- Increases reimbursement rates for independent pharmacies in rural communities
- Offers more pharmacy services to strengthen pharmacists' essential role in delivering care
- Convenes the industry's first Independent Pharmacy Advisory Committee
ST. LOUIS, Mo., April 20, 2023 /PRNewswire/ -- Express Scripts, the pharmacy benefits management (PBM) business of Evernorth, a subsidiary of The Cigna Group (NYSE: CI), today announced key efforts to expand access to health care in rural communities through partnerships with independent pharmacies across the U.S. 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 health care system. 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.
"One in five Americans live in rural areas, yet less than 10 percent 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."
Increasing Reimbursements for Rural Independent Pharmacies
Express Scripts will increase reimbursements to pharmacies that are independently owned and unaffiliated 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.
Expanding Pharmacy Care Services to Drive Growth
Express Scripts, in collaboration with other Evernorth Health Services businesses, 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
- Trainings to empower pharmacists to recognize and combat substance use disorders, including opioid addiction and naloxone administration
- Additional prescriptions for acute infections
- Acute viral condition testing (i.e., influenza, strep A, A1C)
- Lifestyle counseling, such as nutrition and smoking cessation
- Annual behavioral health screenings
"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.
Enhancing Engagement with New Independent Pharmacy Advisory Committee
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 health care 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."
About Evernorth Health Services
Evernorth Health Services creates pharmacy, care and benefits solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Evernorth capabilities are powered by our businesses, including Express Scripts, Express Scripts® Pharmacy, Accredo, eviCore and MDLIVE, along with holistic Evernorth platforms and solutions that move people and organizations forward. All Evernorth solutions are serviced and provided by or through operating affiliates of Evernorth Health, a wholly owned subsidiary of The Cigna Group (NYSE: CI), or third-party partners. Learn more at evernorth.com.
CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS
This press release, and oral statements made in connection with this release, may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements are based on Cigna's current expectations and projections about future trends, events and uncertainties. These statements are not historical facts. Forward-looking statements may include, among others, statements concerning future financial or operating performance, including our ability to (i) expand access to health care in rural communities, through partnerships with independent pharmacies (ii) offer increases reimbursement opportunities and additional care services to rural independent pharmacies, (iii) drive greater medication affordability for the 100 million Americans we serve, (iv) remove barriers to care, reduce total medical costs and improve vitality community by community across the U.S., (v) increase reimbursements to pharmacies that are independently-owned, (vi) enhance performance- and incentive-based programs (vii) increase access to certain care services at independent pharmacies and (viii) drive new business growth opportunities for pharmacy owners and providing convenient care options for consumers; and other statements regarding Cigna's future beliefs, expectations, plans, intentions, liquidity, cash flows, financial condition or performance. You may identify forward-looking statements by the use of words such as "believe," "expect," "project," "plan," "intend," "anticipate," "estimate," "predict," "potential," "may," "should," "will" or other words or expressions of similar meaning, although not all forward-looking statements contain such terms.
Forward-looking statements are subject to risks and uncertainties, both known and unknown, that could cause actual results to differ materially from those expressed or implied in forward-looking statements. Such risks and uncertainties include, but are not limited to: our ability to achieve our strategic and operational initiatives; our ability to adapt to changes in an evolving and rapidly changing industry; our ability to compete effectively, differentiate our products and services from those of our competitors and maintain or increase market share; price competition, inflation and other pressures that could compress our margins or result in premiums that are insufficient to cover the cost of services delivered to our customers; the potential for actual claims to exceed our estimates related to expected medical claims; our ability to develop and maintain satisfactory relationships with physicians, hospitals, other health service providers and with producers and consultants; our ability to maintain relationships with one or more key pharmaceutical manufacturers or if payments made or discounts provided decline; changes in the pharmacy provider marketplace or pharmacy networks; changes in drug pricing or industry pricing benchmarks; political, legal, operational, regulatory, economic and other risks that could affect our multinational operations, including currency exchange rates; the scale, scope and duration of the COVID-19 pandemic and its potential impact on our business, operating results, cash flows or financial condition; risks related to strategic transactions and realization of the expected benefits of such transactions, as well as integration or separation difficulties or underperformance relative to expectations; dependence on success of relationships with third parties; risk of significant disruption within our operations or among key suppliers or third parties; our ability to invest in and properly maintain our information technology and other business systems; our ability to prevent or contain effects of a potential cyberattack or other privacy or data security incident; potential liability in connection with managing medical practices and operating pharmacies, onsite clinics and other types of medical facilities; the substantial level of government regulation over our business and the potential effects of new laws or regulations or changes in existing laws or regulations; uncertainties surrounding participation in government-sponsored programs such as Medicare; the outcome of litigation, regulatory audits and investigations; compliance with applicable privacy, security and data laws, regulations and standards; potential failure of our prevention, detection and control systems; unfavorable economic and market conditions including bank failure; the risk of a recession or other economic downturn and resulting impact on employment metrics, stock market or changes in interest rates and risks related to a downgrade in financial strength ratings of our insurance subsidiaries; the impact of our significant indebtedness and the potential for further indebtedness in the future; credit risk related to our reinsurers; as well as more specific risks and uncertainties discussed in our most recent report on Form 10-K and subsequent reports on Forms 10-Q and 8-K available through the Investor Relations section of www.cigna.com. You should not place undue reliance on forward-looking statements, which speak only as of the date they are made, are not guarantees of future performance or results, and are subject to risks, uncertainties and assumptions that are difficult to predict or quantify. Cigna undertakes no obligation to update or revise any forward-looking statement, whether as a result of new information, future events or otherwise, except as may be required by law.
Media contact:
Justine Sessions
860-810-6523
media@evernorth.com
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