Meeting Women’s Health Care Needs

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CVS Health works vigorously to expand access to high-quality, convenient and affordable women’s health care services through our MinuteClinic, retail pharmacies in communities nationwide and online or in the palm of their hand. As part of our focus on transforming the consumer health care experience, we are committed to providing women with access to the coordinated services and care they need to manage conditions and determine what is best for their health.

Providing Convenient Access to High-Quality Women’s Care

Women, who are often key in maintaining healthy families, access the health system more frequently than men, both for themselves and on behalf of their children. In turn, this means that their own health care can take a backseat to the needs of others.

Many women may find it difficult to receive care at a convenient time and location. For example, a survey conducted by Morning Consult and sponsored by CVS Health revealed that 90 percent of women consider the convenience of location important when accessing health services, while 85 percent consider flexible and extended hours important when selecting a health care facility.Morning Consult poll conducted from October 25-26, 2018, among a national sample of 2,201 adults

Our more than 1,100 MinuteClinic locations offer a full range of essential women’s health services. These services include access to birth control, the human papillomavirus (HPV) vaccine, treatment for yeast infections and pregnancy, urinary tract and bladder infection testing. Additionally, MinuteClinic providers also help women better understand their reproductive health options and provide referrals to primary care physicians or OB/GYNs, as needed.

CVS Health also launched a MinuteClinic University Health program, aimed at addressing the health care gap when young adults leave home for school. Our MinuteClinic locations in certain geographic areas near universities and campuses offer additional services for sexual health, women’s health and well-being screenings.

Increasing Patient Access to Birth Control

Ensuring accessible and affordable medications, including birth control, is a priority at CVS Health. For example, CVS Pharmacy patients can pick up prescriptions ordered through the CVS app on their phone, online, in person at CVS retail pharmacies, or they can have their medications delivered through our home delivery program. Additionally, CVS Caremark Members can receive their prescriptions through our mail order pharmacy, and throughout our network of 68,000 retail and mail order pharmacies.

We also work with public health advocates across the country to ensure that women can be obtain a birth control prescription from their local pharmacist. Pharmacists are currently allowed to prescribe oral birth control medications through Prescriptive Authority and Collaborative Practice Agreements in 13 states and the District of Columbia – covering 2,464 CVS Pharmacy locations. And we will be able to do so in 14 more states by the end of the year.

Affordable Access in the Community

Through community partnerships and philanthropies, we are able to address some of the health challenges women face locally. The CVS Health Foundation has partnered with a variety of groups who are on the front lines of improving access to women’s health services.

For example, we’ve established a multi-year partnership with the National Association of Free & Charitable Clinics (NAFC) with grants awarded to free and charitable clinics to increase access to care, improve health outcomes and lower overall health care costs. Today, 58 percent of NAFC patients are women – and they rely on 1,400 clinics nationwide for services including breast and cervical cancer screening, maternal and infant health and much more.https://www.nafcclinics.org/sites/default/files/NAFC%202019%20Infographic.pdf Since launching the partnership, the CVS Health Foundation has delivered a total of more than $4.5 million in funding to free and charitable clinics across the country.

Addressing Women’s Heart Health

Cardiovascular disease remains the number one killer among women and accounts for one-third of deaths annually.https://www.heart.org/-/media/data-import/downloadables/heart-disease-and-stroke-statistics-2018---at-a-glance-ucm_498848.pdf To address the widespread impact of this disease, we help women understand their risk for heart disease and empower them to take the next best action for their health. Throughout February 2019, we provided preventive heart health screenings at no cost in which women learned their five key personal health numbers that help determine their risk for heart disease: total cholesterol, HDL (good) cholesterol, blood pressure, blood sugar and body mass index.

Additionally, our support of the American Health Association Go Red for Women campaign, includes a new three-year, $15 million commitment to life-saving cardiovascular research and education.

For more information about CVS Health’s efforts to improve care across the nation, visit our News & Insights page and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our Leaders in Care newsletter.

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Tobacco-free for five years

Five years ago, we made the bold decision to eliminate tobacco products from all of our CVS Pharmacy stores nationwide, and we’re still the only national pharmacy to do so.

Not only did our decision lead to 100 million fewer packs of cigarettes being sold in the first year since their removal, but we also took our efforts beyond our stores, helping 228 colleges and universities become tobacco free over the past five years and committing $50 million to deliver the first tobacco-free generation through our Be The First initiative.

And with the significant rise in teen e-cigarette use, we’re now working to combat vaping, too, including a $10 million commitment in 2019 to support youth smoking and e-cigarette prevention strategies and education in partnership with Discovery Education and CATCH Global Foundation, and our pledge earlier this year not to work with advertising or public relations agencies who work with tobacco and e-cigarette companies.

Beyond Tobacco: Taking Steps to Transform Health Care

But our decision to eliminate tobacco was just the start. As a health care company now combined with Aetna, we’re taking even bolder steps to transform the consumer health care experience and help lead our customers, patients and the communities we serve on a path to better health.

On our shelves, customers now have access to more health-focused products and services than ever before. And we recently became the first and only national retailer to require that all vitamins and supplements undergo third-party testing to confirm they meet our high standards.

We’re also removing chemicals like parabens and phthalates from our store brand products and we took SPF less than 15 off our shelves.

At the local level, we’re building healthier communities with a $100 million investment in health and wellness, which includes programs aimed at helping people manage the most prevalent chronic diseases such as diabetes, heart disease and cancer.

Moving into 2020, we will expand our focus on tobacco cessation and prevention, particularly within the Medicaid program where smoking rates are considerably higher than among all adults. We’ll be working with Aetna Better Health managed Medicaid plans and together with CVS Caremark clients interested in creating or expanding smoking cession efforts for their Medicaid members.

At CVS Health, we know that health is a personal journey. And from tobacco removal to our many other health-focused services and offerings, we’re committed to navigating that journey hand-in-hand with our customers and patients to ensure that the future of care is one in which everyone can achieve their best health.

In 2014, we quit tobacco. Nearly 65% of Americans agree that our decision to stop selling tobacco reduces the risk of chronic disease. 62% of adults agree that retailers have an obligation to limit access to tobacco and e-cigarette products. 81% of adults support improving community education about the dangers of smoking.

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Larry Merlo: Improving and Simplifying Care for Medicare Advantage Beneficiaries

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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.

For more information about CVS Health’s efforts to improve care across the nation, visit our News & Insights page and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our Leaders in Care newsletter.

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Heart health with a haircut: Bringing care to underserved communities

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A nurse checking man’s blood pressure.
U.S. Rep. Steven Horsford receives a blood pressure check at the recent CVS Health Las Vegas barbershop event.
A man and a woman check into health screening event.
Community members who attended the barbershop event received free health screenings, as well as blood pressure, cholesterol, weight and glucose monitoring.

A recent heart health community event in Las Vegas highlighted our ability to reach underserved communities, diagnosing and treating people who may not typically have easy access to health care services.

The event in partnership with U.S. Rep. Steven Horsford’s office was held outside a local African American barbershop as a way to bring needed health care to an area with few providers.

“Barbershops and salons provide safe places to have honest conversations about our lives, our health and our community,” said Horsford, noting the important role these spaces play as neighborhood gathering points. “The health care shortage in Nevada is very hard on the African American and Hispanic communities, and we need more companies like CVS Health to step into that gap.”

Health disparities continue to be an issue affecting minority communities, including Nevada. In 2017, the African American community in Nevada had the highest mortality rates of heart disease (291.7 per 100,000 people). This is in contrast to the aggregate rate of heart disease among all race/ethnicity groups (206.5 per 100,000 people).Minority Health Report 2019, Department of Health and Human Services, Office of Minority Health and Equity; http://dhhs.nv.gov/Programs/CHA/MH/

The day’s activities showcased how CVS Health and Aetna are bringing together the combined power of a health care provider and insurer to help consumers achieve improved health. In addition to the free health screenings, including blood pressure, cholesterol, weight and glucose monitoring, a local MinuteClinic practitioner was on site to help patients navigate their health concerns.

“Our vision as a combined company is to help people achieve their unique health ambitions,” said Daniel Knecht, M.D., Vice President of Clinical Strategy and Innovation for CVS Health. “This kind of hyper-local care model allows us to step into the community, and successfully engage with the people we serve in a culturally appropriate and personalized manner.”

Screening results reinforced the need for such care models, especially in underserved communities like West Las Vegas. Over 70 percent of participants had an abnormal blood pressure reading, more than double the national average.https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm

Additionally, over 50 percent had an abnormal glucose reading; the national average sits below 10 percent.https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

Recent studies have demonstrated the key role barbershops play not only in screening but connecting patients to ongoing treatment. In April 2018, a landmark trial published in the New England Journal of Medicine found significant, sustained reductions in blood pressure among patients who engaged with a pharmacist in the barbershop.https://www.nejm.org/doi/full/10.1056/NEJMoa1717250 CVS Health is working closely with these national experts to bring the model to more communities.

Horsford, who had coronary artery bypass surgery at the age of 40, understands the importance of hypertension management and living a healthy lifestyle. He noted that events like the heart health clinic can extend health care services to where they’re needed most.

“In the African American community, we don’t talk enough or share enough between the generations. We need to break the cycle of health care disparities,” he said. “I appreciate CVS Health’s desire to bring their services into the community.”

An afternoon panel discussion moderated by Horsford and featuring CVS Health leaders engaged local community leaders and providers in a conversation about the special health care needs of underserved communities and potential solutions.

David Casey, Chief Diversity Officer for CVS Health, noted that the U.S. health care system needs to do a better job “figuring out how to bring personalized health care to consumers not just where they live, but how they live.”

He pointed to CVS Health initiatives such as Building Healthier Communities, a five-year, $100-million commitment to support critical partnerships with nonprofit organizations, as an example of effective public-private efforts. Another new initiative called Destination: Health will help some of Aetna's most vulnerable Medicaid and Dual eligible members access social services within their community more easily.

Las Vegas boasts nine MinuteClinics, which provide walk-in services seven days a week. Nurse practitioners and physician assistants offer expert medical care for a wide array of minor illnesses, minor injuries and skin conditions as well as monitoring of chronic conditions and the provision of immunizations and physicals.

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Aetna Empowering Physicians to Fight Opioid Crisis via Best Practices

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Although doctors and other prescribers play a key role in fighting opioid use disorder (OUD), they often don’t have the latest clinical information about the risks associated with opioids. To close that knowledge gap, Aetna is collaborating with Alosa Health and clinical experts to educate primary care doctors in their own offices on best practices for the appropriate use of opioids as well as how to screen and treat for opioid addiction.

The goal? To reduce the number of new opioid users and lower risks for patients who are currently on opioid therapy.

Battling Misconceptions about Opioid Prescribing

“More cautious prescribing can help prevent people from getting addicted to opioids and help those who are addicted to find alternative methods for    managing their pain,” said Andrew Kolodny, M.D., co-director of opioid policy research, Brandeis University, and a nationally recognized expert on OUD.

The “academic detailing” pilot is deploying about 30 trained health care educators  to doctor’s offices in Pennsylvania, Illinois, Maine, West Virginia and Ohio, some of the states hit hardest by OUD. These detailers—comprising physicians, nurses and pharmacists — develop individualized education plans with each prescriber and highlight opportunities to improve their clinical practices.

The program is providing physicians with the best peer-reviewed evidence on treating acute and chronic pain and recognizing and caring for patients with OUD utilizing medication-assisted treatments (MAT).

“From 1999 to 2013, prescribers quadrupled the number of opioid prescriptions, and although we’ve reduced it dramatically since 2013, we’re still at three times the level we saw in 1999,” said Elisabeth Fowlie Mock, M.D., M.P.H., an academic detailer based in Maine. “These days, we are seeing a lot of providers who are inheriting patients on high doses of opioids and are not sure what to do  regarding the best next steps.”

Mock noted that the vast majority of patients on long-term opioid therapy who are tiered off appropriately and provided with other, better pain management options report less pain, fewer side effects and more functionality once they are off of the opioids.

“They say that they’ve gotten their lives back,” she said, adding that the program is needed because only 20 percent of people with OUD are receiving treatment for the disorder.

For the AdvocateCare Center, a busy multidisciplinary practice in Chicago that provides team-based care for patients with multiple chronic and acute conditions such as diabetes, heart failure and kidney disease, the opioid education provided helpful insights into the best solutions for pain management.

“It was great to have the training right in our office and be able to easily work it into the workflow of the day,” said Michael A. Richman, M.D.The entire team of social workers, nurses, behavioral health specialists and support staff participated in the training because they all encounter patients daily who are struggling with pain and/or addiction to opioids.

“Our detailer did a great job of laying out options for appropriate pain management,” he said, adding that evidence supports the use of multi-modal approaches such as movement and cognitive therapies, many of which are offered by the AdvocateCare Center. “The materials were easy to understand, and the evidence-backed background she presented was very valuable. The training was really helpful and appreciated.”

Daniel Knecht, M.D., vice president of clinical strategy and policy at Aetna, a CVS Health company, said that the program is helping to deepen Aetna provider partners’ knowledge base and comfort with treating OUD by providing insights around screening and treatment. He noted that many providers haven’t received formal training in pain management or addiction medicine.

Susan Reeves, R.N., a detailer who is working with providers in the Philadelphia area, said many of the physicians she is working with are excited to have access to the latest clinical information on opioids and other pain medications.

“One of their biggest concerns is, ‘What are my options?’ ‘What else can I do?’ ” she noted. “Luckily, evidence-based alternatives like physical therapy, chiropractic care, etc., offer great options. Doctors are relieved to hear the studies about these and other options because they really don’t have time to conduct their own research.”

Focusing on Proven Pain Management Alternatives

Studies of academic detailing have found that clinicians welcome the practice as it improves decision making and reduces health care costs.Academic Detailing: “Marketing” the Best Evidence to Clinicians; https://jamanetwork.com/journals/jama/article-abstract/2598775 It has successfully been used to educate physicians on a variety of health issues, such as atrial fibrillation, chronic obstructive pulmonary disease and appropriate antibiotic use, among others.Optimizing antibiotic prescribing for acute cough in general practice: a cluster-randomized controlled trial; https://www.ncbi.nlm.nih.gov/pubmed/15282232 Educational Outreach to Opioid Prescribers: The Case for Academic Detailing; https://www.ncbi.nlm.nih.gov/pubmed/28226336

“Evidence-based detailing programs are important because they provide direct, often in-person support to busy clinicians to help them screen, treat and manage patients with acute and chronic pain as well as substance misuse and addiction,” said Wilson Compton, M.D., deputy director of the National Institute on Drug Abuse (NIDA).

Stakeholders from across the health care system, including payers, can make a difference in guiding the safe and appropriate use of pain medication now and in the future, according to Dr. Kolodny.

“Aetna can have a very positive impact on opioid addiction, both through advocating for prescribing caution and by helping opioid-addicted people to have better access to treatment,” he said, adding that he’s “impressed with Aetna’s response to the epidemic by developing innovative solutions like the detailing program.”

The year-long pilot program is being guided by a national group of leading experts in pain management and the national opioid situation, drawn from universities across the country as well as NIDA and the Centers for Disease Control and Prevention.

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Aetna’s New Cancer Support Center Connects Members to Personalized Information

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“Take a deep breath.”

That’s how the section of Aetna’s digital oncology hub regarding “navigating treatment” begins – no medical terms or insurance jargon, just a simple reminder.

Dealing with cancer can be an overwhelming experience for patients, families and caregivers. The lack of centralized information about the disease and effective treatments can pose a real challenge both for patients, who must cope with their own personal cancer diagnosis and journey, and their families.

While there is information available online for those dealing with cancer, it can be confusing, contradictory or even downright dangerous when patients rely solely on “Dr. Google” for information.

Aetna is stepping into that information gap by providing members with a comprehensive, user-friendly resource for cancer treatment education and support. A digital oncology hub called the Cancer Support Center is now part of Aetna’s library of online-based member resources.

“Cancer diagnosis and treatment is often the most difficult and physically, mentally and financially stressful time in a person’s life,” said Dr. Roger Brito, senior medical director on the Aetna oncology solutions team. “We made it our mission to try to make that journey a little easier.”

The project was developed as an enterprise-wide initiative, involving medical and content experts from across Aetna who worked together to create easy-to-understand materials that are location-specific and catered to a member’s diagnosis. The information on the hub is structured in a way that reflects a holistic view of the cancer patient journey – from screening and prevention, to diagnosis, to treatment, recovery and beyond.

One of the key benefits of making this kind of information available online is that it can be easily updated to reflect new treatments, standards and best practices. As Dr. Brito points out, many medications used today weren’t even available just a few years ago, so the oncology hub can be continually revised to reflect the latest medical guidance.

“It’s just a constantly changing and evolving state,” he said. “The treatments in two to three years will likely be very different from those we use today.”

The Aetna team identified breast cancer as the type of cancer that affected the most members across all ages and backgrounds (with more than 120,000 claims per year) and chose to launch the hub around this topic. However, the Cancer Support Center will continue to evolve and grow as more information is added for different cancers, including ovarian and prostate cancers.

The support center has been an early success in terms of member and caregiver engagement, according to Dr. Brito, with many visitors coming back to the site repeatedly.

“The goal is to continue to expand the hub so that we can provide the right mix of resources and education,” said Dr. Brito. “We will continue to look for opportunities to support our members and their caregivers to help ease the challenges of this difficult journey.”

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Inspiring Aetna Members to Take Control of Their End-of-Life Care

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“I’d like to talk to you about decisions you might have to make in the future if you become very sick.”

Thus begins a video designed to make end-of-life care planning easier. It is one of nearly 300 decision aids now available for Aetna members and their families as part of a new pilot program to help bridge these difficult discussions.

“This is a very personal conversation,” said Vinnette Perry, director of Clinical Health Services for Aetna. “There’s fear of the unknown. We don’t always talk about how we want to die, and we don’t necessarily want to talk about a loved one dying.”

The pilot program, in collaboration with the nonprofit organization Advanced Care Planning Decisions (ACP Decisions), leverages their comprehensive video library to help patients and their families make the most informed medical choices possible.

Meeting members where they are

Aetna Medicare nurse case managers, who routinely work with members about end-of-life decision making, know that there is no one-size-fits-all approach. Each member faces unique challenges and has unique needs. For example, Perry shared a recent example involving a 77-year-old member with advanced heart failure who was overcome with emotion upon connecting with his case manager; not because of a fear of death, but because he was moved that someone cared. The conversation that began that day resulted in his decision to move across the country to be closer to family.

Nurses, members and their families have access to a library of videos and other content through Aetna’s partnership with ACP Decisions.

It’s estimated that less than 30 percent of individuals discuss end-of-life care with their loved ones, despite over 90 percent recognizing the value of such conversations.https://theconversationproject.org/ Aetna is committed to closing this gap by working to ensure end-of-life planning is a critical part of every member’s care plan.

For nearly 15 years, Aetna’s Compassionate Care program has helped seriously ill members and their families face the end-of-life on their own terms, without unnecessary stress or discomfort. The program features a proprietary algorithm that identifies members approximately 9-12 months before the end-of-life and provides them with comprehensive care management and caregiver support.

An opportunity to stop and think

Aetna’s multi-state pilot with ACP Decisions aims to enhance the Compassionate Care program by connecting Aetna’s vulnerable members and their families with evidence-based decision-making tools. It also encourages case managers to discuss end-of-life decisions with members who are still in good health.

“The videos empower patients and engage them in a way that simply having a conversation, or talking about advanced care planning in the abstract, doesn’t,” said Dr. Angelo Volandes, president and co-founder of ACP Decisions. “Our hope in partnering with Aetna is to make this routine and part of normal patient care.”

Case managers in Pennsylvania, Maine and Illinois completed face-to-face and virtual trainings led by Dr. Angelo Volandes, ACP Decisions co-founder and a national expert in advanced care. planning.

Case managers in Pennsylvania, Maine and Illinois completed face-to-face and virtual trainings led by Dr. Angelo Volandes, ACP Decisions co-founder and a national expert in advanced care. planning.

A series of interactive trainings for local case managers kicked-off in December 2018, demonstrating how to leverage these tools and past experiences in sensitive conversations. Since launching, case managers have seen the impact of these videos first-hand.

Sarah Fischer, an Aetna field case manager, believes the videos help members take control and draw the whole family into the discussion – even for those who feel they already have a handle on end-of-life decisions.

“The videos really make you stop and think,” Fischer says. “This program is giving us an opportunity as well as invaluable tools and confidence to talk with members about these difficult issues.”

The program is currently underway in Pennsylvania, Maine and Illinois, and will continue through the first half of 2020. The teams are monitoring success through a variety of measures, including hospice utilization, inpatient admissions and the completion of advanced care directives. In addition to arming case managers, the program is working to educate and train local providers to use these powerful video tools in their interactions with patients.

“These conversations result in better patient and family satisfaction and reduced unnecessary low-value care,” said Dr. Daniel Knecht, vice president of Health Strategy and Innovation for Aetna, adding that the discussions can even increase life expectancy.https://www.nejm.org/doi/pdf/10.1056/NEJMoa1000678

Jaimie Marvin, a field case manager with a background in hospice care, points out that both members and their families appreciate the ability to understand and speak up about end-of-life.

“Although we don’t always know when we’ll have to say goodbye, it’s comforting to know that you’re protecting someone’s dignity through the final moments of their life.”

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Aetna 360 Behavioral Health Supports Members, Caregivers Through Health Care Journey

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Prioritizing members’ overall needs – including the time and resources needed to get and stay healthy – Aetna has launched Aetna 360™ Behavioral Health. Through this approach, which launched May 1, 2019, Aetna partners with behavioral health and substance use disorder treatment facilities to coordinate care for members, collaborate on holistic discharge planning and provide support for members and their families during treatment and upon discharge.

“Our focus is on how we can help, rather than limiting members to a number of days or conducting traditional reviews,” said MaryEllen Schuman, Director, Clinical Health Services, Aetna Behavioral Health. “This new approach incorporates both a member’s physical and behavioral health, along with any social determinants of health, to ensure we develop a comprehensive, long-term plan that helps them attain and maintain their optimal health.”

Aetna 360 Behavioral Health combines and builds on a pair of recent programs, Member Care Coordination (MCC) and Utilization Management Transformation (UMT). Both programs, which began in late 2017, led to lower readmission rates, higher ambulatory follow-up rates for mental health visits and high engagement and satisfaction rates among members, caregivers and providers.

Under Aetna 360 Behavioral Health, partnering facilities, as well as members and their caregivers, have a single point of contact with Aetna Behavioral Health. The assigned 360 Care Advocate collaborates with the facility to understand the member, family and caregiver’s needs, and then directly with members and caregivers when needed, both during and after discharge. The 360 Care Advocate is supported by a team at Aetna which includes medical, pharmacy, Resources for Living® and others.

“The 360 Care Advocates work behind the scenes to collaborate with providers to ensure members have the resources they need, and then directly with members, family and caregivers to ensure they have access to everything from a primary care provider and transportation to an appointment, to a support group or daycare if they are a caregiver,” said Lynn Watson, Manager, Clinical Health Services, Aetna Behavioral Health. “They also link members to peer support services, several digital resources and community support services to enhance their care and service.”

The 360 Care Advocates collaborate with members’ medical and behavioral health outpatient providers as needed and provide specific resources to caregivers to ensure they can help members navigate the health care system.

At launch, 304 facilities are partnering with Aetna to implement Aetna 360 Behavioral Health. These partnerships extend the successful work that began under the previous pilots.

“We deal with a sick population, but Aetna has been right there with us,” explained Peter Schorr, President and CEO, Retreat Behavioral Health, which operates several substance use disorder and mental health treatment centers, about MCC. “Aetna ensures patients are provided with the stays that they need. It feels good to be trusted and not fight over reviews.”

Facility staff have also benefited from Aetna’s behavioral health initiatives.

“Both our patients and staff view Aetna as an ally that is helping us to tear down barriers to treatment and recovery,” notes Jay Crosson, CEO, Cumberland Heights Foundation, an alcohol and drug treatment center in Tennessee. “The Member Care Coordination program was a real positive mindset change for everyone.”

Aetna will continue to expand the number of partnering facilities implementing Aetna 360 Behavioral Health. Aetna 360 Behavioral Health is currently for Aetna Commercial members of all ages and Aetna Federal Employee Plans.

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Aetna Is Helping Lead the Way on the Evolution of Precision Medicine

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There are many reasons people get sick — from the quality of their health care to environmental factors and behavioral patterns like diet or smoking. Genetic factors — including those aspects of our individual physical makeup that can offer clues to the kinds of diseases for which we are susceptible —also impact our health.

And with the number of genetic tests increasing to more than 50,000 in the last five years, “precision medicine” or “personalized medicine” can play a part in helping to screen for, diagnose, prevent, treat and even cure disease. By tapping into a deeper understanding of a person’s genetics, precision medicine has the potential to unlock opportunities for prevention as well as more focused and effective treatments.

“As our understanding of genomics continues to grow, we are seeing the development of a new generation of genetic testing and targeted treatments,” said Joanne Armstrong, M.D., M.P.H., senior medical director at Aetna. “Although we have a long way to go to replace the current ‘one size fits all’ medical model with individualized genetics diagnostics and hyper-specific treatments, the evolution of this field is exciting.”

Aetna, a CVS Health company, has helped lead the way in that evolution, developing the first comprehensive program for breast and ovarian cancer testing using the BRCA gene test. Aetna also was the first health plan to create and implement a genetic information privacy policy and the first to develop telephone genetic counseling services.

“Aetna has been at the forefront of personalized medicine for more than two decades,” said Heather Shappell, precision medicine program manager, Aetna. “We’ve driven many firsts in this field. High standards and a focus on member safety and health are the foundation of what we do.”

Armstrong noted that as genetic testing and precision medicine become more common, the health care industry must take steps to ensure the quality of results so that patients can get the care they need.

Toward that end, Aetna became the first health plan to require quality credentialing of participating genetic testing labs. The company continues to lead on this front, requiring genetics laboratories with which they contract to enter test results into a public domain database called ClinVar. This database compiles information about human genomic variations in order to advance our scientific understanding of the relationship of genes to overall health.

This type of validation is particularly important in precision medicine. For example, while a lab may determine that a patient has a specific gene variation, the mere presence of that variation isn’t necessarily linked to the presence of a particular disease. Sharing the anonymous patient data among clinicians from around the world allows researchers to discover patterns and possible connections between genomic variations and specific diseases.

“Genetics is an evolving field where many unanswered, critical questions still exist,” Armstrong noted. “For example, as the science of personalized medicine matures, new challenges are emerging. New gene therapies recently approved by the Food and Drug Administration have the potential to cure genetic-based diseases, many of which are lethal. The staggering costs, however, strain the ability of our health care system to provide access to these therapies.”

Precision medicine is poised to expand beyond single disease and gene tests like BRCA and into processes that map out a person’s entire genome, providing clues to help predict future disease. As this type of personalized medicine becomes a more prevalent part of how patients are diagnosed and treated, Aetna is utilizing its long history of leadership in the field to help ensure that members receive the right treatments in the right place at the right time.

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2018 Health Care Trends

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Download the 2018 Health Care Trends report, provided by Aetna.

Despite the United States’ position as an economic powerhouse at the forefront of the tech boom, our health lags behind some countries. World Health OrganizationWorld Health Organisation – Global Health Observatory data http://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends_text/en/ (WHO) figures show that our average life expectancy is lower than 30 other countries, including Switzerland, Australia and Canada. But the tide may finally be turning, with a monumental shift in how we approach health care, towards a personalized approach that focuses on each individual and all aspects of their well-being. Rather than concentrate solely on treating people when they’re sick, health care providers are placing a greater emphasis on keeping them healthy. Instead of visiting clinical facilities for the majority of their care, people are using technology to monitor their health and receive treatment in their homes.

Doctors, hospitals and health companies now have insight into all factors that can affect patient health – from lifestyle to income to genetics. And they are using that information to connect people to a wide range of health and social services within their communities.

The Aetna 2018 Health Care Trends Report explores the key factors driving this shift: New strategies that yield better results from our country’s investment in health care; innovative ways wearables could reduce spending on chronic diseases; the role of diversity in shaping a new health care system; how health companies can help conquer the scourge of opioid addiction. Read on to see how the development of these trends in the years to come can result in healthier communities, happier individuals and better health outcomes for all.

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