Success Stories

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.

Stephanie McGrath, Managing Network Facilitator, details how 96 Pennsylvania Pharmacist Care Network (PPCN) pharmacists met all 2023 program goals in caring for the Medicaid MCO's enrolled patients. Under the multi-service program, network pharmacists address identified patient needs, providing medication reconciliation, med sync, home visits, home deliveries, and making community and health plan resource referrals based on SDoH assessments. Learn more in this short video.

CPESN® Washington DC Metro Area is gaining new momentum with the network's first payer program to provide clinical services to Elevance Health/CarelonRx enrolled Medicaid patients. Tamara McCants, Managing Network Facilitator for the growing network, and Carla Daniel, a pharmacist with Grubb's Southeast - one of the participating pharmacies - describe benefits of the program for patients, pharmacies, and the payer.

CPESN® USA Luminary Hashim Zaibak describes how Hayat Pharmacy in Milwaukee, WI, has grown by welcoming refugees and purposely hiring pharmacy employees who speak a second language. A facilitator for the CPESN Wisconsin network, Zaibak shares how Hayat is expanding clinical services with the purchase of a physician practice and addition of a primary care physician.

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.

The multi-phase Vaccine Hesitancy and Gap Closure Program started in southeast Missouri and is gaining traction statewide. Vaccine hesitancy conversations with CPESN pharmacists and technicians are integrated to Med Sync calls, boosting the revenue potential as pharmacies are being compensated for building on services already being provided. The program is funded by the Missouri Dept. of Health and Senior Services.

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.

Chris Antypas, a CPESN® USA and Pennsylvania Pharmacist Care Network or PPCN (the CPESN network in Pennsylvania) Luminary, shares how Asti's South Hills Pharmacy in Pittsburgh cares for several hundred patients with Arabic as their primary language. The pharmacy has modified some processes to be sensitive to culture and religion, and added a pharmacist who speaks Arabic. Antypas says expanding services to meet community needs benefits the pharmacy as well as its patients.

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."

Connecting first on a personal level is key to building trust, says Bandon Do, a first-generation Chinese-American pharmacist at Bob Johnson's Pharmacy in Seattle.

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.

In this Community Connected Success Story, Ronnie Moore and his team at NYC Minority-Certified Allure Specialty Pharmacy partner with community organizations to provide disease management, and health and wellness education to neighborhood patients..

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.