Addressing Social Isolation Among Seniors

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With studies showing social isolation can be as damaging to your health as smoking a pack of cigarettes a day, loneliness can be just as dangerous as high blood pressure and high cholesterol.

That's why addressing social isolation is a major focus for Aetna’s Medicare business and care managers, who are taking a more holistic view of senior health to help get them on a path to better health.

With studies showing social isolation can be as damaging to your health as smoking a pack of cigarettes a day, loneliness can be just as dangerous as high blood pressure and high cholesterol.
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“The most common challenge with our senior patients, honestly, is that so many of them have no one,” says Aetna Field Case Manager Sarah Fischer, RN. “So many of them don’t have families. One lady said to me, ‘I’m the only one left.’"

Watch the video to see how case managers are introducing seniors to benefits such as the SilverSneakers fitness program, community volunteering and other opportunities for social connection.

“We get them involved, get the area office on aging involved. There are senior newspapers, things like that,” says Sarah. “We just bring these benefits to the member and say, ‘Let’s get you involved in something.’”

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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Addressing Out-of-Pocket Costs for Diabetes Patients

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Rising costs are a burden for too many people living with diabetes today. Patients with a high-deductible health plan shoulder all of their medication costs while in the deductible phase of their insurance, which means they may be forced to make difficult decisions about whether they can afford their medications and fill their prescription.

Recent data reveal there is uncertainty on how to manage and predict the out-of-pocket costs associated with diabetes management. For example, nearly one-third of patients (32 percent) do not feel they have the resources needed to manage their own out-of-pocket costs. To address this challenge, CVS Health is working to eliminate member cost as a barrier to medication adherence.

Improving Medication Affordability and Adherence

Improving diabetes outcomes while reducing costs is a priority for CVS Health. We recently launched RxZERO to enable employers and health plan sponsors to leverage formulary and plan design approaches to offer all categories of diabetes medications at zero dollar out of pocket for their members without raising costs for the plan sponsor or increasing premiums or deductibles for all plan members. The new plan design enables plan sponsors to eliminate member out of-pocket costs for the entire diabetes therapeutic area — including oral medications for Type 2 diabetes — and fully adhere to American Diabetes Association standards.

“Traditionally, the focus of affordability for diabetes medications has been on insulin, which is the cornerstone of therapy for the five percent of people with diabetes who are living with type 1 diabetes. However, the new CVS Caremark solution expands affordable options to include the entire range of diabetes medications — improving affordability for the 95 percent of people with diabetes who are living with type 2 diabetes.”

— Troyen A. Brennan, M.D., M.P.H., is Executive Vice President and Chief Medical Officer of CVS Health

CVS Caremark analysis shows that members taking branded diabetes medications spend on average, $467.24 out-of-pocket per year, with nearly 12 percent spending over $1,000 annually.

A Comprehensive Approach to Diabetes Management

A person living with diabetes is required to take many tasks to manage their therapy annually. To make disease management affordable, accessible and local, CVS Health offers numerous programs to help people with diabetes effectively manage their condition and stay on track with their prescribed treatment plan.

We provide supportive care at our HealthHUB locations to complement the care that patients receive from their primary care physicians. Our HealthHUB model provides a first-of-its-kind community-based store that offers a broader range of health services, new product categories, digital and on-demand health tools and trusted advice. In these locations, people living with diabetes are able to receive the coordinated care and services they need all within our own four walls.

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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Coram Nurses Help Teen Bike across the Country

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Andrew leaving Boston for his cross-country bike trip.
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Coram nurse Melissa Rupert infuses Andrew in Oklahoma City during his trip.

Coram, a CVS specialty business, provides high-quality infusion and tube-feeding care to patients where they live, work and travel. So when 17-year-old Andrew had an opportunity to go on a six-week cycling, cross-country adventure this past summer, his parents knew the Coram nursing team could help.

Andrew has Gaucher disease and receives enzyme replacement home infusions every 2 to 3 weeks. His trip would leave from Massachusetts in June and not return until early August, so he would require infusions along the route. His parents and medical team mapped out the trip and planned for infusions in Oklahoma City and Santa Monica, CA.

Coram nurses worked with Andrew’s primary care team at Boston’s Children’s Hospital to secure connections in the other states who would be willing to help. He needed an in-state physician to write the nursing orders, and a Coram nurse to meet him at a hotel for the infusion. The Coram Oklahoma City and Los Angeles branches ensured Andrew received the specialized care he needed.

Gaucher disease is a rare genetic enzyme deficiency disorder that affects 10,000 to 20,000 Americans, and can largely be controlled with enzyme replacement. Patients experience anemia, low platelet counts, severely enlarged liver and spleen, and bone disease.

Coram’s Vast Nurse Network

“The benefit of working with Coram is that we have more than 38 years of experience providing infusion services to patients,” said Julie Scaramuzzi, Nurse Manager, Infusion. “We meet patients where they are, and Coram has 73 ambulatory infusion suites across the country. Our team helps patients prepare the paperwork to bring liquids through airport security, and secure a nurse and location for the treatment,” she said. Coram has more than 2,000 clinicians who provide care to nearly 200,000 patients annually for a range of complex conditions including immune deficiencies, neurological disorders, digestive diseases and serious infections.

Andrew’s mom, Heidi, connected with Coram to pick up the medication near her home, and with the paperwork in order, boarded planes to Oklahoma and California. She met Andrew and the nurses in the hotels, and Andrew successfully received his treatments on the road. He was able to stay with his biking group for the entire trip.

Julie said “Andrew proves that patients who home-infuse are no longer home-bound. Our team works with many patients who travel for business or even just to see family for the holidays. Our network of nurses is vast and we are able to meet patients where they are, when they need their treatment.”

The Accordant Team Approach for Gaucher Patients

In addition to care from Coram clinicians and nurses, Accordant offers support for members with rare conditions, such as Gaucher disease, through targeted interventions designed to meet each patient’s unique needs.

“The specialized care team is composed of registered nurses, pharmacists, social workers, and a medical director – all backed by a medical advisory board,” Ahmed F. Hassan, Vice President and General Manager, Accordant. “These skilled practitioners set mutually agreed-upon health goals with the patient, discuss symptom management, explain proper use of medications, and even deal with resource issues such as lack of transportation to doctors’ appointments or cost of care.”

The more than 30 physicians on Accordant’s medical advisory board are available to the Accordant team to discuss complex situations and offer insights into care approaches that the nurse may use in supporting the patient. And, all of the team’s care is grounded in the latest evidence-based medicine and clinical guidelines.

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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Managing Diabetes

Our integrated, coordinated care approach

CVS Health is harnessing the power of its unmatched community connections and industry-leading data analytics to help people with diabetes better manage their day-to-day symptoms and lead healthier lives.

Our integrated approach is rooted in early detection and personalized, holistic care management, and offers our patients, customers and members an array of products and services that work seamlessly together, while improving access to care that is more local, more affordable and easier to navigate.

In Our Stores

With locations in 10,000 communities nationwide, our CVS Pharmacy stores are uniquely positioned to help patients manage their chronic conditions such as diabetes in between doctor’s visits. Our pharmacists provide one-on-one trusted counsel to patients daily, reviewing prescriptions to ensure patients are getting the most out of their medicines, while the providers in our more than 1,100 MinuteClinic locations offer screenings to monitor a patient’s vital signs and glucose levels.

We carry a wide variety of diabetes care products in our CVS Pharmacy locations to make it easier for patients to manage their condition.

MinuteClinic providers can identify conditions — including diabetes and hypertension — that a patient may not know about and develop an initial treatment plan with appropriate prescriptions and ongoing monitoring and counseling.

And with our new HealthHub® concept, a new, first-of-its-kind community-based store that offers a broader range of health services, new product categories, digital and on-demand health tools and trusted advice along with expanded capabilities in chronic disease care such as diabetes.

In addition, under our Reduced Rx prescription savings program, patients with diabetes can receive their insulin at a reduced cost at any of the more than 67,000 pharmacies in the CVS Caremark retail network, including our CVS Pharmacy locations.

CVS Pharmacy is partnering with the American Diabetes Association on their November #CountMeIn campaign to highlight the numbers that matter most when it comes to those living with, at risk for and supporting those with diabetes. More information can be found at diabetes.org/CountMeInADA.

For Our Members

We launched our Transform Diabetes Care program in 2017 to help simplify condition management and improve outcomes for members of our CVS Caremark pharmacy benefit manager.

The results so far have been significant: More than 50 percent of enrolled members with uncontrolled diabetes have moved to a controlled status by utilizing the solutions offered by the program, including personalized coaching, monitoring at MinuteClinic and CVS Pharmacy, testing supplies and a pharmacist-led clinical team that reviews blood glucose readings.

Learn more about our Transform Diabetes Care program.

Since launching, the program has expanded to identify members at risk for developing diabetes and related conditions.

Additionally, our Pharmacy Advisor program helps our members with chronic conditions like diabetes do a better job of taking their prescription medications through targeted counseling from pharmacists and monitored pharmacy claims to keep members on track with refills.

In the Community

CVS Health provides philanthropic support across the country to fund prevention efforts as well as education for those at risk for or living with diabetes. 

Through our partnership with the National Association of Free & Charitable Clinics (NAFC), the CVS Health Foundation has provided support to 57 clinics across the country to support expanded services to treat those with diabetes and hypertension.

We also bring free health and wellness screenings directly to local communities through our Project Health events. At these events, participants receive on-the-spot assessments of weight, blood pressure, blood glucose and cholesterol levels – tests that can help detect risk for chronic conditions such diabetes.

CVS Health also supports colleagues who volunteer on behalf of organizations associated with diabetes and also provides sponsorships for events. In 2019, CVS Health has provided over $120,000 to support diabetes organizations.

Find out more about the results of our Morning Consult survey on diabetes care.

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By the Numbers: Improving Diabetes Care

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A man using diabetic testing equipment.

Diabetes is a costly and complex disease that burdens patients and the broader health care system. Today, more than 100 million U.S. adults are now living with diabetes or prediabetes and estimates show that medical costs for people with diabetes are twice as high as for people who don’t have diabetes.https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html

In honor of American Diabetes Month, CVS Health recently partnered with Morning Consult to conduct a survey to better understand how people living with diabetes and the providers who deliver diabetes care are grappling with the disease. We also examined what tools and solutions would be most impactful in improving diabetes care.

Among both people living with diabetes and providers, there is a desire to expand access to care locally, better manage and predict out-of-pocket costs and provide additional lifestyle support.

Expanding Access to Diabetes Care

Managing diabetes can be extremely time-consuming and complicated. Oftentimes, patients must visit different sites of care, facilitate multiple annual exams and communicate with various providers across their care team. The survey revealed that both people living with diabetes and providers believe the health care system could do more to expand access to diabetes care and services. For example:

  • A majority (64 percent) of people living with diabetes are not aware of extended hours for diabetes support, while 61 percent of providers do not offer extended hours.

  • The vast majority of people living with diabetes (89 percent) and providers (98 percent) believe that being able to receive testing and exams for diabetes in a single location would be beneficial.

  • Just 18 percent of diabetes patients see their primary care provider once or more a month, while 37 percent report that they see their primary care provider every two to three months and 35 percent report that they see their provider every four to six months.

This is where CVS Health is making a difference. Today, 71 percent of Americans live within five miles of a CVS retail location. And people come to their pharmacy frequently: Whereas a patient with diabetes might only see his or her physician four to five times a year, they will likely see their pharmacist as many as 18–24 times in the same year.

Through these touchpoints to care, we are expanding access to diabetes care locally. For example, our HealthHUB model provides a new, first-of-its-kind community-based store that offer a broader range of health services, new product categories, digital and on-demand health tools and trusted advice. In these locations, people living with diabetes are able to receive the coordinated care and services they need all within our own four walls.

Addressing Diabetes Costs

Cost is top of mind for both people living with diabetes and providers — and there is uncertainty on how to predict the out-of-pocket costs associated with diabetes management. When asked about managing diabetes, nearly half (47 percent) of providers do not feel they have the resources they need to predict out-of-pocket costs for their patients’ diabetes medications. On the other hand, nearly one-third of patients (32 percent) do not feel they have the resources they need to predict their own out-of-pocket costs.

CVS Health is working to expand visibility into drug cost information across multiple points of care. Through our real-time benefits program, we’re providing tools to doctors so they can see what a medicine is going to cost, and recommend lower-cost, clinically appropriate options to the patient. We’ve also pioneered digital tools, including the Rx Savings Finder, which helps our retail pharmacists find patients savings when they do reach the pharmacy counter.

Improving Disease and Lifestyle Management

People living with diabetes and providers would benefit from enhanced lifestyle support to better manage the disease, including nutritional counseling and access to public transportation. For example:

  • People living with diabetes (58 percent) and providers (80 percent) both report they are likely to utilize nutritional counseling services to help manage their diabetes.

  • Access to public transportation is seen as a barrier among both patients and providers. For example, people living with diabetes (27 percent) and providers (29 percent) rank access to public transportation as poor in their community.

CVS Health offers programs to provide people living with diabetes with personalized support when and where they need it — whether it be in the community, in the home or in the palm of their hand.

For example, our Transform Diabetes Care includes personalized pharmacist counseling and the support of a diabetes coach to help ensure members stay adherent to their care plans. Additionally, through our Pharmacy Advisor program, our members can get one-on-one counseling from pharmacists either in-person at a CVS pharmacy location, or through our URAC-accredited call center.

To learn more about our enterprise-wide approach to diabetes management and care, visit our Managing Diabetes with CVS Health page.

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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Everyday Steps Are Critical for Managing Diabetes

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Donna Castillo was running her usual errands when she stopped by her neighborhood CVS Pharmacy in Anaheim, California, to pick up her new type 2 diabetes medication. She wound up walking unexpectedly into a free health screening event – and didn’t hesitate to take advantage.

The 57-year old former hairdresser, who also suffers from rheumatoid arthritis in her hands and who lives on disability, understands the importance of taking small, everyday steps to manage her health.

“People tend to ignore things,” she says, “but I've learned how the little things matter.” In addition to taking medication, Castillo says living with type 2 diabetes has taught her to carefully monitor her diet. She makes sure to eat breakfast every morning and that her breakfasts always include protein. “Birthday parties are the hardest with all that cake,” she says. “I just take a little piece. I have to be really careful about my sugar.”

The Project Health screening event taking place that day was one of 93 community health fairs across the greater Los Angeles region from September through December, with nearly 600 total events in CVS Pharmacy locations across the country. The free screenings monitor such vitals as blood pressure, blood sugar, and body mass index. CVS Health practitioners also offer advice on how to quit smoking, and give referrals to nearby primary care doctors and other resources.

Since it began in 2006, Project Health has delivered more than $127 million in free health care services to nearly 1.7 million people in multicultural communities with a large number of uninsured or underinsured Americans.

These screenings are particularly critical for people with chronic conditions, like diabetes, which can trigger other health problems such as heart disease and stroke if not monitored and maintained.

Castillo is very familiar with the risks. She was diagnosed around age 50, and the condition runs on both sides of her family, although she is relieved her three grown sons have all tested negative. She stopped by CVS that day to pick up a new medication her doctor had recently prescribed, canagliflozin, which she now takes in addition to daily doses of Metformin.

Type 2 diabetes affects one in 10 Americans, or about 30 million people, according to the Centers for Disease Control and Prevention. While the disease typically surfaces in people over age 45, young adults, teens and children are increasingly being diagnosed.

Nurse Practitioner Elsie Parra, who was onsite at the Anaheim CVS to provide screening tests, has been with Project Health for the past five years, and says too often, patients don’t know they have symptoms that could be red flags for serious health conditions.

“Diabetes, blood pressure, and high cholesterol are all silent killers,” says Parra. “These community screenings are a convenient way for patients to get a fast check-up without an appointment or feels the nervousness some might have when going to a doctor’s office.”

To learn more about our enterprise-wide approach to diabetes management and care, visit our Managing Diabetes with CVS Health page.

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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Accordant: Holistic Support for Patients with Complex Conditions

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Managing rare or complex conditions can often be challenging for patients. They can feel overwhelmed by the condition, medication side effects, complex dosage instructions, comorbidities, complicated provider directions, and experience challenges trying to navigate the health care system.

Health plans and employers, can adopt and offer our Accordant program for their plan members. Accordant provides holistic support for patients with rare conditions through targeted interventions designed to meet each patient’s unique needs.

The specialized care team is composed of registered nurses, pharmacists, social workers, and a medical director – all backed by a medical advisory board. These skilled practitioners set mutually agreed-upon health goals with the patient, discuss symptom management, explain proper use of medications, and even deal with resource issues such as lack of transportation to doctors’ appointments or cost of care. In addition, social workers help patients with community resources such as negotiating utility bill payments, identifying support groups, and grants for home modifications.

In a recent Blue Cross Blue Shield blog post, Accordant Medical Director Dr. Andrew Krueger discusses the importance of comprehensive care management services for patients with complex conditions such as multiple sclerosis and the difference this kind of care can make.

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Improving the Infusion Therapy Experience with Coram

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As health care costs continue to rise, payers, providers and patients are looking for new ways to help improve quality of patient care and their experience while lowering overall costs. One promising area is in home infusion care.

In fact, published research has shown that the home infusion services, like those provided by Coram CVS Specialty Services, can be safe and beneficial for those patients requiring infused therapies and in some cases can be a lower cost alternative to receiving the same services in a hospital or inpatient setting. In addition, the research has also shown that patients overwhelmingly prefer receiving their infusion therapies at home.

Read more about the benefits and value of home infusion care from Tricia Lacavich, Vice President for CVS Specialty Coram Infusion Services, in her recent article in Fierce Healthcare.

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POLITICO Q&A with Dr. Lotvin: A New Front Door to Care

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Dr. Alan Lotvin, Executive Vice President and Chief Transformation Officer for CVS Health, recently sat down with POLITICO to highlight how our recently integrated company is transforming the future of consumer health services and addressing needs in chronic disease care.

The conversation centered on the importance of advancing our health care system to meet consumers where they are and when it is convenient for them. According to Dr. Lotvin, “A lot goes into building a consumer-centric health care model. The first part of it is a recognition that we have to organize a health care system around and for the benefit and convenience of consumers.”

Here are four takeaways from his discussion with POLITICO:

  • Managing conditions requires expanded touchpoints care. It can be difficult to improve patient engagement with just three or four doctor visits per year — underscoring the importance of interacting with patients on a more frequent basis. According to Dr. Lotvin, “What we're trying to do is bring more personalized services into people's homes and communities at a point in time when it's convenient for them to interact with us, but also in a way that is on their terms. When they call us to fill a prescription or walk into one of our stores, they're primed to think about their health, and they tend to be very receptive to messages that are promoting health.”

  • Improving patient health is critical to help manage growing costs. According to Dr. Lotvin, the best way to lower total health care costs is to improve overall health. If we can help patients prevent conditions such as diabetes or high blood pressure, we are able to avoid the expenses that are incurred from managing these conditions over an extended period of time. Dr. Lotvin noted that we must first provide better access to more coordinated care and then take steps to ensure that patients are receiving their care in the most efficient setting.

  • Strengthening care coordination begins in the community. Dr. Lotvin shared the example of a diabetes patient to highlight the importance of providing coordinated, high-quality health care services all under one roof. Anyone living with diabetes should have several annual exams and evaluations. These patients are typically required to visit several sites and providers, which can lead to fragmentation. Through our new HealthHUB model, we’re doing more to ensure that these exams and evaluations can all be done within our own four walls and we can help patients identify the next best action.

  • Analytics are key to improving health care outcomes. Through analytics, we are able to turn insights into meaningful health care actions. According to Dr. Lotvin, the acquisition of Aetna provides the company with the opportunity to analyze health care challenges in a more holistic manner and then identify how we can address them at the community level.

The full Q&A can be viewed here.

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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Supporting Our Patients with Chronic Disease

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As we transform the health care experience for all patients, we pay special attention to the needs of patients with chronic diseases who seek care more frequently. We continue to invest in the development of smart and robust solutions to address the health impacts and escalating costs related to chronic disease in the U.S. Our efforts include expanding preventive care and treatment for chronic conditions, improving medication adherence, coordinating care across the healthcare system, engaging patients where they are, and offering healthier product options at our stores.

Personalizing Care Solutions

Our Transform Care programs continue to deliver frequent and highly personalized care to millions of CVS Caremark members who are managing a chronic condition. The programs combine patient-related health and pharmacy data with drug cost management strategies that make care more effective, affordable and easy to navigate.

Transform Diabetes Care, introduced in 2016, has since been adopted by more than 230 CVS Caremark clients, representing 3.4 million members. The program uses advanced analytics to identify members with diabetes and target appropriate interventions. A certified coach develops and helps execute personalized management plans for Type 2 diabetes patients based on their pharmacy data and electronic health record information. The patients use at-home, connected glucometers for glucose readings, which their coach can monitor to offer help as needed. The program also ensures patients receive prescription refill reminders, in-person counseling on diabetes management, and comprehensive diabetes visits at MinuteClinic locations at no out-of-pocket cost.

By 2021, we plan to offer an enhanced diabetes program that combines CVS Health’s local and pharmacy care with Aetna’s care management, targeting, analytics and other capabilities, resulting in a best-in-class diabetes and chronic offering. The enhanced program will derive from the current Transform Diabetes Care model, making for a seamless transition and member experience for clients who wish to adopt the enhanced product. Features of the enhanced product may include:

Aetna’s care managers can provide a single point of contact for members with chronic conditions regardless of which conditions members have. The member’s care manager will also have access to the member’s information from their engagement in the Transform Diabetes Care program and can coach based off of that information.

Creating Comprehensive Programs for Complex Conditions

Another way we are reducing costs and enhancing patient care is through the development of comprehensive programming designed specifically for complex chronic conditions like kidney disease and cancer.

In 2018, we introduced a program to support patients with End Stage Renal Disease (ESRD), a disease that affects nearly 700,000 Americans. Taking a staged approach, our program seeks to slow the progression of ESRD and reduce associated hospitalizations. Beginning with early disease identification and patient education, the program will follow with the development of a comprehensive home dialysis program, for both hemodialysis and peritoneal dialysis. Understanding that longer, more frequent hemodialysis treatments often lead to better outcomes, we will initiate a pivotal clinical trial of a new home hemodialysis device in support of a planned U.S. Food and Drug Administration (FDA) submission to obtain market clearance.

We will select new program participants by determining who is most at risk for kidney disease and progression to kidney failure, as identified through medical and pharmacy claims data and predictive analytics algorithms, in accordance with HIPAA. Our Accordant Care nurses will engage these individuals to educate them on their risk level, important tests they should consider taking, and the need to see a nephrologist. This team will work with individuals as they progress toward ESRD.

We also work with our health care partners and clients to help manage the cost of oncology care while ensuring access to vital therapies for patients. Our approach promotes evidence-based cancer care, lower-cost but clinically equivalent treatment options, and a holistic patient care model that helps patients adhere to therapy. An important component of our cancer care approach is helping providers stay up-to-date with the latest research and advancements, a challenge in the fast-paced field of oncology.

In 2018, we partnered with the leading oncology organization National Comprehensive Cancer Network (NCCN) to provide physicians with a tool to access the latest evidence-supported information. Treatment Guidelines from the NCCN are integrated into Novologix, CVS Health’s proprietary technology platform, and serve as the clinical foundation of multi-drug regimen prior authorization (PA) for physicians and patients. Novologix helps drive cost-effective regimen selection by determining treatment coverage that meets treatment plan needs.

To learn about the many other ways we’re supporting our chronic disease patients, read our 2018 Corporate Social Responsibility Report.

To stay up-to-date on the latest CVS Health Social Responsibility news and content, sign up for email news alerts.

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