More Than a Script: Partnering with community pharmacists

If you’re reading this, you’re probably very aware of the major changes in health care over the past 15 years: rapidly rising costs for drugs to treat chronic conditions, new reimbursement models, more effective medical treatments, and provider shortages that have caused many professionals in the health care system to take on new duties that reflect the full scope of their expertise and licensure.  

It’s time pharmacists are reimbursed for taking a more prominent role in helping patients and their doctors manage chronic health conditions. As a pharmacist myself, I’m excited about a new initiative program that recognizes the vital role pharmacists play in the health of North Carolina. 

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has launched an innovative pharmacy program for our members who have been diagnosed with diabetes and / or hypertension. It’s called More Than a Script, an important step forward in improving chronic care management and effective medication use. The program – one of the largest of its kind in the nation – allows independent pharmacists to do more of what they’re trained to do: provide personalized, enhanced health care in local pharmacies. 

In partnership with community pharmacies across North Carolina, More Than a Script leverages free, enhanced services provided by pharmacists to increase access to quality health care provided to Blue Cross NC members with chronic health problems that pose a great challenge to our state. These consultations can be virtual, over the phone, or in-person and are provided with no out-of-pocket costs for our members. 

Why are we targeting diabetes and hypertension? These two common conditions are costing everyone in our state – in both quality of life and in dollars.

If you live in North Carolina, there’s a good chance you either know someone with diabetes or are dealing with it yourself. More than 1 million people in our state have been diagnosed with diabetes (PDF), affecting 12.3% of the adult population. Another 244,000 people have diabetes and don’t even know it, posing significant danger to their health. 

The numbers for high blood pressure – also called hypertension in medical circles – are even more alarming. As of 2020, 2.8 million adults in our state have hypertension (PDF), more than one-third of the adult population. Hypertension contributed to a quarter of all deaths in North Carolina in 2018. 

In addition to the impact on quality of life, there is also a financial component to chronic conditions like diabetes and hypertension. For example, people with diabetes incur medical expenses more than two times higher than people without diabetes. Hypertension is responsible for $1.4 billion in hospital charges in North Carolina each year – about $36,000 per admission. Everyone in North Carolina bears the burden of these costs. 

Driving those numbers in a different direction is going to take innovation and collaboration. Those are the foundation of More Than a Script’s enhanced community pharmacy services:    

• Medication management
• Chronic care management
• Diabetes prevention and self-management programs

Here’s how More Than a Script works: A cloud-based electronic health record solution called DocStation mobilizes retail pharmacies to practice to the full extent of their licensure to complement the care of physicians. At the convenience of the pharmacy counter, Blue Cross NC members will receive messages about medical tests, recommended vaccines, and other health information with their pharmacy claims information. Pharmacists will complete direct outreach to members to increase engagement and remove barriers to improve members’ overall health and well-being. 

The goal is to optimize our members’ care by enhancing transparency between the member’s primary care provider and the community pharmacist, improving access to medications while partnering with providers to determine the best medication regimens. Throughout the process, Blue Cross NC keeps providers informed of pharmacist recommendations.   

When a member enrolls in More Than a Script, DocStation serves as a communication hub, allowing pharmacists to send a fax to the member’s provider with any relevant recommendations. Changes to medications would require the provider’s agreement and a prescription written by them. More Than a Script does not take away any decision-making from physicians or other providers.

An important part of More Than a Script is the formation of a Pharmacy Advisory Group, including representation from the Community Pharmacy Enhanced Services Network, the North Carolina Association of Pharmacists (NCAP), the North Carolina Mutual Wholesale Drug Company, and the UNC-Chapel Hill Eshelman School of Pharmacy. In conjunction with Blue Cross NC, this group will share best practices for chronic care management in community pharmacies, allowing for important connections between pharmacists across multiple areas of health care.  

More Than a Script is the next step for Blue Cross NC moving toward value-based care, which also includes Blue Premier℠, our signature transformation effort. Prescription drugs continue to be a primary driver of rising health care costs, with drug costs climbing more than 5% in 2022. Medications for chronic conditions are even more costly, rising 9% during that same year. 

Blue Cross NC will continue innovating to lower these costs for our members. More Than a Script is just one way we’re working to expand access to affordable, quality health care across North Carolina.