This story appears in the September–October 2026 issue of Dispense Times.
Joe Moose and Amina Abubakar on how a decade of CPESN® USA groundwork prepared community pharmacies for the ACCESS Program, what CMS is finally willing to pay for, and where independent pharmacy goes next.
For more than a decade, the Community Pharmacy Enhanced Services Network (CPESN) has been preparing independent pharmacies to practice at the top of their license and to get paid for the care they deliver. With the arrival of the CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) program, that groundwork is being put to the test. Dispense Times sat down with two of CPESN network’s most recognizable voices, Joe Moose of Moose Pharmacy and Amina Abubakar of Avant Pharmacy, to talk about what the program asks of pharmacies, what CMS is really paying for, and where community pharmacy goes from here.
Dispense Times: You have spent a decade building toward pharmacists getting paid for their care. How does the ACCESS program feel like the culmination of that journey?
Joe Moose: Not all pharmacies are the same. Some do different things, and because of that, patients and payers get different, and we think better, outcomes. But it does not happen overnight. If you are running fast and cheap, filling the prescription operation, you cannot have a value-based program dropped in your lap and change your whole model at once. You do it piece by piece. Every CPESN program we have taken on puts one more ingredient in the pantry, and we are cooking the best care we can with what we have. The early programs were simple; they were more coordination than clinical work. Over time the programs built toward being handed a patient with a disease and being asked to produce a better outcome. I do not even like calling them programs to patients. Behind the counter, they are programs, because they have nuances, but to the public they are benefits and opportunities.
Amina Abubakar: Before CPESN, we filled prescriptions and never really understood the value of our access to the patient. CPESN taught us to organize our workflow so that dispensing stays essential but efficient, which frees us up to engage the patient beyond the fill. Then it pushed us to document, because if you did not document it, it did not happen, and that became the care plan. We had to learn to tell the story of the patient in a system that was only built to capture NDCs, so we adopted SNOMED clinical codes to show that a pharmacist intervened, and as a result, the patient got the right medication. All of that happened with small grant funding, before payer contracts. By setting a standard, CPESN even shaped how pharmacy software evolved.
Dispense Times: Given the clinical and documentation muscle CPESN has helped you build, what is CMS actually paying for with ACCESS?
Amina Abubakar: For the first time, CMS is saying it is done paying for a process. Medication Therapy Management was a process: contact the patient, ask about the medications, work inside a set time frame. On the medical side, CMS paid for remote patient monitoring and chronic care management, but there was no accountability for whether the patient actually improved. The ACCESS model takes a different approach. CMS is opening the marketplace and saying it will pay for outcomes, and it is not going to tell you how to get there. The payment reflects that. Roughly half the money comes up front, because they know you have infrastructure and time to invest, and the rest rewards the pharmacies that show measurable improvement.
Dispense Times: Do you feel the network has reached a point where pharmacies can truly succeed in this model?
Amina Abubakar: The data already shows that pharmacists can deliver outcomes. The problem was never capability, it was scale. We had regional wins with state Medicaid programs and individual health plans, but they were small. ACCESS is about taking those results and making them scalable.
Joe Moose: Every pharmacy thinks it is the best and that every patient should come to them. What we finally have is data that shows who is doing better, and a trail that says if you are doing these things, you are more likely to succeed at the next thing. The cornerstone is med sync, and not just syncing everyone’s medications to a date, but a true appointment-based care model. The pharmacies that have the bulk of their patient panel in an appointment-based model are the ones capturing the opportunities and delivering the outcomes payers want.
Dispense Times: Part of the benchmark is having 30 percent of your patient population in that appointment based model. Is that right?
Joe Moose: That is CPESN’s benchmark. Pharmacies without that level of uptake generally are not the ones capitalizing on other value-based programs. It is not the only foundational piece, but it is a foundational one, and it is hard to build a sustainable program without it.
Dispense Times: What is the role of Game Plan Medical in the program?
Amina Abubakar: GamePlan Medical is the medical practice, the designated participant in ACCESS, because the program requires a medical practice to lead. Their thinking was that pharmacies would serve as collaborators in providing ongoing patient care between visits. Physicians recognize that once a patient leaves the office, it is the community pharmacy that has the ongoing relationship and the touch points. So through ACCESS to Pharmacy Care, an NCPA program powered by CPESN in partnership with GamePlan as the CMS ACCESS participant, everyone leverages their expertise to deliver the outcome together.
Dispense Times: This is a ten-year service model. What is the long-term vision, and is it the future you imagined when you started?
Amina Abubakar: This is what we have always wanted. We have talked about payment reform for years, and now Medicare is saying it will pay those who deliver outcomes. Through ACCESS, Medicare can look at each participant and see that this kind of collaborative care produced results. The real question is whether this finally puts us in the right seat to have the payment reform conversation.
Joe Moose: The analogy I use is your car. Do you take it to the mechanic to get it worked on, or to get it fixed? You want to pay someone to fix it, not just to spend time on it. CMS is waking up to that. It is starting to treat this as an investment rather than a bill to pay. I was just on a CMS call about rural health, and the same theme came up. You could pay a mail order operation to get a pill to a rural patient, but if that is not your cost driver, why incentivize it instead of someone who can actually reduce the cost drivers? This is a decades-old model they are breaking, so it will not change overnight, but pharmacies should notice that much of Medicare’s real innovation is happening in straight Medicare, through programs like ACCESS, and not only in Medicare Advantage.
Dispense Times: If a pharmacy wants to get involved or learn more, what is the first step?
Amina Abubakar: Make sure you are part of CPESN or NCPA, or both. These organizations are pouring resources into helping you succeed, from infrastructure to coaching to workflow advancement. You do not want to go it alone. Their motive is for you to stay in business. This is not private equity trying to build value off your membership. The whole ten-year CPESN journey happened because pharmacists believed in it and joined, and that is what made the resources possible.
Joe Moose: You do not want to do all the work only to make someone else look good, other than the patient. If you join NCPA and run the program under NCPA powered by CPESN, you get the shared learnings, and being a CPESN member puts that on steroids. You get best practice training, not just how to check the boxes but how to run the model so the outcomes and the finances both work and the pharmacy is sustainable. If you are not there yet, say you are not at 30 percent med sync, NCPA has a fellowship program built specifically around getting your pharmacy efficient at sync.
Amina Abubakar: The important thing is that the programs do not just give you ‘the what,’ they give you ‘the how.’ There is a guide inside the CPESN and NCPA resources. Whether you are starting from scratch or training new staff after turnover, the tools are there to bring you up to speed, and not at the owner’s expense.
ACCESS to Pharmacy Care provides a simple, scalable, and sustainable pathway for NCPA and CPESN community pharmacies to participate in the CMS ACCESS model. To learn more, visit accesstopharmacycare.org.
