Through a grant-funded pilot program, CPESN® West Virginia pharmacists are enrolling patients for digital monitoring and monthly reporting of blood pressure readings. Starting in three counties, network pharmacists review readings and provide individualized disease management education for patients with uncontrolled hypertension. Updates are shared with primary and specialty physicians, integrating pharmacy clinical services to care planning and delivery.

Renewal of a contract with Nebraska Total Care continues delivery of clinical services to enrolled Medicaid patients by CPESN Nebraska pharmacies. Last year, $177,000 was paid to 39 of the network's 60 pharmacies for chronic care management services - or $4,500+ per store. And the network earned an additional $34K for closing care gaps, contributing positively to the payer's overall quality ratings. Staci Hubert, Managing Network Facilitator describes the program.

Health Quality Innovators (HQI), a regional quality group reporting to CMS, has partnered with four CPESN® networks - Kansas, Missouri, South Carolina, and Virginia - to help boost current COVID-19 immunization rates for long-term care facilities. Renee Price, CPESN® Kansas Managing Network Facilitator, and Clinical Program Coordinator for Graves/Damm Pharmacies in Winfield Kansas, shares why she is excited about the new opportunity. Other CPESN networks are entering similar partnerships.

CPESN® Pennsylvania pharmacies will continue to help UPMC Health Plan's Medicaid patients manage their asthma, COPD, and diabetes medication therapy with renewal of the network's contract. More than 100 Pennsylvania Pharmacist Care Network (PPCN) pharmacies engaged with 3,360 eligible Medicaid patients in 2023 as the program added diabetes care to the program. The pharmacies also conducted more than 1,700 SDoH surveys and made 500 community and health system referrals to help patients address food, transportation, housing and other health-impacting needs.

Kim Wright, CPESN Virginia Luminary, and Rebecca Brown, Family Pharmacy Clinical Director, describe how the network's telehealth pilot with UnitedHealthcare makes doctor visits accessible to Medicaid patients without broadband or who may struggle to take time away from work to see a physician. Most exciting is the opportunity to practice at the top of their license.

Now is the time to embrace change and ramp up clinical programs as states expand pharmacy practice and health plans contract for value-based services, says Duane Jones, Arkansas CPESN Luminary. Jones, who also serves on CPESN USA's Executive Committee, gives Arkansas' test to treat law as an example of opportunity amid rapid market change. Credentialed pharmacists are paid on the medical side for office visits to treat strep, flu, and Covid-19. "Call your local network. Call your Managing Network Facilitator. Get involved."

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.

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.

Alison Haas, CPESN USA Director of Value-Based Contracting, does the 2023 Success Countdown with lots of wins as improved patient outcomes, achieved payer goals, and increased revenue for CPESN community pharmacies.

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.