McKesson ideaShare 2025: Micro-Access Pharmacies Expand Care Through Innovation, Technology, and Policy

As pharmacy deserts continue to challenge health equity, McKesson’s micro-access pharmacy initiative is helping close critical care gaps in underserved and rural communities. In this discussion, Niki Shah, MHSA, MBA, CCHW, and Raj Chhadua, PharmD, discuss how pharmacists are being supported with clinical, business, and technological tools to ensure long-term success. They also explore how telepharmacy, regulatory shifts, and collaborative care models are shaping the future of access, while offering key insights for pharmacists considering this emerging practice model.

Q: What kinds of clinical, business, or technological support do pharmacists receive through McKesson’s micro-access pharmacy initiative, and how does that support their long-term success?
Niki Shah, MHSA, MBA, CCHW: Well, first, the sites that are selected don’t have to use McKesson as their vendor. They can choose where they want to go—it’s free choice. But if they do need support, we have a large array of experts internally, ranging from 340B experts to the actual buildout and design of the pharmacy itself, technology support, and helping them get everything set up. We have all those resources internally. Our partners will ask us for different access to these resources, but it’s really up to each individual site because everybody’s on their own journey, and they’re in different points of maturity.

Q: How do you foresee telepharmacy and other virtual care technologies being integrated into the micro-access pharmacy framework, especially in remote or rural areas?
Raj Chhadua, PharmD: One thing—being in Texas—we have a lot of rural areas, and the biggest hurdle we have is the shortage. We have a provider shortage, and a lot of times pharmacists are filling that gap. But a lot of times when my peers look at this, they look at technology coming in as looking to actually replace a caregiver or provider. That’s not what this is. This is actually enhancing or extending the care of current pharmacists and pharmacies.

So the way we look at technology is more of a support system that wraps around my core pharmacy business and allows me to extend my pharmacy service access to areas that might not have it.

Shah: And I think one of the other things that we’re looking at, too, is in the communities where the pharmacy may be the only point of care—how do we incorporate more services into that pharmacy? We’ve been exploring different ways to embed specialty care in some of our pharmacies and expanding the breadth and depth of services provided in the pharmacy space.
Technology obviously plays a really big part in that. We’re exploring ways that are patient-centric but also support the pharmacist, so that they’re able to see more patients in a shorter amount of time and meet more of their needs in a more efficient way.

Q: What policy or regulatory changes have helped enable the growth of micro-access pharmacies, and what barriers still exist that need to be addressed?
Chhadua: One is the continued expansion allowing pharmacists to practice at the top of their license. We’ve seen regulatory changes that are supporting that. In addition, we see a lot of that in the FQHC space, where pharmacists are now able to really increase counseling, medication adherence, and care coordination.
State by state, it’s starting to expand. These policies help not only allow pharmacists to close gaps in care with a lot of our providers but also utilize technologies like remote patient monitoring to track digital biometrics. That not only helps care for the patient in real time, but also supports service-level improvements—like meeting long-term blood pressure or A1C goals.
Continued advancement in collaborative practice agreements also allows providers to have extended pharmacy services through a professional pharmacist using their abilities to support the team.

But I will say there are still areas where we need robust regulatory support for the 340B program, because these pharmacies in micro-fulfillment centers supporting FQHCs are truly doing what the 340B process and FQHC support were meant to do: support rural areas. We need more policies around that.

Q: What are some lessons learned from the initial implementation of micro-access pharmacies in Texas and Colorado, and how might these lessons inform future expansion?
Shah: Yeah, it’s been a really interesting journey with the six that we’ve selected. Each one had different state requirements. Each one was in a different spot in their level of maturity and understanding of pharmacy operations. Each one had a different model—including remote vending, all the way to a full-on pharmacy that was the only access point in their whole community—and everything in between.

It was really interesting to see where everybody started, and they’re all progressing well toward their openings. The lessons learned are really that the assumption is, because FQHCs are clinical providers, that they know how to do everything. In reality, pharmacy is a brand-new space for them, with a lot of regulations they had to navigate.

Giving them the option to work with McKesson experts and experts like Raj has been really helpful in helping them get their sites operational. As we continue to build on this and hope for additional sites, we now have a lot of great playbooks to share with future locations as well.

Q: For pharmacists interested in the micro-access pharmacy model, what advice would you give them about preparing for this unique practice model?
Chhadua: What I would encourage as a pharmacist and as an owner-operator: understand the 340B space very well, and the FQHC model. Identify the needs and priorities of not only that federally qualified health center, but the community in that area.

Once you’ve got that, aligning those needs with your pharmacy’s capabilities—and your own as a pharmacist—creates a meaningful, community-focused partnership and a higher level of success.

The other aspect is that federally qualified health centers truly are partners. The heart of their business is to take care of the community. A lot of times, they don’t know what they don’t know, and you’re bringing an entirely new aspect and expertise for them to be able to provide that service to their community.

Q: Is there anything you’d like to add?
Chhadua: I will add that McKesson has been a very good partner—and Niki—on taking this project from a pilot phase and expanding it into a really good program. If pharmacists are fearful or scared, they now have an avenue to work with their FQHCs and go to a partner like McKesson and ask, “How do I put this together?”