2026 Health Care Outlook: Michael Hogue, APhA

By Michael Hogue, executive vice president and CEO of the American Pharmacists Association

In recent years, the pharmacy profession has witnessed a period of intense transformation — shaped by emerging technologies, evolving patient needs and policy shifts. Pharmacists find themselves not only at the crossroads of tradition and innovation but also at the heart of multidisciplinary care teams, poised to enhance health outcomes significantly. This evolution promises pharmacy professionals new opportunities to expand their reach, deepen their expertise and influence the trajectory of health care delivery. The landscape of pharmacy is being redefined, with professionals at the forefront of innovation and patient care. Pharmacy professionals must adapt swiftly to capitalize on these opportunities. The coming year is not without challenges, but the potential for positive change is substantial. 

State Laws Are Rapidly Changing

Pharmacists are gaining new ground as legal and regulatory barriers fall, empowering them to practice at the top of their training, and allow pharmacy technicians the authorities needed to fully support the care services pharmacists provide. No one in government, nor in the consumer sector, can deny that pharmacists have been the backbone of public health infrastructure.

While some sectors of organized medicine resist expanding pharmacists’ roles, key physician-led groups back the initiative. APhA maintains strong positive collaborative relationships with the National Forum on Heart Disease & Stroke Prevention, the National Association of Community Health Centers, the American College of Cardiology, and several others.

For state examples of real change, take Tennessee. The state pharmacy association collaborated with the state medical association to authorize pharmacists to initiate and modify therapies for certain conditions independently. Pennsylvania now has authorities and payment for pharmacists to help expectant mothers with prenatal counseling and vitamins. California — our nation’s largest state, with almost 12% of practicing pharmacists in the United States — adopted a standard of care model in 2025 following the lead of Idaho, Alaska and Iowa. 

Perhaps most importantly, we finally have an understanding and growing acceptance — indeed, I’d say momentum — moving away from state pharmacy practice laws that prescribe (pardon the pun) what pharmacists can and can’t do and instead authorize pharmacists to meet the standard of care for their patients. This momentum will carry into 2026, and we will see many more states move in this direction, removing all regulatory barriers to pharmacists practicing to their full potential.

The Practice Model in Community Pharmacy Is Changing

Unfortunately, the financial incentives for pharmacists engaging in non-dispensing activities have not been aligned sufficiently to generate meaningful revenue. However, this is changing. Conducting one or two medication therapy management (MTM) interventions a day or providing a dozen or so HIV tests and PrEP counseling sessions — or even a half-dozen strep tests and consultation sessions a day — is simply not enough consistent revenue to fully support a change in pharmacy community practice models. However, a multitude of services happening in one pharmacy can create enough revenue to generate change. While independent pharmacies have typically been the innovators to produce these opportunities, it’s worth noting that the large national chain corporations are making these models work as well. For example, Walmart has implemented appointment-based scheduling in nearly two dozen states where pharmacists have clear authorities for test-to-treat. Pharmacists cover the schedule, or they cover the dispensing services, but are typically not required to do both in the same shift. This is a huge breakthrough, shifting from the old model of adding additional authorities without removing other duties. It’s very encouraging to see large corporations making real commitments in staffing and scheduling to support generating these new, meaningful revenue streams which engage pharmacists in doing what we were trained to do: truly serve our patients. 

Consumers Are Advocating For Coverage of Pharmacist
Services

Trump administration officials in the Department of Health and Human Services, including Dr. Mehmet Oz, have been championing and facilitating change to engage pharmacists more fully in the care process. APhA has had multiple positive meetings to identify the systems solutions necessary to engage and compensate pharmacists as a part of a revised primary care system. 

Take for example Allison Reich­ert, a pharmacist at Bode Drugs in Vienna, Ill. Illinois law and regulations allow Reichert to perform strep testing. However, there is no third-party payer in the state of Illinois that will cover her services. She’s faced with sending a patient to the nearest urgent care facility over 30 minutes away, creating inconvenience for the patient and tremendous unnecessary cost for the system. Reichert shared this compelling story during her testimony for APhA before the House Ways & Means Committee. One by one, each member of Congress recognized consumer demand is driving the push for increased pharmacist access. There’s now a growing call for pharmacists’ services — critical to our nation’s health infrastructure — to be fully covered and easily accessible. 

Interoperable, Bidirectional EHR Access Is Coming

Perhaps one of the most critical components to successful practice change for pharmacists is access to comprehensive patient health information to effectively monitor and adjust drug therapies. The technology exists. The infrastructure needs some work. For-profit technology companies and large health systems have historically blocked access to critical data, hindering effective care. APhA is collaborating with the administration and regulators to dismantle barriers once and for all, and we predict that 2026 will be the year we look back on as pivotal for pharmacist access to patient care information to deliver the care we are trained to provide.

I can see that 2026 will be a transformational year for our profession, and APhA is advocating for the professional practices of pharmacists and pharmacy technicians. APhA calls on all members to unite in this critical mission to strengthen the profession’s future.

Michael Hogue is executive vice president and CEO of the American Pharmacists Association.