Episode Details

Chronic conditions account for most of the U.S. healthcare burden, yet many patients see their pharmacist far more often than they see their doctor. This makes pharmacies a natural place for ongoing support, even if those interactions have traditionally gone undocumented.

Medicare’s Chronic Care Management (CCM) program recognizes this reality by allowing pharmacists, under physician supervision, to help coordinate care for high-risk patients. For many pharmacies, CCM is simply a structured way to deliver the guidance they already provide between doctor visits.

Pharmacists routinely help patients manage long-term illnesses, reviewing medications, checking for side effects, clarifying instructions, and noticing patterns that may never come up in a brief clinical appointment. Because patients interact with their pharmacy so frequently, small changes in symptoms or adherence are often spotted there first.

CCM builds on this natural relationship. Instead of relying solely on occasional office visits, the program creates a framework where pharmacists and physicians work together to keep chronic conditions stable throughout the year. It transforms pharmacy touchpoints into documented care that can be shared across the patient’s healthcare team.

At its core, CCM is a monthly commitment to help patients with two or more chronic conditions navigate their health more effectively. It includes check-ins, medication reviews, symptom updates, coordination with prescribers, and regular adjustments to the patient’s care plan.

For pharmacies, none of this is unfamiliar. What’s new is the formal process, obtaining consent, maintaining a shared care plan, and documenting each interaction in a way that meets Medicare’s expectations. When done correctly, these monthly activities become billable time under the supervising practitioner.

Before launching CCM, pharmacies need a realistic sense of their workflow and capacity. Most already have the right patient population, since individuals with diabetes, hypertension, COPD, and other chronic illnesses rely heavily on pharmacists for ongoing guidance.

The key question is whether the pharmacy can support a regular monthly rhythm of outreach, documentation, and collaboration. Pharmacies with strong technician support or well-organized teams often adapt quickly because CCM fits naturally into the interactions they already handle every day.

So consider:

How many chronic-care patients you currently serve How often your team interacts with these individuals Staff availability and delegation capacity Space for documentation or clinical calls Willingness to build a consistent monthly workflow

If your pharmacy routinely assists patients managing complex illnesses, CCM naturally aligns with those efforts.

Identify Eligible Patients This is often the easiest part. Pharmacies already know who their high-risk and high-touch patients are, and dispensing histories provide a clear picture.

Patients with chronic conditions such as diabetes, hypertension, heart issues, chronic kidney disease, COPD or asthma, high-risk polypharmacy, are usually eligible for CCM if they manage two or more of these conditions. This represents a significant portion of most community pharmacy populations.

Pharmacies cannot bill CCM on their own — Medicare requires physician oversight. But collaboration benefits both sides. Physicians appreciate having a pharmacy partner who monitors adherence, checks in with patients regularly, and identifies issues early.

Effective partnerships clarify how information will be shared, who updates the care plan, how concerns are escalated, and what level of supervision is required. These agreements help ensure everyone operates under the same protocol.

A reliable workflow is the backbone of a successful CCM program. After obtaining patient consent and establishing a baseline care plan, pharmacies conduc