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The good news is that Americans are living longer than ever, with an average life expectancy of 78.4 years. But the not-so-good news is that the golden years aren’t so golden for everyone. Instead, the U.S. faces a “crisis” in meeting the specialized services and needs of elderly Americans, needs that include long-term care (LTC), pharmaceutical services, chronic care management, clinical services, medication therapy, medication coverage, and patient engagement, to name a few. LTC pharmacy services, for example, are often disrupted by a lack of cohesion among caregivers, due largely to reliance on siloed technology systems that don’t “talk” to each other and block critical information exchange.
The situation is changing, though, and in a good way. Technology solutions, including the PrimeRx pharmacy management system, are providing essential capabilities that allow LTC pharmacies to more efficiently serve patients, thereby improving health outcomes and overall quality of life.
Table of Contents
- Why Are Long-Term Care Pharmacy Services So Complex Today?
- How Do Long-Term Care Pharmacy Services Support Better Outcomes?
- What Operational Challenges Do LTC Pharmacies Face Behind The Scenes?
- How Can Technology Streamline Long-Term Care Pharmacy Services?
- What Does The Future Of LTC Pharmacy Services Look Like?
Why Are Long-Term Care Pharmacy Services So Complex Today?
According to the U.S. Census Bureau, America’s 65-and-over population is expected to nearly double over the next three decades, from 48 million to 88 million by 2050. The aging of the population comes at a cost, though, with KFF reporting that older Americans account for 38% of total health care spending, while representing just 18% of the total population.
The Burden of Chronic Conditions and Polypharmacy
There are many reasons for this. The Centers for Disease Control (CDC) reports that nearly 80% of elderly patients experience multiple (more than two) chronic conditions, while 90% experience at least one. CDC’s list of chronic conditions includes obesity, high blood pressure, arthritis and high blood pressure, among others. Elderly patients are also at heightened risk for cancer, heart disease, and diabetes, and likely to suffer from depression and other mental health conditions.
It’s not surprising, then, that older Americans tend to take multiple medications. According to the CDC, roughly one-third of Americans in their 60s and 70s meet the classic definition of “polypharmacy,” which refers to the use of five or more prescription drugs. Use of multiple medicines, though, can put patients at risk of overmedication with consequences that can include sedation, increased risk for falls and side effects, and reduced effectiveness.
Rising Demand for Long-Term Care Facilities
The aging population has fueled demand for long-term care facilities, including assisted living facilities, nursing homes, rehabilitation centers, and, as patients seek to remain in their personal homes, for visiting nurses and other types of home assistance. Integral to ensuring timely, accurate access to medications, pharmacies play a critical role in the nation’s long-term care ecosystem.
Open vs. Closed LTC Pharmacies
Long-term care pharmacies generally fall into two categories: “open” and “closed” facilities. Open pharmacies operate similarly to retail pharmacies, serving both the general public and community, along with nearby long-term care facilities. Closed pharmacies, by contrast, operate exclusively in service long-term care settings and are not accessible to the general public. Regardless of which category a facility falls under, all long-term care pharmacies face unique responsibilities and requirements.
How LTC Pharmacies Differ from Retail Pharmacies
Unlike retail pharmacies, LTC pharmacies are not open to the public and do not sell convenience items. With no ancillary income streams, they rely solely on revenue from dispensing prescriptions and providing consultative services. LTC pharmacies also carry higher operational costs, driven by the extensive legal and regulatory mandates they must meet.
Dispensing practices differ significantly as well. In a retail setting, medications are provided directly to patients once payer coverage is confirmed. LTC pharmacies, however, must coordinate across multiple stakeholders (facilities, healthcare providers, and payers) to review each prescription, cross-check existing medications, verify coverage, ensure medication accuracy, and meet rigorous packaging and delivery requirements.
To address these demands, LTC pharmacies adopt specialized workflows, dispensing priorities, compliance protocols, and patient management procedures. Since their needs differ so substantially from those of retail pharmacies, it follows that they require pharmacy management solutions built specifically for their environment.
How Do Long-Term Care Pharmacy Services Support Better Outcomes?
LTC pharmacists have increasingly assumed responsibilities that go far beyond dispensing, expanding the scope of care provided to patients. Essential services typically include:
- Medication Therapy Management.
- Medicare patients are eligible to receive medication therapy services, as are non-Medicare beneficiaries who meet conditions including polypharmacy, recent transition of care, and patients under the care of more than one prescriber.
- Drug Regime Reviews.
- Residents of long-term care facilities are required to undergo a monthly review of all medications.
- Comprehensive Facility Records.
- Long-term pharmacies have the added responsibility of producing monthly reports for each facility they service, detailing all medications dispensed along with pricing and claims records, and an overview of all patient services provided.
- Consultative Services.
- Patients rely on LTC pharmacists as a resource in understanding their conditions and explaining medications and potential side effects, among other services.
- Clinical Services.
- LTC pharmacies may offer immunizations, screenings, weight loss/smoking cessation clinics, and other types of clinical services.
- Legal and Regulatory Compliance.
- Pharmacies must comply with multiple legal and regulatory mandates. This includes detailed packaging and labeling requirements to reduce potential medication errors; Medicare and Medicaid regulations; controlled substance reporting requirements; patient management and drug regimen records, coverage verification, and state licensing requirements.
What Operational Challenges Do LTC Pharmacies Face Behind The Scenes?
In addition to the unique patient services inherent to LTC pharmacies, owners face multiple business realities, foremost of which is the cost of dispensing. According to the Senior Care Pharmacy Coalition (SCPC), the average dispensing cost for LTC pharmacies is $14.98 per prescription, more than double the rate of other pharmacies. Despite this, LTC pharmacies are reimbursed an average of one-third of that amount, making it increasingly difficult to deliver cost effective care.
LTC pharmacies are also poised for a financial hit as a result of the Medicare Drug Price Negotiation Program (MDPN), which took effect in 2026. The program reduces the cost of certain medications for Medicare Part D beneficiaries and directs that pharmacies be “made whole” through a combination of payer reimbursements and manufacturer refunds. However, as SCPC advises, of the 10 medications included in the 2026 program, LTC patients rely heavily on eight. “Applying new Medicare Part D negotiated prices on LTC pharmacies will result in an unsustainable 27.5% loss for delivering their essential services.”
Beyond these serious financial realities, LTC pharmacies operate in an environment in which multiple stakeholders (prescribers, caregivers, facilities, and payers) all have an important role to play. But unless team members can share information and update patient records, patients are at risk of receiving conflicting or outdated information or worse, of a medication error.
How Can Technology Streamline Long-Term Care Pharmacy Services?
LTC pharmacies can look to technology for solutions to address their unique needs. PrimeRx, for example, offers comprehensive pharmacy management capabilities, including extensive LTC functionality, that operate within a single integrated platform. Important LTC capabilities include:
- Automation of all pharmacy workflows, including cycle fills, batch processing, and multi-facility scheduling.
- Electronic Medication Administration Record (eMAR) creation and management, including the ability to share with patient healthcare teams.
- Dispensing efficiency.
- Compounding management.
- Medication Therapy Management
- Patient education materials.
- Packaging and labeling.
- Data-based analysis and report generation.
- Compliance capabilities, including requirements for immunization reporting registries, accreditation, CMS dosage, patient chart reviews, and regular medication reviews.
- Transmission of electronic records/messages in real time with the patient care team providers.
What Does The Future Of LTC Pharmacy Services Look Like?
In looking ahead, it can be useful to learn from the past. A 2025 review of LTC pharmacy practices reveals an industry beset by problems that continually drain resources – both in terms of staff efficiency and bottom-line profits. But with the right technology in place, pharmacies can deliver greater value and the lessons of 2025 don’t have to repeat themselves. Instead, a technology-based solution can lead to a more stable, sustainable way forward for long-term pharmacy services.
FAQs
Are long-term care pharmacy services different from retail pharmacy services?
Yes, they are specialized to support seniors, facilities, and complex medication regimens.
Do long-term care pharmacy services help reduce medication errors?
Yes, they use clinical reviews, interaction checks, and coordinated workflows to improve safety.
Can pharmacy software support LTC regulatory compliance?
Yes, modern platforms include built-in compliance and documentation tools.
Are long-term care pharmacy services used in assisted living facilities?
Yes, they commonly support assisted living and other long-term care facilities.
Is technology essential for scaling LTC pharmacy services?
Yes, integrated systems are critical for efficiency, accuracy, and growth.