By 2030, an estimated 24 million Americans will need long-term care, yet access to traditional long-term care services remains limited.¹ Many older adults who need support would prefer to continue living at home, but managing complex medication needs outside of a facility can create significant challenges for patients, caregivers, and providers.

That’s where independent pharmacies can play a bigger role. As demand for care-at-home services grows, pharmacies have an opportunity to support medication access, adherence, packaging, delivery, care coordination, and reimbursement in new ways. 

Overview: Rural pharmacies focused on expanding care

Matthew and Holly Tanner own three independent pharmacies serving rural communities across Georgia: Morris Drug Company in Pearson, Browning’s Pharmacy in Waycross, and Magnolia Drug Company in Homerville. Across those locations, the Tanners have built a patient-centered pharmacy model focused on meeting the needs of communities where access, relationships, and dependable local care matter.

Matthew and Holly have expanded services to include delivery, vaccinations, health screenings, medication therapy management, medication packaging, long-term care at home, and other care-focused offerings across all three of their locations. 

As reimbursement pressure continued to challenge independent pharmacy profitability, Matthew and Holly worked with John Duffy, their Good Neighbor Pharmacy business coach, to evaluate long-term care at home, as a strategy to strengthen margins, formalize services their teams were already providing, and continue expanding care in rural Georgia.

The challenge: Reimbursement pressure created a need for new margin opportunities

Like many independent pharmacy owners, Matthew was facing a familiar but difficult reality: declining reimbursement and sustained gross margin pressure. 

Through financial reviews, business coach, John Duffy helped Matthew and Holly evaluate performance across their three stores, identify gross margin gaps, and compare their stores against one another as well as broader benchmarks. That financial visibility helped frame long-term care at home, not simply as a new service, but as a potential margin-improvement strategy.

At the same time, the Tanners were already providing many services associated with long-term care at home, including medication packaging and delivery. The challenge did not start from scratch. It was determining how to structure existing work in a way that supports patient care and business performance.

As Matthew explained, “The foundation is already there for the program. We were already packaging medications for people and delivering medications for people. So, if you’re already kind of doing the work, you might as well try to possibly get paid for it.”

The opportunity: Long-term care at home, aligned with services already in place

Long-term care at home made strategic sense because it aligned with the Tanners’ existing services and their commitment to relationship-based care. In rural communities, independent pharmacies often play a critical role in supporting patients who need additional help with medication adherence, coordination, packaging, and delivery.

Browning’s Pharmacy in Waycross was the natural place to begin. The location was already serving an assisted living home and packaging medications for approximately 20 patients, giving Matthew and his team an immediate patient base to test the long-term care at home, model, understand requirements, and refine workflows before expanding to Morris Drug Company and Magnolia Drug Company.

Matthew also saw long-term care at home to deepen patient relationships and create a future growth path with small homes and assisted living facilities. In his view, the model gave the pharmacies “another arrow in that patient care quiver” while reinforcing the value independent pharmacies bring to patients who may not receive the same level of individualized support from larger retail chains. 

The action: Business coaching helped turn strategy into execution

John Duffy’s coaching helped turn the long-term care at home concept into an actionable business strategy. He helped Matthew and Holly connect the program to broader margin improvement efforts, including payer mix awareness, cash pricing discipline, and patient-level opportunity analysis.

John also showed the Tanners where to find and how to filter the long-term care at home, report in the AB Solutions Portal by plan and PBM. That reporting helped them better understand which plans could provide stronger opportunities and where shifting appropriate patients from retail to long-term care at home could be more profitable.

Just as importantly, John reinforced a practical execution cadence: convert two to three appropriate patients per week and continue evaluating payer mix as part of the broader margin strategy. This helped keep the work focused, measurable, and manageable across three locations.

Operationally, Matthew initially took on much of the implementation work himself so he could understand CMS compliance requirements and build a strong foundation. Once the process was established, he delegated responsibilities at the store level. Staff pharmacists helped identify patients who were strong long-term care at home, while lead technicians managed organization, packaging timing, and paperwork.

The business impact: A data-guided approach improved margins and conversion momentum

The Tanners began seeing positive business indicators after implementing long-term care at home, especially at Browning’s Medical Arts Pharmacy, which remained the location with the largest long-term care at home, patient base. Matthew noted that Browning’s saw an initial uptick in gross margin after implementation. 

Outcome: A repeatable growth model for independent pharmacy

For Matthew and Holly, long-term care at home, became more than a new service line. It became a repeatable framework for expanding care across three rural Georgia pharmacies while supporting margin improvement. Their approach combined existing patient relationships, operational readiness, financial analysis, reporting tools, and business coaching from John Duffy.

Matthew said implementing any new service across three stores comes with challenges, but he is proud that the team was willing to take the risk, put in the effort, and make the model work. His advice to other independent pharmacy owners is to research requirements, evaluate patient data, understand payer mix, stay organized, and build a process that the whole team understands.

For pharmacies already providing medication packaging, delivery, or support for small homes and assisted living communities, long-term care at home can be a smart growth strategy when supported by the right data and guidance.