Optum launching new programs that lean on independent pharmacies to close care gaps

Optum Rx is rolling out new programs aimed at supporting independent and rural pharmacies in closing care gaps beginning in June.

The pharmacy benefit manager said Tuesday that the new initiatives will focus on three key areas: helping patients in underserved areas connect to community resources, improving maternal and fetal health by boosting access to key supplies and deploying community pharmacies to address healthcare deserts.

The new initiatives kick off what Optum said is a "broader, industry-leading commitment to bridge resource gaps in the community."

“These initiatives provide opportunities not only to help patients, but also to offer appropriate compensation that recognizes the clinical expertise and unique capabilities our community and independent pharmacy partners have to meet the needs of their patients," said Heather Cianfrocco, CEO of Optum Rx, in the release.

Optum Rx will partner with pharmacies to connect patients with Unite Us, a national technology platform that connects people with local resources and community assistance. The PBM said this program will launch on June 1 in seven states—North Carolina, Nebraska, New Jersey, New Mexico, New York, Texas and Louisiana—before expanding nationwide this fall.

The program will focus first on pregnant women and people with diabetes, Optum said.

In July, the company will launch its new Maternal & Fetal Health Program, which will assist pharmacists in directing pregnant women to seek key prenatal care to reduce preterm labor and pregnancy complications. This includes helping pregnant women secure appropriate prenatal vitamins, community diaper bank resources and baby supplies.

Finally, in the fall, the PBM will launch the Pharmacy & Provider Desert Program, which aims to lean on community pharmacies to address key barriers in access to care.

“As one of the nation’s largest [pharmacy services administration organizations], Health Mart Atlas is committed to helping strengthen the overall health of pharmacies and elevate the role they play in people’s lives," Crystal Lennartz, vice president and general manager of Health Mart Atlas & Atlas Specialty, in the release. "Collaborating with Optum Rx is an important extension of this work. Our participating pharmacies are well positioned to help address patient access to available resources in underserved communities.”

PBMs have been in the hot seat in Congress for weeks, and potentially substantial reform is on the horizon for these companies. Optum Rx and its peers have taken steps to roll out new programs that combat the major complaints about pharmacy benefit managers—namely, that a lack of transparency is a major factor in the rising cost of drugs in the U.S.

Rival Express Scripts also unveiled a new program aimed at rural and independent pharmacies last month and said it will roll out new financial incentive programs as well as offer greater opportunity for these pharmacies to participate in its network. In addition, Express Scripts launched a new, more transparent PBM model that it said will keep the company accountable for high-quality service.