Success Stories

Joe Moose, CPESN North Carolina luminary, describes how pharmacists helped this large national MCO gather information from dually-eligible Medicare and Medicaid patients on their COVID-19 vaccination status, and understanding of their choices.

50 CPESN Arkansas pharmacies participate in this large MCO contract to provide an inital Medication Therapy Management session with referred patients.

In partnership with the South Dakota Dept. of Health, CPESN® pharmacists provided blood pressure monitoring, met with patients regularly, and led clinical interventions engaging other health professionals. The results? High percentage of patients met BP goals, and the program has expanded from the initial focus on HTN to include cholesterol values and lipid levels for total cardiovascular risk management.

Program for HTN is expanded in Year 3 to include cholesterol values and lipid levels for total cardiovascular risk management. The goal is through pharmacist-led intervention to lower the patient risk of heart attack or stroke.

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 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.

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.

A partnership beween CPESN Ohio and Ohio-based Mobility Health supported network pharmacies in providing PCR COVID-19 testing.

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.

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.

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.

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.

Network pharmacists submit monthly care plans for this MCO's member taking Asthma, COPD, Opioids, or Behavioral Health medications.

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.

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.

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.

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.

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.

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.

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.

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

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.

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

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.

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.

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.

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

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.

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.