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.
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. In 2024, CMS is adding a “Health Equity Index” that will allow 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.
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.Contact Us