Integrating pharmacists into the Medical Home team

In early 2014, CCNC created CPESN to broaden capacity for care management and medication optimization services, especially to the sub-population in greatest need of these services. Community pharmacy is an opportune setting of care for delivery of these services, as NC Medicaid claims data indicate that the portion of the population most in need of medication-focused care coordination visits the pharmacy more than 35 times annually. Consistent with CCNC’s other Pharmacy Programs, the goal of the CPESN is to improve quality of care and patient outcomes related to optimal medication use, thereby improving the patient’s overall health trajectory, leading to a reduction in total cost of care. The CPESN is an open network which includes 246 NC pharmacies as of December 1, 2015.

The CPESN is part of a 3-year grant funded by the Centers for Medicare and Medicaid Innovation (CMMI) to test new reimbursement models for community pharmacies serving Medicaid, Medicare, dually eligible, and NC Health Choice beneficiaries. CPESN is based on collaborative care model in which community pharmacists are active and integrated participants of the medical home care team.

In partnership with CCNC, CPESN pharmacies provide enhanced pharmacy services that go above and beyond conventional prescription dispensing and basic patient education. Enhanced services include interventions such as synchronization of a patient’s chronic medication fill dates, adherence monitoring and coaching, compliance packaging, and home delivery. Pharmacies participating in the grant additionally offer community pharmacy care management services in close collaboration with the medical home and their care management supports to engage in continuous care plan development and reinforcement.

For more information, visit the CPESN website at https://www.cpesn.com/locator/#!/pharmacies