Community-centered innovation: Prescription pickup lockers expand access

For years, the number of pharmacies in the United States has been declining. Between 2010 and 2021, an estimated 29% of pharmacies across the country closed, making medication access particularly challenging in low-income, rural and underserved communities. Oregon is among the hardest-hit states when it comes to dwindling pharmacy access, with fewer than 15 pharmacies for every 100,000 residents as of 2024, according to one study.

The state has a growing number of pharmacy deserts: communities where residents must travel long distances — often more than 10 miles — to reach the nearest pharmacy.  “In the last several years, we’ve seen pharmacy closures across the state, including closures in some rural areas where there is almost no pharmacy choice left,” said Kristen Benkstein, PharmD, CareOregon Director of Pharmacy-Clinical Services.

Pharmacy deserts, experts say, cause real harm to patients and communities. They make it harder for patients to fill prescriptions for critical medication and get vaccinations and pharmacist-led care. Delays in taking medicine as prescribed can worsen chronic conditions, increase hospitalization rates and lead to poorer health outcomes. 

Beyond brick-and-mortar pharmacies

Several years ago, CareOregon launched an effort to improve access and member choice through partnerships that added prescription-pickup lockers in each of our service regions. The lockers are located at independent pharmacies and Federally Qualified Health Centers (FQHCs), nonprofit health centers that provide care to underserved communities, regardless of patients’ ability to pay.

"The situation got us thinking about ways to improve access for our members. Around the same time, this [pickup locker] technology was starting to take off," said Benkstein, reflecting on the origins of the program.

Supplied by California-based vendor iLocalBox, the lockers are leased and managed by pharmacy program partners. Patients receive a text or email message when their prescription is ready for pickup, much like Amazon package lockers. To protect patient privacy and secure medication, each patient receives a special code to access their locker box.

If questions arise, patients may connect with a remote pharmacist through video conferencing, a feature that helps ensure they get the same level of support they would receive in a traditional pharmacy setting.

Improving access in urban and rural communities 

Today, our program partners operate a total of five co-branded pickup lockers in urban and rural communities throughout the state. An additional locker will open this year in downtown Hillsboro. Since April 2024, more than 4,000 prescriptions have been filled through existing lockers. (See below for a complete list of locations and provider contact information.)

The self-serve lockers have improved access in more ways than one. They fill gaps in communities that have seen pharmacy closures. At the same time, they provide a flexible pickup option for people who can't use prescription delivery services or don't have time to stand in line at their local pharmacy, among other access challenges. 

Better access, better outcomes 

Neighborhood Health Center (NHC), an FQHC with nine medical and dental clinics in the Portland metro area, added a pickup locker at its Tanasbourne location in July 2024. The locker is serviced by NHC’s in-house pharmacy, located at its Canby Medical and Dental Clinic in Clackamas County. 

The locker is especially popular with patients who have had difficulty using NHC's home-delivery service because of conflicts with their work schedules. While the service hand delivers prescription medications to patients' homes, they must be present to accept orders. 

"Home delivery is great, but you have to be home for that to work," said Michele Taney, PharmD, a Registered Pharmacist and Director of Pharmacy. "With the locker, you can stop in and grab your medication if you're on your way home from work or on your way out to work."

For patients with language and literacy barriers, NHC offers extra support when they arrive to pick up medication from the locker. The health center schedules a nurse and/or interpreter to meet with patients to discuss their medications, help fill pill boxes and answer questions. 

“This locker service allows more patients to use our in-house pharmacy and gain access to what an FQHC in-house pharmacy can offer, which is integrated care and sliding-scale discount programs,” explained Taney. 

Based on patient response, NHC is considering installing a larger locker at its Tanasbourne clinic, which would allow it to serve even more patients. It is also considering adding a locker at its Milwaukie clinic. 

Weather, wildfires and access 

In rural Butte Falls, the locker at the Rogue Community Health clinic has helped meet a critical need in a community with only about 500 residents.

About a decade ago, the Butte Falls clinic had an onsite pharmacy, but it was relocated to another clinic due to staffing challenges. Winter weather and summer wildfires often made travel conditions treacherous for patients driving to the nearest full-service pharmacy, so the Butte Falls clinic became an obvious choice for the locker program.

Located in the clinic lobby, the locker has been in service since September 2024. It's available during clinic hours Monday through Thursday and maintained by the pharmacy at Rogue Community Health's White City location.

"We choose this location mostly because the area is so remote and a lot of residents have transportation challenges. This really fills a gap in care," said Amber Taylor, PharmD, Director of Pharmacy for Rogue Community Health, an FQHC serving Jackson County.

Some patients, she noted, need a bit of technological support using the locker, but overall, it’s been well-received. 

"There was a lot of excitement from patients on our clinic advisory committee around it. There was a lot of appreciation for bringing something new and innovative to the community," said Taylor.

Locker locations and contact information 

Área metropolitana de Portland:

Northwest Oregon (Columbia Pacific CCO):

Southern Oregon (Jackson Care Connect CCO)

Serie Inversiones en acción

Our "Investments in Action" series highlights the transformative power of CareOregon's strategic investments in health and well-being. A través de estas historias, exploramos cómo nuestro apoyo va más allá del financiamiento tradicional y contribuye a cerrar brechas en el acceso a la atención médica y los servicios comunitarios. A pesar de los desafíos en el ámbito de Medicaid, seguimos comprometidos con visibilizar estas narrativas clave de fortaleza y resiliencia en la comunidad.