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Kelsey Linn’s path into pharmacy started at a 340B pharmacy start-up serving hepatitis C and HIV populations. Early in her career, Linn saw firsthand how community-based pharmacy care could help people access medications, navigate complex needs and improve their health — a perspective that now shapes her work in pharmacy case management helping Highmark Wholecare members get the care and support they need.
Her pursuit of improved access and better health outcomes has led Linn to build a trusted relationship with the Pennsylvania Pharmacists Care Network (PPCN), through its innovative EngageRx program that goes beyond filling prescriptions and addresses health-related social needs, supports medication adherence and helps members manage chronic conditions through more personalized, community-based care.
In 2022, Highmark Wholecare launched its version of EngageRx in 27 counties to provide reimbursement for pharmacist-provided enhanced patient care services for its members. Since launch, the health plan has collaborated with 118 unique community pharmacies that have provided more than 150,000 services through approximately 100,000 member engagements. Nearly 13,000 Highmark Wholecare members have benefited from the program.
For additional perspective on EngageRx, also see the sidebar.
John Pepper: Let’s start with your career path. Can you tell me more?
Kelsey Linn: I graduated from Duquesne University in 2012 with a PharmD degree and took a job with a national 340B pharmacy start-up that focused on hepatitis C and HIV populations. After five years, I landed at Gateway Health (now Highmark Wholecare) as one of the first pharmacists of the team I currently manage. The job was providing face-to-face engagement for Medicaid members, which is unique because health plan pharmacists aren’t traditionally boots on the ground interacting with members.
At Gateway, I was embedded in AHN Primary Care - Forbes Family, working alongside physicians, nurses and our members. I operated like an ambulatory care pharmacist, which I loved! I gained many insights working in a provider’s office and seeing what staff were challenged with has shaped the way I approach my work.
John Pepper: In your current role as manager of pharmacy case management, how would you describe your job responsibilities to someone who doesn’t work in health care?
Kelsey Linn: My team helps people overcome hurdles that prevent health plan members from getting their medications.
Unless you’ve been in this situation, it’s hard to understand the barriers people face. Those barriers can include being physically unable to get to the pharmacy, coverage issues that cause a medication to be rejected, medication being sent to the wrong pharmacy location, a medication not being on our formulary, or an unaddressed prior authorization requirement.
It requires someone behind the scenes sorting these issues out. Not every pharmacy has pharmacists with the bandwidth to navigate these challenges. They don’t have the time, and they’re not getting paid to do it. That’s what my team is doing on the back end. It's care management.
John Pepper: Pharmacists providing care management through enhanced services is at the core of the EngageRx program. Instead of limiting pharmacists to medication dispensing, how does EngageRx expand its scope?
Kelsey Linn: The traditional pharmacy model is centered around numbers. How many scripts can you fill? How fast can you answer the phone? How fast are you moving people out of here? And if, as a pharmacist, I focus on any one thing, it will negatively impact my ability to be paid, promoted and considered successful. It’s the antithesis of what we want to happen.
That’s why we lean on PPCN. They provide a level of service that’s akin to what I want my family to have or what I want to have for myself. It’s what feels right to provide people. It’s what a pharmacy is supposed to be. Why have pharmacies where people can walk in, but never provide the opportunity for them to interact with the people that they're walking in to talk to?
With EngageRx, we’ve created a value system where when you go beyond filling prescriptions, we pay you. That could be things like vaccine gap closure, health risk assessment, social determinants of health assessments and referrals, hypertension monitoring and management, naloxone dispensing and education, and more. Through this reimbursement, we’re creating the financial support pharmacists need to spend more time interacting with members. It creates a revenue stream that helps pharmacies hire staff and operate more like they used to — with greater capacity for personalized care.
John Pepper: With more than 15 member services offered, Highmark Wholecare has the most comprehensive EngageRx program in the state. What was the strategy behind building this type of robust program?
Kelsey Linn: I’m always listening, following what’s happening in the industry, and anticipating what’s in the pipeline that may become an issue. Sometimes the state comes to us and says they’re seeing a higher incidence of a certain condition and we need to do something about it.
Pharmacists are very good problem solvers because we’re used to solving lots of problems. The first thing we do when an issue is identified is consider what we have in our toolbox that we can leverage. EngageRx has become one of the first things that’s considered as a potential solution because of its flexibility. We’ve created an amazing solution opportunity with this program. I don’t foresee any barriers around its potential.
What I’m seeing from other plans for this program is a more traditional, in-the-box clinical focus. I’m not saying that isn’t valuable, but I’m more interested in building on top of that. At Highmark Wholecare, the focus has always been on members — their needs and social determinants of health (SDOH). It’s about caring for the whole person.
John Pepper: How does EngageRx work operationally?
Kelsey Linn: This program only exists because of the state’s Community-Based Care Management program. We need permission from the state to change or add services. Then Stephanie McGrath, PPCN executive director, and I got to work. We’ve created a guidebook for the pharmacies. We provide an outline of our expectations and ensure the goals of our desired outcomes are understood. For that work, we pay pharmacies for the service. PPCN creates training and guidance materials and provides support for their 200 network pharmacies to explain what the pharmacists should be doing to support the service.
Every month we comb through the EngageRx claims. The pharmacies are requesting payment for services in the program. For example, a woman had an SDOH screening by this pharmacist on this date, and she was also given a vaccine. For these reasons, we’re asking for reimbursement. We check our claims systems to verify the services were provided.
We don’t send patient lists to the pharmacies and say, “These are the folks we want you to engage with.” All Highmark Wholecare members are eligible for EngageRx services. We let the pharmacists figure out on their own who to engage in the program.
John Pepper: How does EngageRx align with Highmark Health’s mission to create a remarkable health experience?
Kelsey Linn: It aligns perfectly because we’re making things easier for people. Nobody wants to be unhealthy, no one wants to have hypertension, no one wants to have diabetes. It's all the things that get in the way that keep people from being as healthy as they want to be or making their health care easy. Health care is hard. It’s hard to make an appointment. My husband has a slew of specialists. We schedule appointments six months out for the middle of the day. We have cars, we have time, we have childcare, we have money, we have resources that a lot of people don’t have, and it’s still hard for us.
The root of what we’re doing is making health care easier and more accessible for people because they deserve it. They can go to their pharmacist in their own community now. They don't have to make that appointment. They don't have to wait six months.
Health care shouldn’t dominate your life. If you’re spending all your time doing something, you will come to hate having to do it, and then you’re not going to want to do it. We want people to enjoy time with their families, their hobbies, doing what they love.
The EngageRx program makes things a little bit easier, and then beyond that, it helps people address the needs that also cause stress in their lives and takes their attention away from prioritizing their health.
The faces of the EngageRx program include a new mother confronting the loss of SNAP benefits; a family’s primary driver losing his ability to drive due to surgery; an expectant mother navigating her antipsychotic meds during pregnancy and post-partum; and a man addressing high blood pressure concerns due to his medications.
These Highmark Wholecare members are having health-related social needs met, ensuring medication adherence, and addressing chronic conditions through the EngageRx program. The program empowers and rewards pharmacists to become vital pillars of support, offering not just medication, but human connection and comprehensive, personalized care.
Heather Eddy, a pharmacist at Waynesburg’s McCracken Pharmacy, a locally owned pharmacy embedded in a rural Pennsylvania landscape, embodies this human-centric approach. “I didn’t become a pharmacist to count pills and be on a computer all day,” Eddy says. “I wanted to help people. Through EngageRx, I’m having a direct impact on patients by being a valuable resource for them and working to make their lives easier.”
Eddy spends her Tuesdays on outreach, connecting with Highmark Wholecare members — identifying needs, providing guidance and, at times, lending a helpful ear. “Women who recently gave birth and are breastfeeding every two hours can’t go anywhere for the first few weeks. It’s hard enough to sleep, let alone leave the house,” says Eddy, a soon-to-be mother of two. “Speaking from personal experience, it’s fantastic to just be with your baby. But they don’t talk back. They don’t bounce ideas off you. They don’t have conversations. New moms appreciate whenever I call them because it's someone who can relate to them and can talk to them about whatever's going on.”
The conversations reveal profound insights into the challenges faced by the community Eddy serves. “I've been shocked and surprised to learn how many people don't have transportation or enough money for food every day,” she acknowledges. “I knew there were these types of issues in the community, but it hits harder when you hear about it directly from people.”
Program structure fosters a deep level of engagement, where patients feel seen and heard. It’s a framework well-suited for the independent and community pharmacies that developed and manage the program.
“Community pharmacies are embedded in the neighborhoods they serve, providing trusted care where people live, work and raise their families,” states Stephanie McGrath, PharmD, Executive Director of the Pennsylvania Pharmacists Care Network, of which McCracken Pharmacy is a member. “They understand local needs and respond with personal, accessible healthcare.”
With more than 50 years’ history in the community, McCracken Pharmacy is defined by its deep local roots. Eddy works alongside her husband, Drew, a pharmacist raised in the town he now serves. The other two store pharmacists, Andrew Behm and owner Scott Adamson, are area natives.
Performance data for EngageRx between 2022 and 2025 is impressive:
For Eddy, the program is about people, not numbers.
“We’re like a good neighbor. A well-stocked, well-prepared neighbor,” she says. “When you visit, they always have what you need. It’s a neighbor who’s helpful and checks in on you on a regular basis. Not to bother you, but to help you and to provide you with information to get you out of whatever situation you're in.”
She laughs, adding, “Like your friendly neighborhood Spider-Man.”
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