New Optum Rx programs meant to support independent and rural pharmacies

Photo: Tom Werner/Getty Images

New programs and partnerships between Optum Rx and community pharmacies are aimed at expanding care access, preventative services and medication adherence in underserved communities, the pharmacy benefit manager said this week.

Optum Rx is launching initiatives meant to support pharmacists in connecting patients to services that address needs such as food, nutrition, transportation, housing and baby supplies.

The initiatives will focus on three main areas:

• Connecting underserved patients to community resources, beginning with pregnant women and patients with diabetes. 
• Improving maternal and fetal health through increased preventative prenatal vitamin use, access to community diaper bank resources and baby supplies.
• Providing increased access to resources through community pharmacies in healthcare deserts.

Launching in select states starting in June, the programs will be offered nationwide to all pharmacies later this year. Optum Rx promised that participating pharmacies will receive "appropriate reimbursement."

According to the company, the programs kick off a broader commitment to bridge resource gaps in the community.

WHAT'S THE IMPACT?

Optum Rx's program, focused on housing, transportation and food, which launches June 1, will help community pharmacies serving Optum Rx members connect those members to the Unite Us site, a nationwide technology platform that identifies social care needs to connect people with community services and resources at a local level.

The program will initially launch in North Carolina, Nebraska, New Jersey, New Mexico, New York, Texas and Louisiana, and will focus on people with diabetes and pregnant women. In the fall of 2023, these programs will roll out nationally.

On the maternal health front, Optum Rx's Maternal and Fetal Health Program, launching in July, will support pharmacists in encouraging pregnant women to seek preventative prenatal care to decrease both preterm labor and pregnancy complications.

This initiative is the latest in a larger effort to address maternal and infant health, with UnitedHealth Group, Optum Rx's parent company, currently investing nearly $9.3 million across 13 states to address the issue.

Finally, the Pharmacy and Provider Desert Program, launching in fall 2023, will attempt to increase access to pharmacy and other healthcare services for members who live in healthcare deserts.

THE LARGER TREND

The announcement from the pharmacy benefit manager comes just a few months after the House Oversight Committee launched an investigation into PBM's tactics, which Chairman James Comer (R-KY) said are "harming patient care and increasing costs for consumers."

Comer called on senior officials at the Office of Personnel Management (OPM), Centers for Medicare and Medicaid Services and the Defense Health Agency (DHA) for documents and communications to determine the extent to which PBMs' practices impact healthcare programs administered by the federal government.

The committee also called on the largest PBMs – CVS Caremark, Express Scripts and Optum Rx – to provide documents, communications and information related to their practices. Calling their practices "anticompetitive," Comer said they're distorting the pharmaceutical market and limiting high-quality care.

CVS Health's CVS Caremark, Cigna's Express Scripts, and UnitedHealth Group's Optum Rx control an estimated 80% of the PBM marketplace, according to the House Committee.
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com