Texas Pharmacists Primed to Play Critical Role in Rural Health Transformation, Benefiting Patients

Pharmacy Inclusion as Primary Point for Health Care Mirrors Administration Goals as Advocated by Dr. Mehmet Oz, CMS Administrator

Texas’ pharmacies are poised to play a critical role in the state’s Rural Health Transformation Program – a new initiative that promises states a portion of $50 billion in federal funding to transform rural health care by building sustainable systems that enhance patient care.

Noting this vital role, the Texas Pharmacy Association (TPA) has proposed that rural pharmacies be included in the state’s funding application to the Centers for Medicare & Medicaid Services (CMS). A funding decision from CMS is expected by the end of the year.

“Pharmacies are the most accessible health care point in rural and underserved communities throughout our state,” said Ben McNabb, an Eastland pharmacist and member of the TPA Board of Directors. “Through chronic disease management, patient education and medication reconciliation, we’re helping prevent costly hospital visits and keeping Texans healthier.”

Pharmacists, technicians, and other pharmacy staff are stepping up to become certified as community health workers. This move, coupled with the pharmacists’ front-line presence in communities statewide, positions Texas rural pharmacies to help patients navigate the health care ecosystem and receive the best support for their conditions.

Pharmacists and community health workers are already helping Texans prevent and manage chronic conditions, support behavioral health needs such as suicide and fentanyl awareness, and collaborate with other health care providers to strengthen the state’s rural health care safety net.

“We’re the ones who notice when someone’s voice sounds different, when a refill is missed or when a caregiver sounds exhausted,” said Brandi Chane, nurse, certified pharmacy technician, and pharmacy owner in Weatherford. “It’s those moments – the phone calls, the check-ins – that prevent unnecessary hospital visits. A call center can’t do what we do. Mail order definitely can’t do that. But a trusted pharmacist or community health worker, embedded in the community, can.”

Texas boasts the largest rural population in the nation, making the Rural Health Transformation Program funding especially vital. Approximately 12.3% of Texas’ 5,120 community pharmacies are located across 200 rural counties with populations under 68,000.

Further, Texas is seeing an alarming number of pharmacy closures, right now at one per week. TPA says the situation will be exacerbated by new, untenable contracts being pushed by Express Scripts, the pharmacy benefit manager that covers state employees, teachers and more. That contract will push many state employees and teachers into mail order pharmacy only and could lead to more pharmacy closures and pharmacy deserts.

Therefore, the funding from the federal program is a lifeline for Texas pharmacists, their patients and families, and the local communities these pharmacies serve.

In recent testimony to the Texas Health and Human Services Commission (HHSC), McNabb said, “With funding through the Rural Health Transformation Program, Texas pharmacies can be the front door to patient care in many rural areas, helping fill critical gaps in the health care system and when the nearest hospital can be hours away. Rural pharmacists are already providing community health interventions that prevent 911 calls, emergency visits and human suffering.”

Crystal McEntire, who owns Panhandle pharmacies in Shamrock and Wheeler, agreed, adding, “Rural pharmacies like mine can safely handle basic front-line health care needs like removing stitches so a patient doesn’t have to drive many miles to an ER and pay hundreds of dollars. This is precisely what leaders like Dr. Mehmet Oz at CMS have been highlighting: expanding front-line health care access in rural communities so neighbors can stay closer to home for routine, non-emergency care.”

According to HHSC, $50 billion will be distributed to all states with approved Rural Health Transformation Program applications between fiscal years 2026 and 2030. Of that, $10 billion will be distributed each fiscal year, and states may spend funds for up to two years after they are awarded.

While the amount of federal funding Texas might receive if its application is approved is unknown, the TPA says its members are prepared to support the state’s program.

“Integrating pharmacists into the Rural Health Transformation Program framework could lead to more preventive care for rural patients, which could reduce unnecessary emergency room visits and hospitalizations,” concluded Jason Davis, TPA President and a pharmacist in Boerne. “Texas pharmacists are poised to help create a patient-centered health care system for all rural Texans.”