Larry Merlo: Improving and Simplifying Care for Medicare Advantage Beneficiaries

Today, more than one-third of Medicare beneficiaries are enrolled in Medicare Advantage (MA) plans and research consistently shows that seniors value the supplemental benefits available through these plans.https://www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage

As seniors continue to seek more personalized care, Larry Merlo, President and Chief Executive Officer for CVS Health, joined the 2019 MA Summit to highlight how CVS Health is uniquely positioned to address the challenges of health care access, quality and costs for older Americans.

Merlo was interviewed by Allyson Schwartz, President and Chief Executive Officer for the Better Medicare Alliance, who inquired about how the combination of CVS Health and Aetna is bringing care closer to the home, making the health care system easier to navigate and improving health outcomes.

Below are three key takeaways from their discussion. 
    

• Meeting beneficiaries where they are: As an example of how the combined company is expanding access to care locally, Merlo shared insights on the early success of our HealthHUB pilot program in Houston — a new, community-based health destination that offers a broader range of health products and services.

  According to Merlo, what beneficiaries will experience at a HealthHUB is unique. For example, their visit will often start with a conversation with a care concierge who plays a critical role in engaging them as they arrive, informing them about in-store services and helping them find the right solutions for their individual needs.

• Making benefits easier to use: To ensure health care works better for beneficiaries, Merlo highlighted the importance of eliminating the system’s complexities. Consider the beneficiary who just had knee-replacement surgery. Typically, the patient has the procedure and has limited communication with the provider afterwards. He or she enters an uncoordinated post-op environment and is left mostly alone to coordinate transportation after the operation, prescription pickup and arranging delivery of additional medical devices for the home.

  According to Merlo, this is where the combination of CVS Health and Aetna makes a real difference. For example, we’ll make sure his or her surgeon is in-network, conduct a home assessment to ensure safety post-operation and help coordinate prescriptions.

• Expanding touchpoints to care: Helping beneficiaries stay adherent to their care plans requires enhanced communication and consultations. Given our footprint in 10,000 communities nationwide, Merlo highlighted how CVS Health is able to serve as a frequent and convenient resource to beneficiaries. For example, a patient might see her physician four to five times a year, but is likely to see a pharmacist as many as 18-24 times in the same year. Merlo noted that older adults tend to have more than one chronic condition and may take multiple medications. Therefore, our pharmacists can help seniors better manage their daily medication regimens.

  According to Merlo, helping beneficiaries take their medicines on-time and as directed is critical to reducing unnecessary ER visits and hospitalizations — as the cost of non-adherence totals $300 billion annually.