Success Stories

Strong engagement with patients diagnosed asthma or diabetes, and pediatric patients diagnosed with ADD/ADHD led to program renewal with Magnolia Health, the Medicaid MCO in Mississippi. Amy Catherine Baggett, managing network facilitator, says sharing patient impact testimonials and pharmacy results with the MCO also allowed expansion to include collecting HbA1c for diabetes patients.

Thao Doan, pharmacist/owner of Tu Quynh Pharmacy and a CPESN® New York City luminary, says her Vietnamese and Chinese patients benefit by using their Medicare OTC cards to purchase healthy food items and traditional health aids. As Medicare Advantage programs increase benefit amounts, patients can use the dollars to buy certain foods. Doan says focusing on what patients need and use helps them make the most of the benefits and adds revenue for her pharmacy.

Watch this short video to learn more about how CPESN USA's 3,500 pharmacies and 8,000 providers help health plans lower cost, while improving patient health outcomes. And see examples how payer programs are generating revenue for our pharmacies. Pharmacy owners collaborating with other pharmacy owners to generate new revenue streams.

Bob Lomenick, CPESN MIssissippi Lead Luminary and pharmacist/owner of Tyson Drugs in Holly Springs, MS, says his staff piggybacks care gap outreach with med sycn calls to schedule UHC HbA1c and blood pressure checks for Medicaid patients. He shares that and other tips in this short video. Other networks particpating in the gap closure program through Dec. 31 are CPESN Virginia, CPESN Florida, and Pennsylvania Pharmacists Care Network, the CPESN network in Pennsylvania.

Wyatt Walker, CPESN® Louisiana Managing Network Facilitator and pharmacist/owner at Walker's Drug Store in Livonia, LA, says administering COVID-19 at four nursing homes turned a profit of about $20K for his store. The vaccines were administerd under the CPESN partnership with Alliant Health Solutions, a Quality Improvement Organization.

Mariela Silva, a clinical pharmacist at Lino's Pharmacy, encourages other community pharmacies to consider having at least one staff member who can communicate in basic Spanish. The CPESN® Texas pharmacy is located near the Mexico border and serves a large Hispanic population. With Spanish as the second most common language in the U.S., Silva says there is opportunity for most pharmacies to engage their Hispanic patients which can help expand services.

Increased pharmacy engagement with a Medicaid MCO population is the goal for CPESN® North Carolina pharmacies participating in a renewed diabetes management program. Clinical services being provided under the contract med sync and other efforts to increase adherence, as well as regular monitoring of glucose levels. Laura Rhodes, Managing Network Facilitator, hopes the deeper patient engagement and refreshed data will lead to another renewal for 2025.

Dayna Wong-Otis, CPESN® Hawaii Managing Network Facilitator, describes the network's newest payer program with MDX Hawaii. Pharmacies on three of the Hawaiian islands will work with patients enrolled in Medicare Advantage programs to help close adherence gaps associated with STAR measures. The payer has already expressed interest in additional pharmacy services.

Vito Colombo, a first-generation Italian, is co-owner along with his pharmacist wife Elaine of Colombo's Pharmacy in Queens where they are members of CPESN New York City. Colombo says he learned from his father the value of greeting customers and making an effort to understand and speak their language. His Middle Village pharmacy is located in a walking neighborhood, rich in its ethnic mix of Italian, German, Irish, Albanian, Polish, and Spanish-speaking people. His tip for other CPESN pharmacists: Using Google Translate to help a customer feel comfortable and understood goes a long way in building trust.

Patient trust allows community pharmacists in Tennessee's two networks to complete Health Risk Assessments with UnitedHealthcare's hard-to-reach members. Amber Suthers, CPESN Tennessee, Managing Network Facilitator, says it's rewarding to see payers recognize community pharmacy's value in caring for patients. The program is open to all CPESN Tennessee and CPESN Northeast Tennessee pharmacies.

Community Health Worker Hailey Yancey pulled back the curtain with a simple Excel workbook that allows the MediCenter Pharmacy team in Jackson, Missouri to see the rewards of their outreach efforts. In 2024 to date, the pharmacy has increased vaccine administration by 186% over the same period in 2023. Christina Hart, pharmacist and co-owner, says the information motivates the staff, and leads to higher goals.

Inpatient admissions were 33% points lower for high-risk Medicaid patients engaged with CPESN community pharmacists during a pilot outreach program, compared with those members not reached by local pharmacists. Results of the claims data lookback study are reported in research released by the Elevance Health Public Policy Institute. Lindsey Ludwig, CPESN Iowa Executive Director, describes the impact of the two-year program in this short video. Elevance Health/CarelonRx currently has programs in 11 CPESN networks with plans to add more this year.

CPESN® Maryland Managing Network Facilitator Dixie Leikach shares insights for understanding the upcoming Jewish High Holidays, and tips for supporting pharmacy patients during fasting, and schedule changes associated with the holidays. She also highlights opportunities when Jewish patients may be more open to conversations about preventative care, and overall health management.

Strong performance by CPESN Minnesota pharmacies statewide led to an expanded UCare Minnesota contract. The gap closure program has been expanded to 16 areas of care, including five care coordination measures.

Christine Lee Wilson first looked to her home delivery patients when she decided to add pharmacy at home services to Professional Pharmacy in Baltimore, MD. The program is growing and so is revenue.

The Corporation for Ohio Appalachian Development (COAD) has expanded its Pathways program statewide, opening opportunities for CPESN pharmacies to receive and make care coordination referrals through county and regional HUBs. Pharmacies need to train or hire certified Community Health Workers and complete a credentialing process. Medicaid is the primary payment source for CHW services.

Veronica Riera-Gilley, a board certified geriatric pharmacist, describes how she and the Medicine Shoppe team in Sherman, TX Medicare Part D patients. Watch this short video to learn more about working with a senior population.

CPESN® USA has partnerships with six regional Quality Improvement Organizations for pharmacies in 23 networks to help long-term care facilities increase current COVID-19 vaccination rates for residents and staff. Cindy Warriner, a CPESN Virginia facilitator, and a senior pharmacist consultant with Health Quality Innovators, says the partnerships showcases for all federal health decision makers the value that community pharmacy brings to 65+ patients.

Laura Rhodes, CPESN Florida Managing Network Facilitator, says the network is off to a strong start with pharmacy outreach to close care gaps for plan-identified Medicaid patients.

CPESN Georgia pharmacies participating in a national Medicaid MCO program are seeing a growing number of patient encounters with positive feedback. Johnathan Hamrick, Managing Network Facilitator, says the value-based program launched last fall and focuses on improving adherence and closing care gaps

Paula Miller, a CPESN Kentucky Managing Network Facilitator, shares her personal passion for providing healthcare services to disabled patients. She is co-owner of Ruwe Pharmacy with three locations in northern Kentucky, and her pharmacy works with local agencies to deliver pharmacy services to patients living in group homes.

Tim Mitchell, owner of Mitchell's Drug Stores in Neosho, MO, says adding pharmacy at-home services through CPESN® LTC@Home has been a "lifesaver" for his three pharmacies. The CPESN Missouri lead luminary credits two clinical pharmacists on his team with spearheading the pharmacy at-home program along with deep Community Health Worker involvement. Watch this short video to learn why he encourages others to add at-home services through the CPESN LTC@Home special purpose program.

Amy Catherine Baggett, CPESN Mississippi Managing Network Facilitator, shares details of a new Medicaid MCO contract with Magnolia Health. Network pharmacists engage plan-identified patients diagnosed with diabetes or asthma to improve medication adherence. A third program for pediatric patients taking medications to treat ADD/ADHD includes counseling, and coordination with primary care providers to improve adherence.

Laura Rhodes describes how the UnitedHealthcare telehealth program allows CPESN pharmacies to be "connectors within our communities." The expansion of a Virginia network pilot has been introduced through the CPESN networks in Florida and North Carolina and is benefitting patients who lack access to broadband internet, live in rural areas with limited transportation options, or cannot miss work to make routine care appointments.

CPESN Alabama Luminary Jessica Hung, owner of Semmes Pharmacy in Semmes, AL, describes the network's first payer program.

New CareSource Medicaid MCO statewide contract with CPESN Ohio allows all network pharmacists to provide and bill for clinical services as needed by their patients. Kevin Day, clinical pharmacist and president of Day's Pharmacy in Cincinnati and the network's Managing Network Facilitator, describes the program and opportunities it represents for CPESN pharmacies.

CPESN® USA id working with the new Vita Savings ACO to define how network pharmacies will help meet patient care metrics. Vita Savings will go live in 2025.

CPESN® pharmacies in Tennessee and Virginia closed statin adherence gaps for 50% of assigned Medicare Advantage patients, helping HMG Health System score a 4.5 CMS Star Rating.

Pharmacist Clint Hopkins and Joel Hockman, co-owners of Pucci's Pharmacy in Sacramento offer STI, HIV, and HCV point-of-care testing and treating, PrEP and PEP in a growing program with 2-3 patients daily.

Austin Crocker, Lead Clinical Pharmacist at APOTHEcare, a division of Tyson Drugs in Oxford, MS joins Stephen Lewis, MD, Chief Physiatry Officer for CPESN® PPC@Home to describe their chronic disease rehab care pilot. The CPESN Mississippi pharmacy is owned by Luminary Bob Lomenick and is participating in the Special Purpose Program CPESN PPC@Home.