Success Stories

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® 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.

CPESN® Wyoming, Medicare Part D MTM

Under this Year 5 program renewal with a national payer, CPESN Wyoming pharmacies provide enhanced Medication Therapy Management and safety reviews for Medicare Part D patients at high risk for adverse drug events. The goal is to demonstrate a positive impact on medical spend directly tied to pharmacist interventions.

CPESN® Pennsylvania, Diabetes and COPD Management

In this contract with a statewide Medicaid MCO, Pennsylvania Pharmacist Care Network pharmacists identify gaps in care and address medication adherence for plan-identified patients with COPD and diabetes.

CPESN® Virginia, Diabetes Management Program

More than half of CPESN Virginia's pharmacies had patients eligible for diabetes managment care under a contract with a large national managed health plan. Services include HbA1c monitoring and a focus on nutrition, motivational interviewing, med management, and care coordination.

CPESN® Ohio Flu Vaccines

A CPESN Ohio network-wide contract with a national MCO focuses on increasing flu vaccination rates, year-over-year.

CPESN® Pennsylvania, Worksite Vaccine Clinics

Ron McDermott describs how Pennsylvania Pharmacist Care Network pharmacies held on-site COVID-19 vaccination clinics for employees of the Bechtel Shell Cracker Plant in PA. More than 3,000 doses were administered through a CPESN contract with WorkCare.

CPESN® Missouri, Medicare Advantage

Under this Medicare Advantage contract, CPESN Missouri pharmacies provided Med Sync services to patients taking medications for diabetes and hypertension.

CPESN® Nebraska, Medicaid Managed Care Plan

CPESN Nebraska Luminary Staci Hubert describes services provided by that network's pharmacies under a Medicaid managed care plan for high-risk patients. Enhanced pharmacy services include Med Sync, Adherence packaging, and Medication reconciliation.

CPESN® Minnesota, Safety Reviews Medicare Part D

Lindsay Christensen, Managing Network Facilitator for CPESN® Minnesota, describes that network's Year 5 renewal of a program where pharmacists provide safety reviews for Medicare Part D patients at high risk for adverse drug events. The program goal is to have a positive impact on medical spend directly tied to pharmacist interventions.

CPESN® Ohio, Medicaid MCO

Kevin Day describes how CPESN Ohio pharmacies provide enhanced services to close gaps in care for patients as identified by a large Medicaid Managed Care Organization. Provider status allows direct billing for patient care.

South Dakota CPESN®MTM Program

This is a third-year renewal with a large pharmacy technology solution for this program focused on Medication Therapy Management services.

CPESN® North Carolina, Troy Medicare

In this Payer perspective, Troy Medicare Co-Founder and Chief Pharmacy Officer, describes the benefits of working with community pharmacists in the CPESN North Carolina network. Pharmacies help manage COPD, diabetes and congestive heart failure patients.

CPESN® Wyoming, COVID-19 Grant

Through the Wyoming Department of Health, CPESN Wyoming received CDC grant funding to offset pharmacy costs associated with adminstering COVID-19 vaccines, including salaries, training, vaccine storage units, computer hardware and software, and travel for in-home vaccinations.

CPESN Missouri, HRSA Grant

CPESN® Texas, Managed Medicaid Plan

Enhanced pharmacy services provided by CPESN Texas pharmacies under a Managed Medicaid Plan affiliated with a large hospital system included medication adherence support, asthma action plans, and social determinants of health surveys.

CPESN® Massachusetts, Statewide Health System

This program includes deprescribing, prescribing, and adherence support to improved health outcomes for plan-identified patients.

CPESN® Wisconsin, NeuGen Health

In partnership with a health care consulting firm, CPESN Wisconsin pharmacies provided enhanced services to school employers, including comprehensive care planning, adherence support, medication reviews, and a med sync prgoram.