EquityRx for Independent Community Pharmacies

Our Services

Initial Care Management Services

  • Remote Therapeutic Monitoring (RTM)

    Focus on improving adherence to prescribed medications, monitoring responses, and managing side effects in real time using digital health tools.

  • Annual Wellness Visits (AWV)

    These are annual preventive wellness visit to create or update a personalized plan to prevent future health risks by addressing current health status.

  • Social Determinants of Health (SDOH)

    Assessment that collects non-medical data, such as current living, food access, employment and transport to understand and support social needs

  • Remote Patient Monitoring (RPM)

    The use of cellular-enabled devices to collect health data from patients outside of traditional healthcare settings and transmit those vitals to healthcare providers.

Expanded Care Management Services.

Community pharmacies serve millions, including underserved, rural and high-risk populations. EquityRx strives to make care more accessible by offering remote preventative and care management services to empower your patients.

Through EquityRx, CPESN pharmacies can participate in a range of reimbursable services using Collaborative Practice Agreements, clinical staffing from JoinCareTeam PC, and infrastructure from Certintell.

Our goal is to build one unified platform that supports every CMS care management service — clinical, behavioral, and community — for Medicare, Medicaid, and Dual Eligible patients. It must handle documentation, workflows, time tracking, communication, billing, and reporting for all programs.

Community Health
Integration (CHI)

Personalized and supportive services provided to patients with unmet social drivers of health (SDOH) needs that interfere with, or present a barrier to, the diagnosis, treatment, and self-management of illnesses, diseases, or conditions.

Pharmacogenomics Diagnostic Services (PGx)

A drug-gene test that analyses how genes may impact an individual’s response to prescription or over-the-counter medications. This test assists in determining the most suitable medications and their appropriate dosages.

Medicare Shared Saving
Program (ACO)

ACOs aim to provide the right care at the right time while reducing unnecessary services. If an ACO successfully lowers costs and maintains high-quality care standards, it is eligible to share in the savings it achieves for Medicare. 

Preventative Lab Services
(PLS)

Medical tests used to detect health problems early, before symptoms appear, which helps in preventing serious illnesses. These services include routine blood tests to check for conditions like high cholesterol or diabetes, as well as other screenings based on a person's health history.

Principal Care Management (PCM)

PCM can be provided to patients with one complex chronic condition expected to last at least three months and that places the patient at significant risk of hospitalization, acute exacerbation, functional decline, or death.

Chronic Pain Management (CPM)

Various services, including specialized treatment programs and chronic care management (CCM). Coverage includes prescription drugs (Part D), outpatient services (Part B), and inpatient care (Part A), though specific benefits and costs depend on the plan.

Behavioral Health Integration (BHI)

The practice of treating a patient's physical and mental health needs in a single, coordinated system. This approach recognizes the connection between physical, behavioral, and social factors affecting a person's well-being to deliver "whole-person care".

Transitional Care Management (TCM)

The goal of TCM is for a provider to “oversee management and coordination of services, as needed, for all medical conditions, psychosocial needs and activity of daily living support.”

Advanced Primary Care Management (APCM)

APCM services combine elements of several existing care management and communication technology-based services you may already be providing to your patients. These services are subject to the usual Medicare Part B cost sharing requirement.

Chronic Care Management (CCM)

A critical component of primary care that contributes to better health and care for individuals. CCM allows healthcare professionals to be reimbursed for the time and resources used to manage Traditional Medicare patients' health between face-to-face appointments.

Principal Illness Navigation (PIN)

Services provided by auxiliary personnel or peer support specialists for Traditional Medicare patients with a serious, high-risk condition or illness to help patients navigate treatment for their health condition.

 FAQs

  • Yes, your pharmacy must be a part of CPESN networks to participate in the EquityRx program. The ability to provide EquityRx care management and preventative services is exclusive to pharmacies within the CPESN network.

  • EquityRx provides the essential infrastructure and resources necessary to help community pharmacies successfully expand their care services.
    Pharmacies serve as the direct delivery points for care alongside a complete support system that includes the people, processes, and technology to help provide new care services. By offering integrated clinical workflows, billing expertise, and a licensed clinical team, EquityRx ensures pharmacies can deliver and be reimbursed for care management and preventative services.

  • EquityRx aims to turn frequent patient interactions into clinical check-ins that create reimbursable revenue streams through the care already being provided every day. With EquityRx, the valuable time spent with patients can be documented and billed for to not only secure revenue, but more importantly, enhance patient outcomes through sustainable services.

  • EquityRx's care management and preventative services are designed to support patients with convenient, innovative, comprehensive, and personalized care that meets patients where they are at. Through remote services provided by community pharmacies, patients can receive the care they need outside of traditional doctor visits. These additional services aim to reduce barriers and provide proactive care so your patient's can live healthier and happier lives.