This is a summary of an article recently published in Becker's Hospital Review,
authored by Stacey Decembrele, MPH, Staff Vice President of Pharmacy Network Management, Strategy & Contracting at Elevance Health;
and Cody Clifton, PharmD, Director of Practice Transformation and Clinical Programs at CPESN USA.
Elevance Health and CarelonRx are collaborating with high-performing CPESN community-based pharmacies to improve health outcomes and healthcare delivery, particularly for Medicaid patients. This initiative highlights the indispensable role of local pharmacists in pharmacy care, serving as a critical link between patients, healthcare providers, and health plan organizations.
Highlights of community pharmacy's impact
1. Vital pharmacy care: Local pharmacists are highly accessible and trusted, making them essential partners in improving health outcomes for Medicaid patients. They play a significant role in maximizing safe medication use, mitigating adverse effects, and ensuring medication adherence.
2. Identifying at-risk patients: The collaboration focuses on supporting at-risk patients by utilizing analytics to match clinically high-risk Medicaid members with local CPESN pharmacies. This involves personalized care plans and regular follow-ups to empower patients in managing their health.
3. Reducing healthcare costs: The partnership between Elevance Health/CarelonRx and CPESN has led to a significant decrease in emergency department use (17.9%) and inpatient admissions (30.1%), resulting in reduced overall healthcare costs.
4. Enhancing quality measures: Local pharmacists contribute to achieving industry-established care measures, with improvements seen in the Asthma Medication Ratio (AMR) and a decline in reliever inhaler use among participating members with chronic respiratory conditions.
By fostering collaboration between PBMs and community pharmacies, Elevance Health and CarelonRx set a new standard for patient-centric pharmacy care, offering impactful interventions and promising a sustainable model for future healthcare delivery.
Read the full article here: Elevance Health, CarelonRx work with high-performing CPESN community-based pharmacies to improve health outcomes, enhance healthcare delivery with Medicaid patients - Becker's Hospital Review | Healthcare News & Analysis
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