Healthcare leaders are spending a lot of time on artificial intelligence, digital transformation and interoperability, yet a recent summit of chief pharmacy officers highlighted a different priority: alignment across the system.
Alignment emerges as the core obstacle
Participants at the TPG Chief Pharmacy Officer Summit, which gathered chief pharmacy officers, health‑plan executives, health‑system leaders and technology innovators, reported that the biggest challenge is not a lack of tools but a mismatch of incentives. Despite rapid adoption of AI, expanding digital health services and increasing data accessibility, patients still face a fragmented system and providers remain burdened by administrative tasks.
Consumers are reshaping expectations faster than health organizations can adapt. Patients now demand convenience, transparency, digital access and speed—attributes common to most services they use outside of health care. Companies such as Amazon Pharmacy and Lilly Direct are not merely adding new offerings; they are altering what patients expect from the entire care experience.
“Patients expect healthcare to function as one system. The industry still operates as many,” the summit’s summary noted. The disconnect between consumer expectations and the existing infrastructure, built around legacy reimbursement models and regulatory frameworks, is becoming harder to ignore.
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Pharmacy’s evolving role and reimbursement hurdles
Pharmacists, traditionally reimbursed for dispensing medications, are increasingly positioned to contribute to medication optimization, preventive care, chronic disease management and patient education. The capability exists, but the business model lags. Leaders repeatedly asked pharmacists to improve outcomes and support population health while working under reimbursement structures that often fail to recognize these contributions.
The broader issue extends beyond pharmacy. Incentive structures that reward individual activities rather than shared outcomes were evident in discussions about pharmacy benefit management, biosimilar adoption and formulary design. Health plans focus on affordability and risk, providers on clinical outcomes, pharmacies on access and adherence, and manufacturers on innovation. This siloed approach creates complexity that patients experience as confusion, delays and higher costs.
AI was a prominent topic at the summit. Organizations are exploring its use for prior authorization, clinical documentation, medication management, workflow automation, customer service, care coordination and predictive analytics. While AI can improve efficiency and support clinical decisions, participants agreed that it cannot fix a broken incentive structure. Technology may speed up existing processes, but it cannot resolve competing stakeholder priorities or eliminate fragmentation on its own.
Trust emerged as a recurring theme. Patients need to understand how decisions are made and believe that organizations act in their best interests. Without trust, reforms encounter resistance, technology adoption slows and broader transformation stalls.
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Looking ahead, the sector faces a paradox: an abundance of innovation paired with a shortage of alignment. Aligning payers with providers, reimbursement with outcomes, and technology with patient needs could reduce friction, simplify care and build the confidence required for lasting change.
While the summit emphasized the need for systemic alignment, the practical path forward remains uncertain. If organizations can restructure incentives to reward collaborative outcomes, they may unlock the potential of AI and digital tools that have so far been underutilized. Conversely, without such reforms, even the most advanced technologies risk being underused or misapplied.
In the short term, regulators and payers will likely play a major role in reshaping reimbursement models. Pilot programs that tie payments to measurable patient outcomes could provide early evidence of the benefits of alignment. Successful examples may encourage broader adoption across the sector.
The consensus among summit attendees is clear: the next chapter of health care will be defined not by which organization deploys AI first, but by who can bring together disparate incentives, simplify the patient journey and earn trust.
