Design of value-based payments for pharmacist services: a scoping review

This scoping review aimed to summarize published studies on the implementation of value-based payment (VBP) models for non-dispensing services provided by pharmacists in hospital or community settings for any population.

We searched PubMed, Web of Science, and ProQuest for studies published between 2005 and March 2025. Studies were included if they described and/or evaluated VBP for services provided by pharmacists in hospital or community settings. Studies were screened and selected by at least two authors. Narrative synthesis was conducted.

Search strategies yielded 976 references, 17 of which were included: 7 studies on VBP model implementation, 4 studies on proposed VBP, and 6 studies on stakeholders' perceptions of VBP. The majority of identified studies had observational designs and were conducted in the U.S. The payment methods included pay-for-performance, performance-based capitated payments, shared risk, and bundled payments. The payment mechanisms were: tiered thresholds, where incentives are paid for meeting a series of target performance levels, and absolute incentives, which are paid as a single amount for an absolute increase in performance. Details concerning the payment structure were limited. Several barriers to implementation of VBP models were identified: constraints on time, the complexity of documentation and billing, inadequate infrastructure impeding clinical and performance data sharing, and the continued lack of recognition of pharmacists as health care providers.

Pharmacist-led VBP models are emerging, but replicating VBP in new settings is limited by poor transparency. Success requires addressing infrastructure gaps, documentation complexity, and formal provider recognition to facilitate effective scaling.