The University of Tennessee Health Sciences College of Pharmacy’s PGY-1 Community-Based Residency Program, in collaboration with Kroger Health, has developed a successful model for expanding access to A1C testing in community pharmacies.
A pilot study conducted by the residency program and Kroger Health, completed in May 2026, found standardized A1C testing in community pharmacies improved access to screening while increasing patient engagement and satisfaction.
The project focused on integrating A1C testing, a key screening and monitoring tool for diabetes, into community pharmacies’ workflows to improve consistency, accessibility and patient engagement in diabetic care. Select stores in Kroger’s Nashville Division, covering the Nashville area, middle Tennessee, Knoxville, northern Alabama, and parts of southern Kentucky, served as the study’s pilot program.
The results of the study prompted Kroger to expand the program to more than 90 pharmacies across the region.
The initiative was also selected by the American Pharmacists Association (APhA) Foundation for an incentive grant, marking the sixth consecutive year the residency program has received one, reinforcing its leadership in community-based pharmacy innovation.
“We are not trying to replace doctors or other medical workers,” said Ken Hohmeier, PharmD, director of the PGY-1 Community-Based Pharmacy Residency Program. “Instead, we are trying to show how pharmacists can be a key part of the healthcare team to improve health outcomes in long-term managed diseases.”
Community-Based Pharmacy Residency at UT Health Sciences
The PGY-1 Community-Based Pharmacy Residency at UT Health Sciences is among the nation’s oldest accredited programs and is recognized for leadership in community pharmacy education.
Residents collaborate on clinical projects, spending about two-thirds of their time on direct patient care and the remainder on project work, which often results in peer-reviewed publications. Leadership development is integral to the program, preparing residents for advanced roles to address health disparities in both rural and urban areas.
Residency and Kroger leadership report significant gains in residents’ confidence, clinical decision-making and patient communication. These skills directly contribute to the expansion of clinical programs and to residents’ professional development.
Improving Access to A1C Testing
A1C testing, a simple blood test that measures average blood sugar levels over the past two to three months, is important for managing and diagnosing prediabetes and diabetes. In the short term, A1C testing improves adherence to guidelines and improves blood sugar control; in the long term, it reduces the risk of heart disease, stroke and diabetes-related complications such as neuropathy and kidney disease.
Improving access to A1C testing is crucial in Tennessee, where more than 812,000 residents, 14.6% of adults, have diabetes, exceeding the national median and underscoring the need for more accessible, community-based care.
While traditionally performed at medical offices, time constraints and limited physician availability can hamper consistent testing in some communities. Community pharmacies, with convenient locations and an expanding role in clinical services, uniquely offer patients improved access to routine monitoring and preventive care.
From Pilot Program to Scalable Model
The initiative began in early 2026 at 27 Kroger pharmacy locations in the Nashville Division. Using an evidence-based approach, it integrated A1C testing into daily pharmacy workflows, setting the stage for wider adoption.
Participating Kroger pharmacists were able to easily and efficiently collect A1C samples, use point-of-care devices for testing, counsel patients, and share results with physicians, all covered by insurance.
Previously, training and testing tools were only available at some pharmacies in the division, and workflow challenges and conflicting priorities regularly hampered testing efforts. Additional barriers included inconsistent testing availability and limited accessibility.
The study aimed to address these issues at selected Kroger stores by improving patient access and insurance coverage for specific plans and populations. This also allowed evaluation of other factors influencing implementation and consistency.
“This effort creates a win‑win for every stakeholder involved.”
Dr. Ken Hohmeier
The study conducted from January to April 2026 demonstrated full readiness and participation, as all 27 Kroger pharmacy locations completed training before the program launched. Every site with eligible patients offered the A1C service, and pharmacists documented outreach for 94% of identified patient opportunities. Seven patients assessed as needing the service received on-site A1C testing, and all reported high satisfaction, citing the convenience of integrating testing with routine shopping and receiving immediate results. These outcomes illustrate the program’s effectiveness in training staff, providing services, and achieving high patient satisfaction.
Together, these results show that A1C testing can be successfully integrated into community pharmacy workflows at scale, leading to increased patient access, efficient service delivery and high patient satisfaction, all without disrupting daily pharmacy operations. This approach improves access to vital testing in communities with the greatest need.
“What energizes me most is that this effort creates a win‑win for every stakeholder involved,” Dr. Hohmeier said. “Physicians and patients benefit, and insurers are eager to collaborate because community pharmacies offer both clinical expertise and unmatched accessibility. But for this to make a real impact, it must be delivered at scale, not in a few pharmacies, but across many. This project is a critical step in demonstrating that we can scale a new clinical service in a way that expands access and supports patients, all while keeping the pharmacy team’s workload manageable.”
More information about the PGY-1 Community-Based Pharmacy Residency Program is available at uthsc.edu/cprp.