CPESN® Community Pharmacy + Payer = Success

Here's a preview of the 100+ Payer video stories in this showcase. It features CPESN local pharmacies from coast to coast, in small towns and in the Bronx, from the Midwest to the Deep South delivering on more than 177 Payer contracts and raising the bar on quality. It's a story about scaling - learning from one success to build another for 41 national Payer contracts, and growing. Local. Quality. Scale.
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CPESN® Florida, MTM Program for Diabetes Patients

CPESN® Florida network facilitator Laura Rhodes shares her network's success contracting with a large commercial health plan to provide enhanced MTM services to patients taking medications for diabetes and hypertension (2:53).

CPESN® Indiana, Employer Program

CPESN® Indiana luminary JD Faulkner shares his network's success with a Pharmacy Benefit Managment company to deliver enhanced services to covered lives through the PBM's employer clients (2:27).

Health Dept., Kidney Fdtion. Fund COVID-19 Testing

CPESN® Hawaii pharmacist Courtney Elam shares her network's success working in partnership with the Hawaii Department of Health and the National Kidney Foundation to provide COVID-19 Testing (1:40).

CPESN® NC, Medicare MTM Program

CPESN® North Carolina pharmacist Tori Grooms shares her network's success with a large MCO through conducting patient outreach to complete Medication Therapy Managament reviews for health plan identified Medicare patients.

CPESN® Arkansas, Clinical Trial Referrals

CPESN® USA and Arkansas CPESN® board member Duane Jones shares his network's success providing patient identification and patient recruitment into clinical trials with RxE2 (5:00).

Leveraging Grants to Build Clincial Services

CPESN® New York Vice President Chris Daly shares his network's success being awarded a CDC 815 grant through the New York Department of Health to provide DSME services. All three CPESN NY networks are involved – Upstate NY, NYC, and Western New York, with 30 to 50 pharmacies participating at any time.
10 pharmacies are now accredited to hold their own diabetes classes and refer patients into those classes.

CPESN® West Virginia Nalox(ONE) Program

CPESN® West Virginia luminary Gretchen Garofoli describes that network's participation in Nalox(ONE) with grant funding through the West Virginia Drug Intervention Institute. Eight CPESN West Virginia pharmacies have opted into the program to counsel patients, provide disposal kits, and prescribe and dispense Naloxone based on risk screening. Pharmacies are reimbursed on a per patient encounter, and for follow-up patient calls made by pharmacy technicians

CPESN Hawaii® Home Health Vaccines

CPESN Hawaii® luminary Keri Oyadomari describes how pharmacies in that network provided In-home COVID-19 vaccines to more than ,000 small care homes, group homes, foster homes with 1 to 8 patients. The service was funded through a grant from the state department of health.

Holston Medical Group, Emergent ACO

A multi-state agreement with Holston Medical Group gives CPESN pharmacists new patient insights with access to patient Electronic Medical Records (EMRs) and direct communication with physicians on services they provide to referred patients. CPESN Northeast Tennessee initiated the relationship with HMG which has a presence in TN, VA, NC, SC. Its Emergent ACO also has presence in NE and parts of CA. The program was first rolled out to CPESN pharmacies in NE Tennessee and SW Virginia.

CPESN® Minnesota, Medicaid & Medicare

Medication Therapy Management (MTM) services are provided by CPESN Minnesota pharmacies to both Medical Assistance (Medicaid) and MinneaCare patients taking at least one prescription medication to manage a chronic condition. Reviews are conducted face-to-face or via telehealth.

CPESN® Hawaii, Brief Med Reviews 65+

Dayna Wong-Otis describes a brief medication review program for the 65+ population funded by Hawaii Medical Services Association (HMSA). Pharmacists look for age-inappropriate medications, duplications, interactions, and findings reported to patient’s primary care physician with recommendations.

CPESN® Colorado - Chronic Care Management

Dana Sadowski describes how a Colorado Department of Health grant has provided funding for CPESN Colorado pharmaies to become accredited and begin offering clinical services including Diabetes Self-Management Education (DSME) and blood pressure monitoring.

Luminary Perspective - The Payer Journey

CPESN® Missouri and USA luminary Tripp Logan describes how he connected the dots on backyard relationships to build a grant-winning partnership in this video highlighting patience and persistence in making the community pharmacy case for quality health service delivery, improved patient care, and overall lower costs.

CPESN® North Carolina, COVID-19 Vaccine Outreach Program

Joe Moose, CPESN North Carolina luminary, describes how pharmacists helped this large national MCO gather information from dually-eligible Medicare and Medicaid patients on their COVID-19 vaccination status, and understanding of their choices.

CPESN® Arkansas, Medication Therapy Management

50 CPESN Arkansas pharmacies participate in this large MCO contract to provide an inital Medication Therapy Management session with referred patients.

Improved Outcomes, HTN Monitoring Program

In partnership with the South Dakota Dept. of Health, CPESN® pharmacists provided blood pressure monitoring, met with patients regularly, and led clinical interventions engaging other health professionals. The results? High percentage of patients met BP goals, and the program has expanded from the initial focus on HTN to include cholesterol values and lipid levels for total cardiovascular risk management.

South Dakota CPESN® South Dakota Department of Health

Program for HTN is expanded in Year 3 to include cholesterol values and lipid levels for total cardiovascular risk management. The goal is through pharmacist-led intervention to lower the patient risk of heart attack or stroke.

CPESN® Pennsylvania Medicaid Medication Synchronization

Under a contract with a Medicaid MCO, 100 Pennyslvania Pharmacists Care Network - CPESN® Pennsylvania pharmacies engaged eligible patients to participate in Medication Synchronization services. The goal was to close HEDIS® identified gaps in care, using MedSync and documenting through eCare plans.

CPESN® Arkansas, Behavioral Health Med Adherence Program

CPESN® Arkansas pilot program to improve medication adherence in behavioral health patients. Pharmacists provided counseling on adherence to behavioral health medications, and conversion to long-acting anti-psychotic injectables for some patients.

CPESN® Virginia, Health Risk Assessments

This program under a contract with a large national health plan called for completion of health risk assessments for plan identified patients. Pharmacists and their support staff completed the HRAs in person and by telephone.

CPESN® Ohio, POC Testing for COVID-19

A partnership beween CPESN Ohio and Ohio-based Mobility Health supported network pharmacies in providing PCR COVID-19 testing.

CPESN® Mississippi, Medicaid Diabetes Care

In its first statewide payer program with a Medicaid MCO, 53 of 58 CPESN Missisippi pharmacies had patients eligible for pharmacist-led intervientions for diabetes patients.


CPESN® Upstate New York Health Screenings

John Croce, CPESN Upstate New York Managing Network Facilitator, describes a six-month health screening program and survey of social determinants of health. Referrals are made to healthcare teams for needed services.

South Dakota CPESN® Medicare Remote Monitoring

Josh Orhtman with South Dakota CPESN describes a pilot program for remote monitoring for Medicare beneficiaries. Patients heart failure, diabetes, hypertension receive blood pressure monitors, scales, diabetic testing supplies. Pharmacies and physician teams receive health status readings via cellular signals from the patients' in-home monitoring devices.




CPESN® Ohio, Medicaid MCO Program

This multi-state contract with a Medicaid MCO covers Medicaid patients living in Ohio and Indiana. Network pharmacies provided Comprehensive Medical Reviews and targeted interventions.

CPESN® Iowa, Care Plans

Network pharmacists submit monthly care plans for this MCO's member taking Asthma, COPD, Opioids, or Behavioral Health medications.

CPESN® NYC Population Health Program

CPESN NYC pharmacists work with Medicare Part D patients to increase adherence rates for statins, oral diabetic drugs, and HTN medications under this contract with a statewide health insurer.

CPESN® Massachusetts, Community-Based Healthcare System

Todd Brown describes how CPESN Massachusetts pharmacists work with a large community-based healthcare system to close identified gaps in care, provide medication sychronication, and adherence support to Medicaid dually-eligible and Medicare patients.

CPESN® Kansas, MTM Program

Renee Price describes a Medication Therapy Management program with a statewide managed Medicaid program where network pharmacies worked with care managers to improve patient health conditions. The program started with 5 to 10 pilot stores in Kansas, and added two to three pharmacies monthly.

CPESN® Mississippi, Medicare Advantage Plan

Under renewal of this contract with a Medicare Advantage Plan, 58 CPESN Mississippi pharmacies provide diabetes monitoring and management including A1c testing to establish a base level, counseling to help patients with an A1c >9, bring it under 9%, and make referrals for annual retinal eye exams.