Complex Care Pharmacy Programs
Nebraska Total Care members with complex care needs have access to Complex Care Pharmacy Programs to help with their medications.
In August 2020, Nebraska Total Care implemented the ExactCare program, a high-touch pharmacy model coupled with proprietary technology and automation to provide comprehensive medication management, adherence support, and decreased total cost of care for the most complex and costly members. Eligible members on 6 or more maintenance medications or with known adherence issues who opt in to the program, receive a comprehensive in-home assessment (currently telephonic due to COVID), medication reconciliation, monthly medication review, “ExactPack” multi-dose adherence packaging, monthly home delivery of medications at no cost to member, and ongoing refill management services by a team of licensed pharmacists including medication refill synchronization to ensure adherence. Comprehensive Medication Reviews are also completed for eligible Nebraska Total Care members utilizing the Outcomes MTM platform. ExactCare has the MyECP mobile app that includes medication reminders via text, push notification, or email to take the right medication at the right time, allows members to access their list of medications 24h/365 days, and includes member resources to better understand their medications and potential side effects.
ExactCare Pharmacy makes it easier to manage medications by prepackage medications and providing free delivery every month.
- ExactCare packages medications by day and time. This helps members know what medications to take and when to take them.
- ExactCare works with a providers to handle prescription refills and avoid misses doses.
- ExactCare reviews the member’s medications every month, and discusses them with the providers if there are potential risks.
Eligible complex care members receive an introductory letter and follow up call from ExactCare to arrange an initial assessment either in person or by phone. In that assessment, they review the current medications and explain how they can help manage their complex medication regimen.
If a member you serve may benefit from ExactCare Care Management would be happy to help with the referral process. You or the member can call 1-844-385-2192 (Relay 711) and choose the Care Management option.
In May 2021, Nebraska Total Care Implemented the Community Pharmacies Enhanced Services Network (CPESN) chaptered organization, Nebraska Enhanced Service Pharmacies (NESP) Complex Care Program. NESP is a quality improvement clinically integrated network of 61 independent Nebraska pharmacies focused on developing and implementing enhanced patient care services. Each member receives a comprehensive 10-step medication review, monthly home delivery of medications in adherence packaging at no cost to member, and ongoing refill management services including medication refill synchronization and monthly medication reconciliation to ensure adherence. Comprehensive Medication Reviews will also be completed for eligible Nebraska Total Care members utilizing the Outcomes MTM platform. Local pharmacy engagement allows members who choose the option of continued routine face-to-face interactions with their clinical pharmacist and demonstrates the appreciation of local collaborative relationships with NE plan-pharmacy-provider partnerships.
Local community NESP pharmacists provide monthly home delivery of medications in adherence packaging, in depth counseling, and patient centered care.
- Complete medication review by local NESP pharmacist
- NESP pharmacist calls your doctor to discuss problems with your medications
- Monthly management of refills and medication packaging to help members know what medications to take and when to take them
Local NESP pharmacist(s) will notify eligible complex members they are eligible for the program, provide an introductory letter, and offer the opportunity to sign up for the opt-in program. A member specific care plan will be developed by the local NESP pharmacist following a review of current medications.
If a member you serve may benefit from NESP complex care pharmacy program, please refer the member to one of the pharmacies on the NESP interactive map, which includes pharmacy name and NESP pharmacist contact information.