A Comprehensive Assessment of the Current Landscape, was highlighted for its impact and alignment with the NCPDP Foundation’s vision to advance innovation for the common good. It was a true honor to accept the award on behalf of our talented team, and I remain incredibly proud of the work we’re doing together.

Another standout moment was the announcement of a $1 million endowment to the NCPDP Foundation in recognition of John W. Hill, NCPDP’s Chief Operating Officer and Executive Director of the Foundation. John has been a longtime friend and trusted voice in the industry, and this recognition was incredibly well deserved. It was heartening to see him honored for his decades of leadership and contributions, and I couldn’t be prouder to see a friend and colleague celebrated in this way.

More than once, I found myself reflecting on the role of community in all this. It’s easy to get caught up in the regulatory grind or technical debates, but NCPDP reminds us that relationships, collaboration, and shared purpose are what keep the momentum going. As I said in my recent Monday Musings, awards are nice, but it’s the people who matter most.

Looking ahead, our work on the NCPDP Foundation project on viable pharmacy model continues, and we’re committed to delivering insights that can help move the industry forward. There’s still no simple answer to redesigning the pharmacy business model—but based on what I saw and heard last week, there’s no shortage of smart, passionate people ready to take on the challenge.

At POCP, we’re here to help our clients keep moving forward—toward better care, smarter workflows, and real results for patients. If you’re trying to figure out your next step, tackling a thorny challenge, or eyeing an opportunity that could make a difference, let’s talk. You can reach out to me directly or connect with our team. And if you’ve got ideas or strong opinions about what a scalable, modern pharmacy business model should look like, I’d really like to hear them. This is a complex problem, but we’re not going to solve it by sitting on the sidelines.