What is "eCare"?
The Pharmacist eCare plan is a standard that allows pharmacy technology providers to have a common method of exchanging information related to patient care delivery, including patient goals, health concerns, active medication list, drug therapy problems, laboratory results, vitals, payer information and billing for services. This will allow for a true collaboration of care between pharmacists and doctors, with the goal to provide better outcomes for patients overall health in the future.
What is CPESN?
The Community Pharmacy Enhanced Services Network (CPESN) came out of a three-year grant from the Centers for Medicare and Medicaid as a pilot to evaluate new ways of reimbursing pharmacies for improving patient health in North Carolina. There are now CPESN networks across the country, from Alabama to Nebraska to Texas.
Think of CPESN as a PSAO for eCare networks. It is the primary contracting entity for eCare networks, although some PSAOs, buying groups, and software companies (e.g., Strand) have also negotiated eCare contracts with health plans.
Through this program, pharmacists walk patients through an educational course and document the consultation in a platform (e.g., Strand). This information is then billed to the provider and the pharmacy is reimbursed for acting on this preventative measure.
So, what is Strand?
Strand is a clinical platform that provides pharmacies with the tools they need for successful patient education and intervention. Strand also has a billing platform that enables pharmacies to send claims directly to the payer, making it easy to integrate this new model directly into the pharmacy's workflow.
Formerly known as Creative Pharmacist, they are the most advanced eCare software in the market -- they've been around for about 10 years. In fact, they were the very first diabetic counseling software, and helped write the CPESN guidelines.
What clinical intervention opportunities are reimbursable for my pharmacy?
These opportunities vary by state, so we advise that you reach out to your local CPESN chapter or ask your eCare software what you are eligible for.
Check out some best practices for completing clinical interventions using Amplicare!