Payer Solutions

CPESN® pharmacies are clinically integrated, performance based, and willing to be held accountable.

Value contracting is made easy for Payers, Partners, and Purchasers with a single agreement covering 49 networks of more than 3,500 independent community pharmacies in 44 states. Download our Value-Based Contracting Framework here.

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Amina Abubakar, Pharmacist/Owner, Avant Pharmacy and Wellness - CPESN® North Carolina Luminary

Amina Abubakar

Pharmacist/Owner, Avant Pharmacy and Wellness - CPESN® North Carolina Luminary

CPESN Pharmacies provide enhanced patient care
services that go beyond medication dispensing to:

  • Collaborate with other health providers to identify and close care gaps
  • Identify at-risk patients, respond with pharmacist-led interventions
  • Provide informed medication management and optimization 
Miki Bowen, Medication Mgmt. Pharmacy Tech. (left), Michelle Farrell, Owner Boscobel Pharmacy - CPESN® Wisconsin Luminary
Miki Bowen, Medication Mgmt. Pharmacy Tech. (left), Michelle Farrell, Owner Boscobel Pharmacy - CPESN® Wisconsin Luminary

CPESN USA EngageRx® Services

  • Social determinants of health screenings
  • Health risk assessments
  • Pharmacy health status monitoring services
  • Point-of-Care testing
  • Immunizations
  • Comprehensive adherence programs
  • Care coordination
  • Medication therapy management
Nick Dziurkowski, Pharmacist/Owner The Pharmacy at Wellington, Little Rock CPESN® Arkansas
Nick Dziurkowski, Pharmacist/Owner The Pharmacy at Wellington, Little Rock CPESN® Arkansas

Solutions for Payers

Commerical insurers
Commerical Insurers

CPESN pharmacies provide individualized health services to commercial insurance plan members with a focus on keeping patients healthy and out of the hospital.

Medicaid
Medicaid

Medicaid programs in a growing number of states rely on CPESN pharmacies to reach patients managing challenging health issues. CPESN pharmacies focus on decreasing the cost of care, one patient at a time through increased access to effective care and health-risk reduction programs. For example, pharmacy services have increased medication adherence for behavioral health patients, resulting in improved overall health. 

Managed Care Organizations
Managed Care Organizations (MCOs)

CPESN pharmacies support Medicaid MCOs by assisting with HEDIS gap closures including Asthma Medication Ration (AMR), Controlling High Blood Pressure (CBP), Statin Therapy for Patients with Diabetes (SPD), Hemoglobin A1c Control for Patients with Diabetes (HBD), and more. Pharmacies are also a point of connection for patients to be referred to plan resources and/or primary care when needed. 

Medicare
Medicare

CPESN pharmacies focus on quality and reduction in total cost of care through high-touch patient care services. CPESN pharmacists work with Medicare plans across the country to improve medication utilization through adherence programs, medication therapy management services, and management of patients with chronic conditions.

CPESN Pharmacies Provide Enhanced Patient Care Services That Go Far Beyond Medication Dispensing

CSEPN Flow Chart
CSEPN Flow Chart

Solutions for Partners

Healthcare Systems
Healthcare Systems

CPESN pharmacies work with health systems to provide transitions-of-care support through medication reconciliation services, and ongoing pharmacy support such as adherence packaging and home delivery. Ongoing patient monitoring services, data sharing, and collaboration with the full health team improves patient outcomes.

ACOs
ACOs

CPESN pharmacies are uniquely positioned to assist practices in value-based care models in achieving success in medication-related quality measures, including STAR ratings. Services delivered in partnership with ACOs include medication compliance, medication synchronization, adherence packaging, and cost containment recommendations.

Physician Practices
Physician Practices

Building on trusted community alliances with physicians, CPESN pharmacists integrate clinical services to medical practices including chronic care management, diabetes education and support, disease screenings, annual wellness visits, and medication reviews.

Grant-Funded Programs & Demonstration Projects
Grant-Funded Programs & Demonstration Projects

Grant funding in partnership with state health departments and CPESN local networks support pharmacist services in health population management and disease risk intervention programs.

Solutions for Purchasers

Medicare

Medicare

CPESN pharmacies participate in value-based care models to achieve success in medication-related quality measures, including STAR ratings. CPESN pharmacists provide comprehensive medication reviews and medication reconciliation services at transitions of care to reduce readmissions.

Self-Insured Employers

Self-Insured Employers

CPESN pharmacies work directly with self-insured employers to deliver chronic disease screening, education, and prevention programs that result in increased employee productivity, lower absenteeism, decreased hospital and ER visits, and overall lower cost of care.

Health Departments

Health Departments

Through partnership programs with state health departments, CPESN community-based pharmacies are recognized as valuable partners in chronic disease management.