Success Stories

CPESN New Jersey has its first statewide payer program with Elevance Health/CarelonRx, bringing to 12 the number of CPESN networks with Elevance value-based programs. New Jersey pharmacies may contact Managing Network Facilitator Mina Sidhom [email protected] to learn more about the gap closure program for enrolled Medicaid patients

CPESN Michigan pharmacies have their first statewide payer opportunity with UnitedHealthcare's Pharmacy Care Hub. The program for enrolled Medicaid and dual eligible members includes medication management, counseling, and other services pharmacies may already be providing. And participating pharmacies may provide point-of-care testing, coordinate a telehealth doctor visit, and fill any resulting prescriptions - for a seamless patient experience, all within the pharmacy.

Valerie Akers, pharmacist and owner at Parkview Pharmacy in Minnie, KY, shares a multigeneration story of how investment in CHW training and a focus on improving rural healthcare is benefiting her community.

The value-based expansion of services allows CPESN® Florida pharmacies to work with patients over time to help them reach or maintain blood pressure and A1c goals. Theresa Tolle, pharmacist and owner of Bay Street Pharmacy in Sebastian, FL, describes how the payer program expansion benefits patients and pharmacies.

Tina Dotzler, owner and pharmacist at Pexton Pharmacy in Harlan, IA, says value-based reimbursement under the Elevance Health/ CarelonRx program allows dedicated time to help patients reach health goals. Watch this video to learn more about how the CPESN® Iowa pharmacy helped one patient reach her A1c goal.

Kate Riddell, a CPESN ® Indiana community pharmacist, shares stories of meeting patients on their terms to deliver medications and clinical care. Overcoming access barriers is a daily way of doing business at Conway Drugs and Parkside Pharmacy in Lebanon, IN – whether it calls for perching on a drive-through window ledge or delivering medications to rural patients.

Clinical Pharmacist, Rob Nicols of Greenwood Pharmacy in Waterloo Iowa shares information about the Community Health Assessment and Monitoring the Pharmacy (CHAMP) program. As the Phase I pilot study location for the program, their pharmacy hopes to increase screening rates for the second leading cause of deaths in Iowa, lung cancer. Despite national guidance, only 20% of eligible Iowans currently receive screening. The CHAMP program aims to increase this rate by thousands.

Annie Eisenbeis, Lead Network Facilitator for CPESN Missouri, urges all networks to build and leverage stakeholder relationships as their states make plans for coming rural health transformation funds.

Hawthorne Health CEO Josh Rose shares information about an exciting non-dispensing revenue opportunity for CPESN® pharmacies.

E.J. Stoepfel, CPESN USA Payer, Purchaser, Partner Lead, describes two exciting non-dispensing revenue opportunities with RxE2. The Multiple Depression Disorders study is open now in 15 states, and the COPD study launches in January. There are opportunities for up to 100 pharmacies in each six-month study.

Amy Catherine Baggett, CPESN® Mississippi Managing Network Facilitator, describes development of the Medications Optimizing Maternal Safety MOMS™ program. She shares patient stories from her own practice as pharmacist and co-owner of Love's Pharmacy in Diamondhead, MS.

A limited number of CPESN® pharmacies in OH, KY, TN, MS, and AR are participating in a pilot program through CPESN Community Health to refer patients to the American Lung Association's Lung Health Navigators. Patients who enroll receive free, customized, one-on-one education and support in managing COPD and other lung disease. Devin McKenzie, Clinical Services Programs Director at Dover Family Pharmacy in Dover, TN, describes that pharmacy's experience.

Since 2022, CPESN North Carolina pharmacies have cared for nearly 2,000 patients through a Medicaid MCO's Diabetes education and management program. Laura Rhodes, Managing Network Facilitator, says the program has been renewed, and she shares patient impact stories.

Stephanie McGrath, Managing Network Facilitator for PPCN, the CPESN Pennsylvania network, shares how pharmacists are working with local business to offer on-site vaccine clinics for employees. Employers sign up at the network website to be matched with participating pharmacies.

Lura Thompson, Managing Network Facilitator for CPESN Virginia, describes the new Medication Optimizing Maternal Safety program available through UnitedHealthcare's Pharmacy Care Hub.

CPESN California Luminary Sanjay Patel says a Medicaid vaccine program for school-age children is helping the community, the state, and benefiting network pharmacies.

Bri Morris Gilbert, Arkansas CPESN Managing Network Facilitator, reports on that network's participation in an adherence program for patients with complex behavioral health conditions. The network converted 74% of non-adherent patients to adherent through the payer program that started as a pilot in 2 states and is now active in 10 states.

Jessica Robinson, CPESN® Tennessee Managing Network Facilitator, was tired of hearing stereotypes about community pharmacists being “less clinical” or “not real providers" when she decided to push back with a LinkedIn post that calls out the perception of community practice mediocrity. She is being heard, loud and clear. In this short video, the community pharmacist who also teaches pharmacy students at East Tennessee State University, invites a closer look at a day in the life of the community pharmacist. "This is the frontline of healthcare, and it demands brilliance, resilience, and heart."

CPESN Hawaii reports that network pharmacies closed 45% of health plan identified care gaps as part of the MDX Hawaii payer program. Dayna Wong-Otis, Managing Network Facilitator, says participation was network-wide and that pharmacies have streamlined patient outreach processes for success.

Over 80% of A1C POCT completed at CPESN pharmacies for a health plan program that included longitudinal diabetes care were at goal (≤8%). Cody Clifton, CPESN USA Director of Practice Transformation and Clinical Programs, says those metrics helped the health plan payer reach its HEDIS® gap closure goal for the diabetes measure.

Pennsylvania Pharmacist Care Network (PPCN) pharmacists completed > 13,000 SDoH assessments for Medicaid patients, leading to 2,300 referrals for assistance with housing, transportation and other basic needs. Stephanie McGrath, CPESN® Managing Network Facilitator, shares insights from the two-year program.

CPESN® North Carolina and CPESN® Washington pharmacies are partnering with local prescribers to provide colon cancer screening kits to at-risk patients. CPESN North Carolina Managing Network Facilitator Laura Rhodes describes the grant-funded program in this short video.

Carewell Pharmacy in Gilbert, WVA is one of three CPESN West Virginia pharmacies to participate in the Rx Healthy Heart program funded by the Pallottine Foundation of Hungtington. Patients in the program record their blood pressure at home and report the readings to the pharmacist who provides coordinates care with their physicians. Courtney Riffe, Carewell Pharmacist and Owner, says the services are documented through eCare plans that trigger reimbursement with bonus opportunities when patients reach their goals.

Cost Plus Drugs Co-Founder Mark Cuban tackles tough future state questions for an audience of CPESN USA independent community pharmacy owners and leaders during this interview with Troy Trygstad, CPESN USA Executive Director. The interview was pre-recorded and presented as the opening plenary at the 2025 CPESN USA Mid-Year Leadership Event held in Concord, NC.

Kevin Day, president of Day's Pharmacy in Cincinnati and CPESN® Ohio's Managing Network, says network pharmacies delivered strong results in closing 2024 care gaps for CareSource patients. He points to the value-based care arrangement, along with fair dispensing, and reasonable fee-for-service programs within medical billing as wins for Medicaid patients and network pharmacies.

CPESN Minnesota pharmacies closed nearly 40% of quality measures during a statewide value-based program to improve health outcomes for UCare members. Lindsay Christensen, Managing Network Facilitator, describes how those results produced sustainable reimbursement for the 126 participating pharmacies.

Payment for patient encounters to address gaps in care allows CPESN Iowa community pharmacists more time for direct care that improves health outcomes. Tammy Bullock and Fabi Gallardo, pharmacists at Osterhaus Pharmacy in Maquoketa, IA describe how their team approach under the program helped a legally blind patient better manage his medications.

Abbi Linde, CPESN Wisconsin Managing Network Facilitator, shares tips for maximizing grants that do not allow use of funds for patient services. Creativity in applying for and writing grants has helped that network secure administrative funds, as well as support for program implementation, training, and documenting best practices.

UHC Medicaid patients receive same-day care, including physician visits; and expanded billing pays the pharmacy for the health services care the patient needs. Carley Moses, a pharmacist at Peoples Pharmacy in Norfolk, VA, shares how the program is benefiting the CPESN Virginia pharmacy and its patients.

For a second year in a row, Maryland pharmacists met their goals for patient encounters as part of a HEDIS care gap closure program with Elevance/CarelonRx. That's just one success for CPESN DMV - the first regional multi-state network - as shared by Managing Network Facilitator Dixie Leikach in this short video.