Introduction to ACCESS to Pharmacy Care
An NCPA program, powered by CPESN, in partnership with GamePlan Medical.
A practical enrollment pathway for pharmacies ready to build on trusted patient relationships, med sync workflows, and chronic care follow-up — with training, implementation resources, and support designed to help your team get started.
Start Here: Is ACCESS a Good Fit for Your Pharmacy?
This page is intended for pharmacies that are not yet enrolled. In about 15 minutes, pharmacy owners, managers, and clinical leads can understand the ACCESS model, review basic enrollment expectations, and decide whether to move forward with enrollment readiness steps.
Program Overview: Is ACCESS Right for Your Pharmacy?
ACCESS to Pharmacy Care helps community pharmacies participate in CMS ACCESS by connecting pharmacy-based chronic care workflows with GamePlan Medical, the CMS ACCESS participant. The program is designed for pharmacies that want to build on existing patient relationships, med sync or appointment-based model workflows, adherence support, care coordination, and follow-up.
- Identify Original Medicare patients who may qualify for chronic care support.
- Use med sync or ABM touchpoints to support ongoing care.
- Assign a clinical lead and complete required training after enrollment.
- Confirm patient fit before submission.
- Obtain consent and support eligibility/alignment steps.
- Collect required baseline measures and document follow-up care.
- Your med sync readiness or transformation pathway.
- Your team has capacity to start with a small number of high-feasibility patients.
- Your pharmacy can follow program documentation and training expectations.
Choose the Right Resource for Where You Are
You do not need to watch every webinar before deciding whether ACCESS may be right for your pharmacy. Use the guide below to choose the most relevant resource for your current question.
Best if your team is new to ACCESS and needs the program model, why community pharmacy fits, care tracks, high-level payment concepts, and basic workflow.
Best if you are evaluating enrollment requirements, med sync threshold readiness, patient pre-qualification, consent, alignment, track criteria, and baseline windows.
Best if your pharmacy is preparing to choose first patients, confirm baseline feasibility, operationalize workflow, avoid common pitfalls, and document follow-up care.
Payment Model Details: Where to Review the Latest Information
Payment information is reviewed in more detail in the Intermediate webinar, especially slides 6 and 7, which walk through the ACCESS to Pharmacy Care payment model for both patients not at goal and patients already at goal when aligned.
The Beginner webinar introduced early payment concepts at a higher level, but that information was shared before agreements were finalized and did not include the at-goal patient payment model. For the most current payment overview, pharmacies should refer to the Intermediate webinar payment slides.
Pharmacy Requirements to Enroll
Before enrollment, confirm your pharmacy can meet the core ACCESS readiness expectations below. Pharmacies that do not currently meet the med sync threshold may still have a pathway through qualifying transformation efforts.
Calculate Your Med Sync Percentage
Use either calculation method below to determine whether your pharmacy meets the 30% med sync threshold.
Number of prescriptions in sync ÷ total prescriptions over the past 100 days.
Number of patients in sync ÷ total patients with fills over the past 100 days.
Option 1 is typically easier. Use the guide for step-by-step calculation support.
Use Your Result to Determine the Enrollment Pathway
After calculating your med sync percentage, use the threshold guide below to determine whether your pharmacy meets the requirement or needs to complete a qualifying transformation effort before moving forward.
≥30% Med Sync
Pharmacy has achieved the 30% med sync threshold, and with NCPA membership or CPESN participation may move forward with ACCESS to Pharmacy Care Program enrollment.
Note: The NCPA Program Gateway to enroll is expected to be available in Late-August.
Does Not Meet 30% Med Sync Threshold
If a pharmacy does not meet the med sync threshold, there are options to achieve qualifying transformation efforts based on med sync percentage. Pharmacy must achieve one of the options to move forward with program enrollment.
Needs Improvement
Pharmacy does not yet meet the 30% med sync threshold, but may move forward by completing one qualifying transformation effort:
Use Flip the Pharmacy resources to support workflow changes and strengthen med sync performance.
Explore FtP Med Sync ResourcesFtP eBook Guide for ACCESS
Needs Significant Improvement
Pharmacy does not yet meet the 30% med sync threshold and will need a more substantial qualifying transformation effort before moving forward:
Use Flip the Pharmacy resources to support workflow rebuilding and strengthen med sync performance.
Explore FtP Med Sync ResourcesFtP eBook Guide for ACCESS
What Happens After Your Pharmacy Enrolls?
Once enrollment is processed, your pharmacy will receive an email with next steps and the tools needed to begin onboarding, training, and implementation planning.
Open the Training Center
Training Center details are provided on Tuesdays via email after enrollments are completed. This process starts in Late-August.
Complete Required Modules
Required modules are available to pharmacies after enrollment and must be completed prior to receiving patient lists.
Use Implementation Resources
Implementation resources are available to pharmacies after enrollment along with the required training modules.