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FALL 2025 I RETAIL/COMMUNITY • SPECIALTY • LTC
CARE AT HOME
Q. How are payers and PBMs responding to LTC at home?
Are they recognizing it as a distinct service model?
Yes, but it’s a work in progress. Forward-thinking industry leaders are
beginning to recognize that LTC pharmacy at home is not just retail or LTC
pharmacy, it’s a hybrid model that requires its own compliance structure,
reimbursement model, and credentialing process. This year we are seeing
some payers and plans have already begun carving out service sets and are
requiring proof of service standards. Although this can be frustrating for
pharmacy owners and operators, it’s exciting! This evolution opens the
door for contracting opportunities for pharmacies that can help them better
support their at home patient populations, and even provides space for
value-based opportunities for pharmacies that can demonstrate outcomes.
Q. What does the future of LTC at home look like and how
can independent pharmacies position themselves to lead?
The future of LTC pharmacy at home is both urgent and promising.
As health plans, ACOs, and regulatory bodies continue to prioritize aging-in-
place initiatives, the demand for qualified LTC pharmacy at home partners
will grow. Independent pharmacies are uniquely positioned to lead because
of their community relationships, agility, and ability to provide personalized
care. To lead in this space, pharmacies must ensure compliance with CMS
standards for long-term care, implement dedicated LTC at home workflows,
and actively engage with local providers, MCOs, and community partners
to build trust and demonstrate that independent pharmacies are capable of
delivering high-touch, clinical care, not just filling prescriptions.
Q. What are some of the biggest misconceptions about
LTC at home pharmacy services?
The biggest misconception is that LTC pharmacy at home is just “retail
with delivery.” Many assume it’s simply a matter of putting prescriptions
in a bag and dropping them off at a patient’s home. In reality, the LTC
at home model is a clinical, outcomes-driven model that mirrors the level
of pharmacy services traditionally provided in a skilled nursing facility.
In a retail model, the interaction often ends at the point of sale. In contrast,
LTC at home pharmacy care involves ongoing clinical oversight, robust
documentation, proactive medication management, and close coordination
with healthcare providers, caregivers, and home-based services. Pharmacies
are responsible not only for dispensing but also for ensuring that the
medications are administered correctly, safely, and consistently, often to
medically complex or cognitively impaired patients.
Other common misconceptions include:
• “It’s only for hospice or home health patients.” — LTC at home services are
not limited to patients in those programs. Patients do need to qualify for
this level of service, but any individual who requires a skilled level of
medication management, typically due to chronic illness, polypharmacy,
or functional impairment, may qualify, even if they’re not receiving
formal in home care.
• “Only big LTC pharmacies can do this.” — In fact, independent,
community-based pharmacies are leading the charge in LTC at home.
With the right infrastructure and training, smaller pharmacies can
provide these services with greater flexibility and personalization than
many larger operations.
• “There’s no formal framework or regulation.” — This model must meet
CMS’s long-term care pharmacy requirements, including medication
regimen reviews, 24/7 pharmacist access, adherence packaging, and
timely delivery. It also requires pharmacies to meet minimum care
standards, including qualifying patients, providing care coordination,
clinical documentation, and cycle medication reviews. It is not a gray
area; it’s a regulated level of care that is being audited for service
support and even now has accreditation pathways.
Ultimately, LTC pharmacy at home is about bringing the institutional
pharmacy model into the community … with all the clinical rigor,
patient safety measures, and outcome tracking required to support high-
risk populations aging in place. My favorite aspect of the model is that
pharmacy is no longer just a dispenser … it becomes a central player in the
care team, exactly what it should be.
CARE
RESOURCES
Lindsay Dymowski Constantino, President & CoFounder of Centennial Pharmacy Services
Lindsay Dymowski Constantino is the president and cofounder of Centennial Pharmacy Services, one of the first pharmacies in the country exclusively
focused on long-term care at home. She also serves as the cofounder and president of the Long Term Care at Home Pharmacy Quality Commission, which
partners with payers, health plans, and other industry leaders to develop compliance frameworks and operational standards that allow pharmacies and
other healthcare providers to confidently and compliantly deliver long-term care pharmacy services in the home setting. A nationally recognized leader
in community-based pharmacy innovation, Lindsay is passionate about building scalable, sustainable models that support aging and medically complex
patients where they want to be — at home.