CPESN® Iowa Pharmacist Services Reduced Inpatient Admissions, Lowered Costs of Care for High-Risk Medicaid Patients

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® Ohio, CareSource Provider-Status Contract

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® Hawaii, Two-Year Adherence Contract Renewal with HMSA

Hawaii Medical Services Association (HMSA) recently renewed a two-year contract with CPESN Hawaii to continue a gap closure program focused on increasing adherence for Medicare patients. Kerri Okamura, Program Support Lead for the Pacific Region, says the renewal adds an annual administrative payment to the fee-for-services program.

CPESN® Mississippi, Expanded Medicaid MCO Program

As CPESN Mississippi pharmacies reached out to their UnitedHealthcare patients to collect blood pressure and A1c readings, they were able to meet additional needs and help patients overcome barriers to care. Amy Catherine Love Baggett, owner of Love's Pharmacy in Diamondhead and the network's Managing Network Facilitator shares how the payer program to close HEDIS® led to care coordination successes.

CPESN Ohio is Statewide Pharmacy Provider Network for Humana Medicaid

Kevin Day, owner of Day's Pharmacies and CPESN Ohio Managing Network Facilitator, describes the statewide Medicaid program exclusive to CPESN Ohio network pharmacists that allows billing for provider-status initiatives without a collaboration agreement. The program for Humana's Medicaid enrollees has a January 1, 2024 start date.

CPESN® Virginia, Medicaid MCO Program

CPESN® Virginia is preparing to launch the network's first value-based payer program to provide services to Medicaid patients enrolled in an Elevance/CarelonRx plan. Lura Thompson, CPESN VA Managing Network Facilitator, shares details in this video.

RxSelect CPESN® Pharmacies Help Lower Cost of Care in Oklahoma

RxSelect CPESN® the Oklahoma local network provides comprehensive and targeted medication reviews for Medicaid patients at a high risk for return hospitalization or emergency visits. The result = lower total cost of care.

CPESN® Maryland, Medicaid High-Risk Patients

CPESN® Maryland has it's first contract to provide high-touch clinical services to Medicaid patients with diabetes and asthma.

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.