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Stephanie Smith Cooney is senior director of independent pharmacy affairs for Express Scripts at Evernorth, one of the nation’s largest pharmacy benefit managers (PBMs). Her background as a community pharmacy owner provides a unique perspective as she explores new ways to support independent pharmacists and their essential roles on the front lines of health care.
Stephanie Smith Cooney
Cooney joined Express Scripts PBM in August 2023 to establish the Office of Independent Pharmacy Enablement and lead the industry’s first Independent Pharmacy Advisory Committee. In the ensuing months, she’s met with countless independent pharmacists and people throughout Express Scripts to learn more about opportunities to collaborate and innovate, as well as the challenges that are critical to overcome so that pharmacists can continue to provide the care that members need.
We sat down with Cooney to ask about how her job has developed, what she’s learned, and what she’s looking forward to in the future.
I was drawn to Express Scripts by the possibility of trying to help two entities that need each other: Express Scripts needs independent pharmacists in our networks, and the independent pharmacists are relying on Express Scripts for their business model to work. By having a seat at the table and bringing the viewpoint of the independent pharmacist, I can be an agent for change.
I was excited about the IndependentRx Initiative, which had launched in April 2023 to strengthen the role of independent pharmacists in rural communities and increase their reimbursement opportunities. In addition, I was intrigued by the opportunity to lead the Independent Pharmacy Advisory Committee, which met for the first time in November, shortly after I joined Express Scripts.
I admit to being skeptical when I came on board, wondering if this was just for show or optics. However, nearly a year in, I believe there’s an interest in trying to figure this out and support independent pharmacies, and I’ve felt very supported in this role from the beginning. I’ve been pleased that so many people across so many parts of the organization are open to what I have to say and are open to thinking about things in a different way.
This culture of change, of innovation, is what I’ve noticed from day one. So much of the work I’ve been doing has supported my original mindset, that I can be an agent for change and that there is a lot of value in having the perspective of an independent pharmacist at Express Scripts. We’ve naturally evolved into the conversation, figuring out the next iteration of the collaboration between independent pharmacists and Express Scripts.
My role is not limited to any one area, and I’ve found that to be helpful. One of the less tangible benefits of my cross-functional role is helping teams think about the perspective of the independent pharmacist in a way that is causing more collaboration among teams. For example, we are bringing some of those teams together around the support role Express Scripts plays and the customer service role that we have with independent pharmacies.
Some of the feedback I get is that there was an expectation that having a person in this role to serve as an advocate would lead to immediate change. We are making progress, but change isn’t going to happen overnight because we’re striving to get it right. I understand what they’re feeling, and the urgency they are feeling. However, one thing that I have learned is that because we are a large organization, implementing new systems can take a while – such as standardizing any changes across thousands of providers.
We have a lot underway. Many of our improvements are rolling out in steps, so they might not yet be obvious to the observer.
This committee and this initiative are critical. The 38 members of the group, who are all pharmacy owners or managers, have an open channel of communication with me. These 38 voices are representing the viewpoints of independent pharmacists. Their voices are being elevated and heard, and they are informing our strategy.
There’s a broad representation of pharmacists on the committee. Some of them own a single store, and a couple own 20 stores or so. They’re from all over the country, including a pharmacist/owner from Alaska who lives on an island only accessible by ferry. Others have inner-city locations.
It’s a diverse and innovative group. These are leaders in this space, people who are open to new ways of thinking. They are interested in change. I reach out if I have a question or need feedback, and they always can provide ideas. There’s a lot of ad hoc communication. We’ve had two committee meetings so far, with the most recent taking place a few days ago, and we are planning to host the next in November.
When we convened for the first time, what I heard from the group was that they are most concerned about the service experience with Express Scripts and reimbursement. That meeting influenced our most recent announcement about the collaboration with CPESN USA, and we expect to be able to share more updates soon. It’s gratifying to see feedback from committee members implemented this quickly.
At the end of the day, I think the general sentiment of independent pharmacists is they don’t want to see patient access suffer. They want to take care of their patients – they’ve been doing that for a very long time, and they want to be able to continue doing that. Their concerns hit especially hard because they are on the front lines seeing patients going without care or not having access to care.
In my mind, that’s the whole purpose of this initiative. We’re trying to figure out how to address the issues pharmacists face in a way that makes sure patient access is protected.
