Express Scripts launches initiative to expand rural healthcare access

Express Scripts, the pharmacy benefits management business of Evernorth, a subsidiary of The Cigna Group is aiming to expand access to health care in rural communities through partnerships with independent pharmacies.

The new IndependentRx Initiative will offer increased reimbursement opportunities and additional care services to rural independent pharmacies—and create an Independent Pharmacy Advisory Committee to expand the role of rural, suburban and urban pharmacies in the healthcare system, Express Scripts said.

"These steps build on Express Scripts’ recently announced actions to further evolve the PBM model and drive greater medication affordability for the 100 million Americans the company serves. The IndependentRx Initiative is expected to benefit thousands of independent pharmacy partners across the country and will expand significantly over time," the company said.

[Read more: Align reimbursement to expanded role of pharmacists]

"One in five Americans live in rural areas, yet less than 10% of physicians practice in those locations—creating critical access gaps. Independent pharmacists often can close those gaps as the front lines of care in their local communities," said Adam Kautzner, Pharm.D., President of Express Scripts. "That's why we're committed to leveraging and supporting the clinical expertise of pharmacists who want to do more for their patients. By deepening our partnership, together we will remove barriers to care, reduce total medical costs and improve vitality, community by community across the U.S."

Express Scripts will increase reimbursements to independently owned and unaffiliated pharmacies with a drug wholesaler in areas with only one pharmacy within 10 or more miles from an Express Scripts customer. This includes enhancing performance- and incentive-based programs that pay pharmacies more when they drive better outcomes, such as prescribing 90-day supplies of prescription drugs that improve adherence. In addition, all independent rural pharmacies will have increased opportunities to participate in Express Scripts’ retail pharmacy networks, the company said.

In collaboration with other Evernorth Health Services businesses, Express Scripts will increase access to certain routine, preventive and chronic care services at independent pharmacies – driving new business growth opportunities for pharmacy owners and providing convenient care options for consumers. This includes reimbursing independent pharmacists for a variety of health screenings, testing and clinical services, such as: 

• COVID-19 and other routine vaccinations;
• Acute viral condition testing (i.e., influenza, strep A, A1C);
• Lifestyle counseling, such as nutrition and smoking cessation;
• Annual behavioral health screenings; and
• Ability to prescribe medications for acute infections or substance abuse, among others.

"Independent pharmacies already add value beyond dispensing medications – and they can do even more. We need to ensure rural communities have access to the same quality, affordable care as those living in densely populated communities. Where you live shouldn’t dictate the type of care you receive or how long you have to wait for it,” Kautzner added.

[Read more: Independent pharmacies fight back]

To fully realize the vision and potential of this initiative, Express Scripts will establish the industry’s first Independent Pharmacy Advisory Committee. The newly established committee will convene a diverse group of pharmacy leaders across rural, urban and suburban areas – all focused on continuing to drive competitive reimbursement practices, learning from each other’s business models and creating new solutions that leverage independent pharmacists to alleviate provider shortages across the healthcare delivery system.

“Partnership is in our DNA because it helps achieve better outcomes for the people we serve,” Kautzner said. “That’s exactly our goal with this committee. By bringing together a differentiated set of perspectives and expertise, we’ll unlock new innovation opportunities and accelerate a sustained commitment to pharmacies and patients across the country.”