We’re not the local SDoH solution expert in your town. Neither is the Health Plan or the PBM. YOU ARE!

Getting Paid for Social Determinants of Health Services

CPESN Health Equity is the first special purpose network introduced by CPESN USA to help participating community pharmacies increase revenue, maintain cashflow, and further entrench their local presence. Aggregating health equity initiatives across local networks establishes community pharmacy's collective expertise in Social Determinants of Health service as the value-based marketplace matures.

Watch this short video to learn how CPESN Health Equity workforce training helps Community Health Workers address health literacy and expand patient access to pharmacy care.

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Bonnie Scheffer, Lead CHW, L&S Pharmacies, CPESN® Missouri
Bonnie Scheffer, Lead CHW, L&S Pharmacies, CPESN® Missouri

While pharmacy-based health equity outreach was initially grant-funded, state Medicaid plans and payers are adding services to their reimbursement models. For example, some Medicare Advantage plans pay for pest control for enrolled members. Why? Because the $50/month of pest control is cheaper than a $50,000 COPD hospitalization resulting from cockroach allergens. CMS added a “Health Equity Index” that allows higher payments to providers that address health related disparities – food insecurity, loneliness, access to care. CPESN pharmacies and their support staffs address health-related disparity issues today, identifying community resources, and making referrals, and providing informal counseling. 

Managing Network Facilitators for local CPESN networks are encouraged to invite CPESN Health Equity MNF Jake Galdo to a chapter meeting to tell them more about the health equity revenue opportunity. 

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CPESN Health Equity

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Cost: $25 / month

Benefits:

  • Annual subscription to the Choose My Pharmacy value-based quality reporting system, with annual quality improvement initiatives
  • Four (4) hours of Social Determinants of Health Continuing Pharmacy Education for all CPESN Health Equity affiliate pharmacists and staff to create marketable in-pharmacy Social Determinants of Health specialists
  • State-based Community Health Worker development and best practice support
  • Aggregation and convening of pharmacy health equity experts for collective value expression 
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Minimum Standards

  • CPESN USA member in good standing and affiliated with a local network
  • Participation in the Choose My Pharmacy value-based quality reporting system (quarterly data upload)
  • Minimum of one team member at each CPESN Health Equity pharmacy completes the annual 4-hour Social Determinants of Health Continuing Pharmacy Education
  • Obtain and maintain a Community Health Worker within 18 months

Health Equity

Your Secondary CPESN Chapter affiliate focused on helping you get paid for local Social Determinants of Heath service delivery. CPESN Health Equity readies your pharmacy to address the growing health inequity crisis.

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