ARKANSAS COMMUNITY PHARMACY ENHANCED SERVICES NETWORK Anne Pace, Pharm.D.

Pharmacist Objectives 1. Define a community pharmacy enhanced service network 2. Describe the mission of Arkansas CPESN as it applies to patient care outcomes and the health system 3. Review the Arkansas CPESN required and optional enhanced services provided in community pharmacy settings 4. Demonstrate how a clinically integrated network of community pharmacies can collaborate with health systems to improve patient care

Technician Objectives 1. Define a community pharmacy enhanced service network (CPSEN) 2. Outline the mission of Arkansas CPESN 3. Discuss which enhanced services are required and optional per Arkansas CPESN 4. Explore how a clinically integrated network of community pharmacies can work with health systems to improve patient care.

What are the top 3 needs in managing complex patients? identifying target patients avoid readmission control costs

Formation of Community Pharmacy enhanced services network In 2014, Community Care of North Carolina (CCNC) created the initial Community Pharmacy Enhanced Services Network (CPESN) A network of 262 North Carolina pharmacies committed to broadening the availability of medication management resources to the highest-needs population $15 million grant by Center for Medicare and Medicaid Innovation (CMMI) Round 2 Health Care Innovations Award Determine payment models for enhanced services Determine workflow, communication, task sharing between community pharmacies and PCMH Determine health information technology required Support for growth and adoption by other states

WHAT IS Arkansas CPESN? A network of high performance community pharmacies striving to… optimize patient health outcomes through appropriate medication management, and integrate enhanced patient care services with other providers, health systems, and accountable care organizations (ACOs)

Arkansas CPESN Mission Statement Arkansas CPESN serves to coordinate care in community-based pharmacies through collaboration with other health care providers to optimize medication therapy to ensure patients are achieving positive therapeutic outcomes and reducing overall healthcare costs

ARKANSAS CPESN DEVELOPMENT TIMELINE August 2016 Sept – Oct 2016 Dec – Jan 2017 Informational webinar Identified luminaries and workgroup volunteers Determined minimum required pharmacy services and participation agreement March 2017 Launch Sept 2016 Nov 2016 Feb 2017 Informational webinar Live kick-off meeting Pharmacy recruitment and distributed participation agreement

AR CPESN REGIONAL DIRECTORS Max Caldwell – CEO – Wynne Brandon Cooper – Jonesboro Michelle Crouse – Lake Village Bobby Glaze– Camden Duane Jones – Springdale Keith Larkin – Fort Smith Brenna Neumann – Bentonville Anne Pace – Little Rock

Current AR CPESN Network

REQUISITE ENHANCED Services Medication Synchronization with personal medication record Adherence Packaging Comprehensive Medication Review with follow-up Transitions of Care with 24-hour availability Immunizations

Transition of care Medication reconciliation, medication therapy management, and patient education Service provided on referral or targeted toward patient populations at increased risk for readmission, such as patients with heart failure, chronic obstructive pulmonary disease, asthma, advanced age, low health literacy, and frequent hospitalizations. Non-dispensing 24-hour on call to assist in these transitions. Home delivery

Other available enhanced Services Delivery Compounding Durable Medical Equipment Participation in REMS programs Specialty Pharmacy Dispensing Home Visits Nutrition Counseling Smoking Cessation Programs Therapeutic Substitution Point of Care Testing

Quality Assurance and improvement

AR CPESN is open to community pharmacies who agree to: Provide five key requisite services; Share their data and be subject to audit in order to measure and assess quality control; and Be subject to remediation or termination if performance falls below network standards. To date, 162 community pharmacies have signed participation agreements, including chains and independents.

AR CPESN PHARMACIES OFFER: focused interventions that change patient behavior and lead to improved patient health outcomes the experience necessary to provide medication optimization and other enhanced services scores that are 5% higher than other pharmacies on multiple measures of medication adherence a collaborative approach with other health care team members who are held jointly accountable

Pharmacy locator www.cpesn.com/locator

Potential

CPESN networks Across the Country

Value based model Ref: 2010 performance analysis of Community Care of North Carolina primary care practices with integrated community-based pharmacy

Did You Know? Community pharmacies see their complex patients 35 times per year compared to 3.5 times per year for physicians.

anne@kavanaughrx.com Thank You