Discover
Identify healthcare programs and services that may be available to pharmacies.
Connecting pharmacies to healthcare opportunities
MDHIN Pathways
Discover the pathway. Build the capability. Connect the care.
MDHIN Pathways helps pharmacies identify, understand, and participate in healthcare opportunities that expand the role of the community pharmacy.
✓
One network. More opportunities. Better access to care.
One Pharmacy. More Pathways to Care.
Turn pharmacy access into healthcare opportunity.
Community pharmacies are already among the most accessible points of healthcare in the country. MDHIN Pathways helps turn that access into opportunity. Pathways brings together the information, connections, workflows, and resources pharmacies need to identify services they may be able to provide and the programs through which those services may be supported.
Medicaid opportunitiesCommercial payer programsClinical pharmacy servicesMedication managementDisease managementPreventive careImmunizationsLaboratory servicesCare navigationPopulation healthProvider collaborationEmerging programs
Opportunities vary by state, payer, program, provider qualifications, enrollment status, and applicable requirements.
The pathway from opportunity to participation
Finding an opportunity is only the beginning.
A pharmacy needs to understand the requirements, determine whether it qualifies, establish the appropriate provider relationships and enrollment, understand the billing pathway, and build an operational workflow. Pathways helps organize that journey.
Verify
Review the applicable state, payer, program, provider, enrollment, billing, and operational requirements.
Prepare
Understand the credentials, enrollment, documentation, workflows, and clinical capabilities needed to participate.
Connect
Connect with the appropriate healthcare, payer, provider, and technology resources.
Participate
Support the pharmacy as it begins delivering services through the applicable program or pathway.
Grow
Identify additional services and opportunities that expand the pharmacy's role in community healthcare.
A nationwide view of pharmacy opportunities
Organized by state and by service.
Medicaid programs, commercial payers, state regulations, enrollment requirements, billing rules, clinical services, and reimbursement structures can vary significantly. Pathways is being developed to make those differences easier to navigate.
01
Medicaid
Explore state Medicaid programs and potential pharmacy participation pathways.
02
Payers
Identify opportunities for pharmacies to participate in payer and health-plan programs.
03
Clinical Services
Explore clinical and patient-care services available to qualified pharmacies and pharmacists.
04
Medication Management
Identify medication management and related clinical service opportunities.
05
Disease Management
Explore pharmacy-based disease management and population-health programs.
06
Preventive Care
Identify opportunities involving immunizations, screening, wellness, and preventive services.
Pathways for every state
Built around verification, not assumptions.
Each state pathway can evaluate the provider, payer, clinical, operational, and billing details that determine whether an opportunity is actionable.
EnrollmentPharmacy, pharmacist, provider type, specialty, and taxonomy requirements
ProgramsMedicaid participation, managed-care considerations, and payer programs
AuthorityClinical service authority and program-specific qualifications
BillingBilling requirements, reimbursement, and claim submission pathways
ProvidersBilling, supervising, and rendering provider requirements
DocumentationRecords, care workflows, and program-specific documentation
OperationsWorkflow, staffing, credentialing, and clinical capability readiness
Verification StatusClear distinction between verified pathways and items needing confirmation
✓
Requirements can change.
Pathways distinguishes verified opportunities from opportunities that still require additional confirmation.
Built for connection
For pharmacies and healthcare partners.
For Pharmacies
Whether you are an independent pharmacy, community pharmacy group, specialty pharmacy, or growing pharmacy organization, Pathways can help you identify opportunities to expand your healthcare capabilities.
- Explore new opportunities
- Understand requirements
- Build the right workflow
- Connect with resources
- Expand the care you provide
- Discover what is possible
For Healthcare Partners
Pathways creates opportunities for healthcare organizations, providers, payers, and other partners to connect with community pharmacies through existing local infrastructure.
- Patient access
- Care navigation
- Clinical programs
- Population health
- Preventive care
- Community delivery
The MDHIN Pathways Network
Connecting the pharmacy healthcare ecosystem.
Pharmacies
Providers
Payers & Health Plans
Clinical Programs
Technology & Workflows
Patients & Communities
The result is a more connected approach to pharmacy-based healthcare, with less searching, more clarity, better opportunities, and a more connected pharmacy.
Start your pathway
Every pharmacy has a starting point.
Maybe you are looking for your first clinical service, want to participate in Medicaid, are ready to expand your existing clinical services, or need to identify payer opportunities across additional states.
Your pharmacy may already be capable of doing more. Pathways gives you a place to start.
MDHIN PathwaysConnecting Pharmacies. Improving Lives.