Improving access to care for rural Americans by supporting and empowering independent pharmacies

We sat down with Adam Kautzner, a pharmacist and the president of Express Scripts, who discussed some of our recent endeavors to improve access to quality care in rural America.

Approximately 20% of Americans live in rural areas, but less than 10% of physicians practice in those locations. This creates gaps in access to quality care for rural Americans.

At Express Scripts by Evernorth, we believe that independent pharmacists can help close those gaps as they serve on the front lines of care in their communities. With that in mind, we recently announced ways to expand the role of rural, suburban, and urban pharmacies in the health care system. These announcements include expanding rural health care access through partnerships with independent pharmacies, enhanced pharmacy services through Evernorth MoreThanRx Services, the launch of our Independent Pharmacy Advisory Committee and the appointment of our new Head of Independent Pharmacy Affairs — a new role within our organization — to deepen partnerships and expand access to care.

To better understand the strategy behind these endeavors, we sat down with Adam Kautzner, a pharmacist and the president of Express Scripts, who talked us through some of the details and why improving access to care is near and dear to him.


Adam Kautzner, PharmD
President, Express Scripts

Express Scripts has a series of initiatives to expand rural health care access through partnerships with independent pharmacies. Can you tell us more about your work with independent pharmacies and why?

Access to quality care is a concern across America, and we believe pharmacies — particularly independent pharmacies — can help us close some of those gaps. Last year, we funded a study with Columbia University Mailman School of Public Health, which found that 80% of patients see pharmacists as being essential to their care. That's especially true in rural areas. When you consider the physician shortage we are seeing in rural America, it’s easy to see the criticality that pharmacists play in care overall.

There are areas of the country where hospitals, doctors, specialists and other health care providers are not easily accessible. This creates a shortage of care in both rural and urban areas due to geographical and economic limitations. For many, getting access to a primary care doctor when they need a prescription just isn’t easy.

Our goal is to expand access to care while also supporting small businesses. We've announced plans to increase reimbursement rates for rural independent pharmacies. And even more importantly, we are going to enhance the level of engagement that we have with independent pharmacies. These efforts will be led by our new Head of Independent Pharmacy Affairs and our new Independent Pharmacy Advisory Committee.

You seem really passionate about expanding access to care for rural Americans. Talk to me about why that is.

I am a pharmacist, I'm from rural America, and I truly believe that independent pharmacists play an important role for patients and their care.

We continue to hear from our customers and from our clients on challenges to overall access to care. We’re working closely with independent pharmacists to expand the level of services they can provide to patients in a much more accessible way. And we believe it is going to be very efficient from a health care system perspective when pharmacists and pharmacies are able to provide different services beyond what they do today — evolving to meet patients’ needs today and in the future.

How will we help independent pharmacies expand the level of care they provide?

We would like to help these independent pharmacies go beyond dispensing medications and administering routine vaccinations to provide other components of care like COVID-19 testing, influenza or strep testing, hemoglobin A1C testing if you're a patient with diabetes, or lifestyle counseling for nutrition, smoking cessation, behavioral health screenings, or biometric screens. These are all health-related services that people typically would seek from a physician, but an independent pharmacy could do that for you and do it in an efficient way, both from a time and a cost perspective.

Much of this is powered by MoreThanRx, a suite of solutions from Evernorth that opens new doors of access for patients through partnerships with retail pharmacies across the nation. This includes chronic disease management through screenings and risk assessments, advanced opioid management with a holistic point-of-sale program and counseling, and medication administration services when pharmacist-administered injectables for medications may be appropriate.

Tell me more about how increased reimbursements will work.

We cover 100 million-plus Americans across the United States, and we have many members in rural areas. We use what’s called geo mapping and an overlay of all pharmacies in our network to identify when a pharmacy is the only one within 10 miles of a member. In those cases, we’re making an improved amount of reimbursement available to those independent pharmacies.

What’s in it for Express Scripts?

We want to be able to improve the care for all Americans that we serve, and we know that health equity and accessibility to care is critical. This is important to our clients and members, and therefore important for our organization. Our goal is to make sure members get the care they need, where and when they need it,

A person’s ZIP code should not determine how healthy they are and what type of care they receive. We have to continue to strive to do better, and this is a way that we're going to do that through helping independent pharmacies provide greater levels of care to the communities that they serve.

See how our solutions can help
MoreThanRxSM Services
Evernorth MoreThanRx Services is a suite of products that opens new doors of access to patients through our partnerships at retail pharmacies across the nation and through home delivery. Pharmacists in our network can test for common disease and illness, immediately prescribe and fill the medication, and provide medication counseling – often all in one visit.