By Adam Kautzner, Pharm.D, president of Evernorth Care Management and Express Scripts, and Stephanie Smith Cooney, Pharm.D, senior director of independent pharmacy affairs at Express Scripts
Today, it takes a simple click to have most anything delivered straight to your phone or your door – sometimes even same day. While we believe that accessing health care should be that simple, we know that for many people, it is not. According to a recent report from the National Association of Community Health Centers (NACHC) and HealthLandscape at the American Academy of Family Physicians (AAFP), over 100 million Americans face barriers to getting much needed primary care.
In a health care system that is undeniably fragmented, we face growing health care deserts and workforce shortages in rural and urban communities alike. In fact, it’s estimated America will face a shortage of 86,000 physicians by 2036 – translated, that is a loss of more than 27 physicians in every county in the U.S. New solutions to increase access continue to face challenges. For example, one of the most influential companies in the world, Walmart, recently announced its decision to shutter all 51 of its doctor-staffed clinics after being open only for a few years.
The stats are alarming. Physicians are being inundated with appointments and patients, and those who are most fragile with multiple chronic illnesses are facing the poorest outcomes and highest costs. Compounding these issues, broader economic pressures, the rising prices of hospital and surgery procedures, and prescription drug costs set by drug manufacturers are creating the perfect storm – people getting sicker despite advancements in care.
We both grew up in rural America – Stephanie in a small Pennsylvania town and Adam in rural Missouri. We know firsthand the impact access to necessary health care can have on a small town. Similar passions inspired both of us to become pharmacists – Adam as a pharmacist for a regional Missouri hospital and Stephanie as an owner of an independent pharmacy for over 15 years. While our career paths took different turns along the way, we ended up in roles where our goals align and honor our early ambitions – to help people live their healthiest lives possible. These shared experiences led us to understand the solution to a fragmented health system lies within our ability to create points of connection locally. One of the most significant keys to success is independent pharmacists, who are well positioned to serve as these connection points to bridge the unique care gaps within their communities. During the COVID-19 pandemic, we saw this come to life when independent pharmacists stepped up to care for their local communities – from delivering needed medications and educating people on everyday illnesses to administering vaccines when traditional providers had to prioritize caring for the sickest people.
We believe an opportunity exists for more collaborative and innovative partnerships between pharmacy benefits managers (PBMs), like Express Scripts, and independent pharmacists. By leaning into community-level care, we can reach patients where they are, alleviate the strain on stretched health care physicians and providers, and fortify our nation’s independent pharmacies through enhanced revenue streams. With this goal in mind, last year we launched the Independent Pharmacy Advisory Committee, which convenes a diverse group of independent pharmacists to ideate solutions that include their perspectives and experiences. Through open dialogue with 39 independent pharmacy leaders, we are taking steps to work in tandem with pharmacy organizations to bring equitable care to people living in health care deserts through expanded care access initiatives.
Independent pharmacies are a viable solution to alleviating the provider shortages that threaten our mutual interest – to create vitality across the communities we serve. Synergy between companies like ours and independent pharmacists enables us to provide care to those who need it most, reduce cost barriers, and improve outcomes. When we work together with our neighbors and communities top of mind, we can take meaningful steps to build a sustainable system for health care.
