Inside Phoebe Putney’s Medication Management Clinic: How One Rural Health System Saved $1 Million and Cut Readmissions

Darren Evans, PharmD, is vice president of pharmacy services for Phoebe Putney Health System, where he oversees pharmacy operations across the system's 4 acute care hospitals in southwest Georgia, including its cancer center, employee pharmacy, medication management clinics, informatics, specialty services, and 340B programs. Evans has been a driving force behind Phoebe's expanding pharmacy footprint, which most recently included the 2025 opening of a combined specialty and retail pharmacy on the health system's main Albany campus—a move designed to give patients, employees, and the broader community easier access to essential medications, curbside pickup, and specialty care support in one location.

That expansion reflects a broader strategy Evans has championed at Phoebe: using pharmacists as frontline problem-solvers for the access and affordability barriers that disproportionately affect rural patients. Central to that strategy is the health system's Medication Management Clinic (MMC), a pharmacist-led program built to close gaps in care between hospitals, providers, and pharmacies. Since its inception, the clinic has fielded 962 referrals and helped patients save more than $1 million across 542 prescriptions in its first year alone, while a dedicated pathway for congestive heart failure patients has helped drive down hospital readmissions.

In this Q&A with Pharmacy Times, Evans discusses how the MMC evolved from a small referral-based pilot into a population health strategy, the outsized role of the 340B program in sustaining it, and what pharmacy leaders at other rural or regional health systems should consider before building a similar model.

Pharmacy Times: Phoebe Putney serves a largely rural patient population in southwest Georgia. What does medication adherence look like in your region, and what gaps in care motivated you to build this program?

Darren Evans, PharmD: Medication adherence in rural southwest Georgia is influenced by many of the same challenges seen across underserved communities, including transportation barriers, medication affordability, limited access to primary care, lower health literacy, and a high burden of chronic disease. What we found was that most patients weren't intentionally nonadherent—they simply faced obstacles that prevented them from obtaining or taking their medications as prescribed. The greatest gap existed between the provider's office, the hospital, and the pharmacy, where patients often lost continuity of care.

We recognized an opportunity for pharmacists to bridge those gaps by creating a centralized medication management clinic (MMC) focused on improving medication access, affordability, education, and ongoing support. Ultimately, our goal was to move beyond dispensing medications and create a pharmacist-led care model that helps patients successfully manage their therapy, improves health outcomes, and strengthens coordination across the continuum of care.

Pharmacy Times: Walk us through how the Medication Management Clinic came together. What did it look like in the early days, and what has it evolved into?

Evans: The MMC began with a simple but intentional vision: to better leverage pharmacists as clinical partners in helping patients overcome medication-related barriers. Initially, the program relied on retrospective referrals, with providers identifying patients after affordability, adherence, or access issues had already been recognized.

As we demonstrated measurable value, the program evolved into a comprehensive medication access and management service integrated across multiple clinical workflows. Today, our pharmacists work collaboratively with physicians, care managers, specialty pharmacy, and hospital teams to optimize medication therapy, assist with financial assistance programs and prior authorizations, support transitions of care, and proactively identify patients before medication-related challenges lead to poor outcomes. What started as a targeted intervention has become a population health strategy that supports patients across the continuum of care while helping providers deliver more coordinated, efficient, and patient-centered care.

Pharmacy Times: Can you elaborate on what the specialty pharmacy does?

Evans: Our specialty pharmacy is a critical component of our overall medication management strategy because it serves patients who require high-cost, high-complexity therapies. Many of these medications carry significant financial burdens, particularly for the rural and underserved populations we serve.

The MMC and our specialty pharmacy work together to ensure cost is not a barrier to treatment. Our pharmacists help patients navigate manufacturer assistance programs, charitable foundations, copay assistance, and other financial resources while coordinating closely with providers to ensure therapy is initiated and maintained. This integrated approach allows us to improve medication access, support adherence, and help patients realize the full benefit of these life-changing therapies.

Pharmacy Times: With 962 referrals, you've clearly built strong pipelines into the clinic. How do you identify which patients need medication management intervention, and who's making those referrals?

Evans: Those 962 referrals occurred since the program’s inception, which speaks to both the need within our community and the confidence our providers have placed in the MMC. Since then, referral volume has continued to grow as the program has become more integrated throughout our health system. Our referrals come from multiple sources, including primary care providers, specialists, care management teams, hospital discharge coordinators, CHF [congestive heart failure] navigators, and pharmacists. We focus on patients with complex medication regimens, affordability concerns, multiple chronic conditions, high-risk medications, or barriers that place them at increased risk for poor outcomes.

One of the keys to our success has been embedding pharmacists into clinical workflows so patients are identified proactively rather than reactively. Medication-related barriers don't occur in just 1 setting—they may become apparent in the physician's office, during a hospitalization, at the pharmacy, or through care management. Building strong interdisciplinary relationships has allowed us to identify those barriers earlier and intervene before they result in avoidable complications or hospitalizations.

Pharmacy Times: More than $1 million in savings across 542 prescriptions is remarkable.

Evans: We're incredibly proud of those results, especially considering they were achieved during the MMC's first year of operation. More importantly, those savings represent patients who were able to access therapies they otherwise may not have received.

Pharmacy Times: What are the most common affordability barriers your patients are running into, and how does the clinic address them?

Evans: The most common barriers we encounter are high out-of-pocket costs, insurance coverage limitations, specialty medication expenses, and the financial realities many patients face while living on fixed incomes. Too often, patients are forced to choose between paying for medications and meeting other basic needs.

The MMC works closely with manufacturers, charitable foundations, patient assistance programs, and our own internal resources to identify the most appropriate and affordable option for each patient. In some cases, that means securing copay assistance; in others, it's identifying clinically appropriate therapeutic alternatives or leveraging our 340B program where appropriate.

Ultimately, affordability is one of the strongest predictors of medication adherence. Our role is to remove those barriers so patients can focus on managing their health rather than worrying about whether they can afford their treatment.

Pharmacy Times: The 340B program is often discussed in policy circles, but you're using it at the point of care. How does 340B factor into what you're doing, and what would your program look like without it?

Evans: For organizations serving rural and medically underserved communities, the 340B program is much more than a reimbursement mechanism; it's an essential resource that allows us to reinvest savings directly into patient care. At Phoebe, those savings support clinical services that improve medication access, expand pharmacist-led care, and reduce financial barriers for vulnerable populations. Programs like the MMC, our Integrated Care Oncology Pharmacy Clinic, and other pharmacist-led initiatives are strengthened through investments made possible by 340B.

Without those resources, health systems serving communities like ours would face difficult decisions about the scope and sustainability of many clinical programs. We view 340B as an opportunity to reinvest in our patients by expanding access, improving outcomes, and addressing health care disparities throughout southwest Georgia. For us, 340B isn't simply a pharmacy program; it's a community investment strategy that enables us to deliver services our patients otherwise might not have access to.

Pharmacy Times: CHF transition-of-care referrals reaching 15% of your total volume—and contributing to a drop in readmissions—is a standout result. Can you walk through what that care pathway looks like and why medication management is so central to it?

Evans: Patients with heart failure often have some of the most complex medication regimens in health care, and the period immediately following hospital discharge is one of the highest-risk transitions in their care journey. Medication changes, affordability concerns, and the need for patient education all converge during this time, creating significant opportunities for medication-related complications if left unaddressed.

Our process begins before the patient leaves the hospital through close collaboration with our CHF Navigator and inpatient care teams. Patients are referred to the MMC, where pharmacists perform medication reconciliation, assess adherence risks, evaluate affordability, ensure prescriptions are obtained, and provide disease-state education.

One of our primary goals is to identify barriers before they result in a preventable readmission. If a patient cannot afford a newly prescribed medication or doesn't understand how to take it, we want to address that within days of discharge—not after they've returned to the hospital. Whenever possible, we see patients within 7 days of discharge because early pharmacist intervention has consistently demonstrated its ability to improve adherence and reduce readmissions.

This is an excellent example of how pharmacists contribute beyond medication management. By addressing clinical, financial, and educational barriers simultaneously, the MMC improves outcomes while supporting Phoebe's broader population health and value-based care strategies.

Pharmacy Times: How does delivering this kind of program in a rural setting differ from what you might see in an urban health system? What adaptations have you had to make?

Evans: Rural health care requires a fundamentally different approach because the barriers patients face extend well beyond the clinical setting. Limited access to providers, transportation challenges, financial constraints, and longer travel distances all influence a patient's ability to receive and adhere to care. Having grown up in a rural community myself, I understand many of these challenges firsthand, which has shaped how we designed the MMC.

Success in a rural environment requires collaboration, flexibility, and meeting patients where they are. We've integrated pharmacists into care management, strengthened partnerships across physician practices and service lines, leveraged telephonic outreach, and proactively addressed barriers to medication access before they affect patient outcomes.

Health care organizations in rural communities often serve as more than hospitals—they are trusted community partners. That responsibility requires us to think beyond traditional models of care and design services that remove barriers, improve access, and keep patients engaged throughout their health care journey

Pharmacy Times: You're a PharmD leading a program that touches outcomes, finance, and transitions of care. How do you see the pharmacist's role evolving within health systems, particularly in underserved communities?

Evans: I believe pharmacists are uniquely positioned to improve clinical outcomes, enhance the patient experience, and strengthen financial stewardship simultaneously. As health care continues to evolve, pharmacists have become far more than medication experts—they are population health leaders, care coordinators, educators, and essential members of interdisciplinary care teams.

In underserved communities, that role becomes even more significant because pharmacists are often the first to identify barriers that would otherwise go unnoticed. Whether it's medication affordability, health literacy, adherence challenges, or access to therapy, pharmacists are uniquely equipped to develop practical solutions that improve outcomes while supporting providers and care teams.

Looking ahead, I expect pharmacists to play an increasingly important role in chronic disease management, transitions of care, value-based care initiatives, health equity, and ambulatory care. The organizations that fully integrate pharmacists into these care models will be better positioned to improve quality, reduce the total cost of care, and deliver a more coordinated patient experience.

I often say that the future of pharmacy isn't defined by the medications we dispense—it's defined by the barriers we remove. When pharmacists are empowered to improve access, coordinate care, and optimize therapy, they become one of the most effective drivers of better outcomes for patients, providers, and the health system as a whole.

Pharmacy Times: Beyond the numbers you've shared, how do you think about success for this program? Are there outcomes that are harder to quantify but equally important to you?

Evans: The metrics are important because they demonstrate the value of the program, but they only tell part of the story. Some of our most meaningful successes can't be measured on a dashboard.

Success is the patient who no longer has to choose between paying for groceries and filling a prescription. It's the patient who finally understands their medications and feels confident managing their condition. It's the provider who knows they have a trusted clinical partner helping remove barriers that once prevented patients from achieving the best possible outcomes.

Those moments build trust, improve quality of life, and strengthen the relationship between patients and the health care system. While they may be difficult to quantify, they're often the outcomes that have the greatest and most lasting impact.

At the end of the day, success isn't defined solely by the number of prescriptions we fill or the dollars we save; it's measured by the lives we improve and the confidence patients gain in managing their health.

Pharmacy Times: For a pharmacy director at another regional or rural health system looking at a similar model, where would you tell them to start?

Evans: Start by identifying the patient problem you're trying to solve—not by designing a pharmacy program. Whether the greatest need is medication affordability, transitions of care, chronic disease management, or specialty medication access, let the needs of your patients define the services you build.

Begin with a focused pilot, establish meaningful outcome measures, and engage physician champions early. Demonstrating measurable value through both patient outcomes and operational results is essential to gaining organizational support and sustaining long-term growth.

Most importantly, don't view pharmacy as a standalone service. Integrate pharmacists into the broader care delivery model and position them as strategic partners in improving quality, access, and financial stewardship. When organizations do that successfully, growth becomes a natural outcome because the value pharmacists bring is evident to patients, providers, and health system leaders alike.