If you haven’t heard, you may have a CPESN pharmacy coming to a neighborhood near you. What is CPESN you ask? It could be one of the more important acronyms to add to your alphabet soup vocabulary of acronyms – Community Pharmacy Enhanced Services Network.
CPESN originated in North Carolina (NC) where pharmacists worked together with other health care providers to provide coordinated care through the medical home model, Community Care of North Carolina (CCNC). CCNC employed pharmacists to help with optimization of medication use, including the embedding of pharmacists in primary care offices, long term care facilities and hospitals, however, there was no formalized relationship with local community pharmacies and so NC CPESN foundations were laid.
NC pharmacists asked themselves the following questions: How could they differentiate themselves as high performing pharmacies? What types of enhanced services could collectively be offered? What are the minimum criteria to participate? How will the network be accountable for maintaining quality standards? After determining answers to these questions, the NC CPESN was developed as an open network, allowing participation of all pharmacies willing to meet the established minimum criteria, deliver enhanced services and document interventions.
After the formation of the NC CPESN, CCNC received a 3 year grant from the Center for Medicare and Medicaid Innovation (CMMI) to test payment reform in community pharmacies for Medicare Medicaid, dually eligible Medicare-Medicaid, and NC Health Choice beneficiaries by using a collaborative care model where community pharmacy was part of the medical home team. By 2014, 246 North Carolina pharmacies were committed to the CPESN approach of active integration of pharmacist activity with primary care physicians, specialty providers such as behavioral health professionals, and the extended care team of the Patient Centered Medical Home.
What is the CPESN participant criteria? Pharmacies agree to
- Support medication adherence
- Conduct medication reconciliation after hospital discharge
- Prevent medication waste by verifying patient need prior to each fill
- Provide clear and clinically-relevant communication with the provider and care team
- Offer comprehensive medication review, care plan development and reinforcement
CPESN pharmacies also offer other enhanced services including:
- Adherence packaging
- Home delivery
- Point of Care Testing
- Nutritional counseling
- Smoking cessation
- Long acting injections
- 24 hour emergency services
In September 2015, CCNC launched the Multi-State High-Performing Community Pharmacy Collaborative (MSPC) to facilitate the expansion of additional high-performing CPESNs nationally. Through this collaborative, pharmacies and organizations and existing pharmacy networks and state pharmacy associations, are pursuing development of additional CPESNs nationwide. The nationwide expansion is supported by joint collaboration between CCNC and the National Community Pharmacists Association (NCPA) and the formation of CPESN-USA. The CPESN-USA role is to:
- Develop and sustain local CPESN networks
- Establish a national marketplace presence for collective regional and national offerings
- Provide services and solutions such as consulting expertise, marketing expertise, and technology solutions
- Establish relationships, payment models, and payment opportunities with the medical benefit side of the payer infrastructure
CPESNs have launched in 15 states and are at various stages of planning in 30 others.
Which pharmacies are ideal participants in CPESN? Pharmacies that:
- Focus on PATIENTS instead of PRESCRIPTIONS
- Establish STRONG RELATIONSHIPS with their patients and members of the local health care community
- Provide ENHANCED SERVICES
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