Helping Patients Better Manage Diabetes

Bottom of the article

As CVS Health’s Senior Director of Transformation Stella Wong explains, diabetes is a difficult condition to manage. There are a number of things patients need to do on a routine basis, such as checking blood glucose levels, eating right, exercising, or taking the right medications at the right time.

“The list is literally hundreds of items long,” Stella says.

CVS Health is in a unique position to help. From new, innovative programs to in-store screenings at MinuteClinics and HealthHUB locations, learn how we’re helping people with diabetes better manage their condition and lead healthier lives.

From new, innovative programs to in-store screenings at MinuteClinics and HealthHUB locations, watch this video to learn how CVS Health is helping people with diabetes better manage their condition and lead healthier lives.
Tweet this

“Our tremendous reach into people’s communities (and) our focus on new technologies will allow us to add an entire other layer of support and care for patients,” says Dr. Alan Lotvin, Chief Transformation Officer. “We have the opportunity and the ability to fundamentally reshape and augment the care delivery system in the United States.”

Watch the video above to learn more.

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.

Hide Media Contacts (Sidebar)
No
Article
Hide Share
Off
"Likes" Count
14
Display Hero
Off

Why Building Trust is Key to Delivering Crucial Care to Pharmacy Patients

Bottom of the article
Close-up photograph of doctor holding patient’s hand.

CVS Health pharmacists are often called on to employ not only clinical services, but a fair amount of detective work as well. Patients often report that their diet, exercise, and medications are all in check, but if they’re not experiencing results to match, then it’s time to dig a little deeper.

Elderly or infirm patients can pose special challenges: They can be mistrustful of medical professionals, stuck in old habits, and might not even be physically able to visit their local CVS for prescription recommendations and tests. Often, all the pharmacist has to go on is phone consultations and lab results. And yet, often that’s enough to produce life-changing results.

Pharmacist Angela Stigliano realizes that building trust with patients is a necessary part of the job. She’s a clinical pharmacist for CVS Health’s Medication Therapy Management (MTM) service, and provides care to members over the phone or via video chat.

She shared a recent success story about a patient with diabetes that demonstrates why trust is so important. The percentage of Americans 65 and older with diabetes is high, at about 25.2 percent or 12.0 million seniors (diagnosed and undiagnosed).https://www.diabetes.org/resources/statistics/statistics-about-diabetes It is a disease that can be well-controlled with diet and lifestyle changes — but they’re not always easy to make and adhere to without a helping hand.

Asking the Right Questions to Get a Diabetes Patient Back on Track

In March 2018 Stigliano began working with Vicki, a woman in her sixties who reported having a stroke that had left her with mild physical impairments. Though she had a long history with diabetes and high cholesterol, her doctors were confident that she would make a full recovery.

In their initial phone call, Vicki insisted that she followed a strict diet and was very mobile, but given the precarious state of her health, that “didn’t make sense,” says Stigliano: She was gaining weight, her A1C was unstable, and she wasn’t taking her cholesterol medication as prescribed. These factors put her at risk not only for another stroke, but heart disease as well.

Through a series of thirty-minute phone calls every few months, Stigliano fostered a friendly relationship with Vicki.

“I would use phrasing like ‘Tell me about your diet these days,’ instead of saying, ‘Have you been dieting?’ This allowed her to tell me about her diet without the feeling I was searching for a ‘correct answer,’” she says. “It can be difficult to be forthcoming with a stranger about a sensitive topic like being overweight or unable to walk and care for yourself properly.”

These days, there’s a lot of confusion about what a “healthy diet” actually means. Vicki reported trying a keto diet, and skipping meals, both unwise choices for a diabetic.

“Purposely not eating enough can be just as unhealthy as eating fast food every day. Not having enough range in your diet can also become unhealthy as well,” says Stigliano. She recommends the easy-to-follow MyPlate tactic to patients like Vicki. “You’re not telling them what to eat and what not to eat, but to focus more on portion sizes; to look at their diet and their plate a little bit differently.”

A CVS Health clinical pharmacist shares a recent diabetes patient success story that demonstrates the importance of relationship-building in her work.
Tweet this

After several months, Stigliano was pleased to hear that Vicki had begun to be more honest with herself and her medical team. She compromised with her prescriber, and was put on a low-intensity statin three times a week. And, as Stigliano had gently suggested over the course of their interactions, she began a low-carb, high-protein diet, and increased her physical activity.

All of these changes started to pay off. Vicki’s A1C had been steadily improving due to her adjusting her insulin, but after taking the initiative to make lifestyle changes, she had lost approximately twenty-five pounds, reduced her A1C to consistent readings at or around 7 percent, and mentioned that her LDL cholesterol had come down by 100 points on her latest lab test. And she felt positive, healthy, and empowered.

“When we first started talking, Vicki was not in good spirits,” says Stigliano. “She was very upset about her stroke, and really down, very defeatist. But, after Vicki began to take control of her health, Stigliano says, “It sounded like I was speaking to a whole different person. She was excited to tell me about her lifestyle, the change in her as person. She ended our most recent phone call by saying, ‘I’ll talk to you soon. I need someone to stay on top of me!’”

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.

Hide Media Contacts (Sidebar)
No
Article
Hide Share
Off
"Likes" Count
0
Display Hero
Off

The Importance of Bringing Diabetes Care into the Community

Bottom of the article

This article was written by Dr. Dan Knecht, Vice President of Health Strategy & Innovation at CVS Health.

1.5 million: That’s the number of Americans who are diagnosed with diabetes each year. 327 billion: That was the total cost of diagnosed diabetes in the United States in 2017, according to the American Diabetes Association.

These are big numbers, but they don’t tell the whole story. In addition to my day job as Vice President of Health Strategy and Innovation at CVS Health, I practice as a physician at Mount Sinai West Hospital in New York City. During my weekend rotations, I see firsthand the very real and negative impacts of uncontrolled diabetes on my patients. Diabetes can cause vision loss, kidney failure and neuropathic pain, in addition to accelerating and worsening cardiovascular disease.

Thankfully, the news is not all bad. As the number of people diagnosed with diabetes rises, so are the resources and treatment options available to them.

CVS Health recently partnered with Morning Consult to better understand the needs of people living with diabetes and the providers who deliver diabetes care. What we heard from patients and doctors is a desire to:

  • Expand access to local care
  • Better manage and predict out-of-pocket costs
  • Provide additional lifestyle support in the form of nutrition, exercise and social services

In honor of Diabetes Awareness Month, I sat down with fellow diabetes experts Dr. Steve Edelman, M.D., founder and director of Taking Control of Your Diabetes, and Joy Pape, R.N., a nationally known family nurse practitioner and certified diabetes educator, to discuss how we can address some of these needs through real action.

Watch our full CVS Health Live discussion above.

Read Dr. Knecht’s full article on LinkedIn.

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.

Hide Media Contacts (Sidebar)
No
Article
Hide Share
Off
"Likes" Count
3

How a Trusted Partnership Helped One Type 2 Patient Live Healthier

Bottom of the article
A photo of a scale on wooden floor.

When Regina Wu first met Kenneth, she asked him about his diet and exercise — as CVS Health pharmacists routinely do with their patients. Kenneth, a 77-year-old man with diabetes and a sweet tooth who once weighed 286 pounds, said he often drank a liter of soda per day.

Regina immediately sensed a red flag.

“I know that soda is something people can become addicted to in a way,” she says. “It’s caffeinated, high in sugar, and people start to crave a soda fix. And soda is a big problem for blood sugar control.”

Research shows drinking sugary beverages like soda every day could increase a person’s risk of developing type 2 diabetes by 26 percent. For those already diagnosed with type 2 diabetes, soda consumption can hamper their efforts to keep their blood sugar at an acceptable level.

That certainly was the case with Kenneth. He took his medications diligently, but his A1C reading was 10.1 percent. A normal A1C is less than 5.7 percent, and the goal for type 2 diabetes patients is to keep their A1C levels below 7 percent. Kenneth was struggling enough with his blood sugar that his doctor increased his insulin dosages.

Losing weight and changing eating habits can be challenging if the problem seems large and insurmountable. Regina saw an opportunity to focus on a small, manageable change: reduce Kenneth’s soda intake.

It’s these kinds of interactions that CVS Health had in mind when we created our Medication Therapy Management program. The program is designed to allow CVS pharmacists to engage one-on-one with patients, identifying any barriers in their treatment, recommending lifestyle changes, and creating an ongoing dialogue to ensure that patients are taking their medication and getting the follow-up care they need.

Regina and her colleagues frequently work with type 2 diabetes patients: Approximately 1 in 10 Americans — or about 30 million people — have type 2 diabetes, 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.

Regina spoke every few months with Kenneth, urging him to drink even just one less can of soda. Then, in 2018, Kenneth was hospitalized with an infection, and he was hospitalized a second time about a year later. After Kenneth came home from the hospital, he cut back to two Diet Cokes a day. By May 2019, his A1C reading was 8.6 percent, much closer to his target level, and he now weighs 240 pounds. He’s on a 50-gram-carbohydrates per day diet, walks more often, his blood pressure levels have improved and his medication dosages have been reduced. He has kicked the soda habit completely, and has become an advocate among his family members to minimize soda drinking.

“I see the pharmacist as part of the care engagement team,” Regina says. “It really takes a village and the pharmacist is someone patients can talk to in between doctor visits or after hospital discharge. They get to know me, I get to know them, and it becomes a friendship, and with that trust, we talk about how to make small changes that can add up.”

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.

A photo of a scale on wooden floor.
Hide Media Contacts (Sidebar)
No
Article
Hide Share
Off
"Likes" Count
0
Display Hero
Off

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.

Patient stories, features and related content

Display Date

By the Numbers: Improving Diabetes Care

Bottom of the article
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.

A man using diabetic testing equipment.
Hide Media Contacts (Sidebar)
No
Article
Hide Share
Off
"Likes" Count
2
Display Hero
Off

Everyday Steps Are Critical for Managing Diabetes

Bottom of the article
A woman receiving a blood pressure check.

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.

Hide Media Contacts (Sidebar)
No
Article
Hide Share
Off
"Likes" Count
2
Display Hero
Off

POLITICO Partnership Elevates Discussion on Social Determinants of Health

Bottom of the article

Tom Moriarty, chief policy and external affairs officer, and general counsel, recently spoke to 100 health care and policy influencers at a POLITICO Live event in Philadelphia, Pennsylvania, about the importance of local and personalized solutions in addressing the social determinants of health. The event was part of the Health Care Innovators series, sponsored by CVS Health, which showcases leading voices and practices in health care innovation.

Watch the full remarks here.

Understanding Community Health Care Needs

Most of our health and well-being happens outside of the doctor’s office where we live, learn and work. Furthermore, data show that 60 percent of our life expectancy is determined by factors such as housing, transportation, education and food.

Moriarty noted that these factors underscore why we must understand and analyze how local environments impact health—and the importance of data in the U.S. News & World Report Healthiest Community Rankings. In Philadelphia, nearly one in five residents smoke and more than one-fourth are grappling with obesity. According to Moriarty, our communities are ripe for health care innovation and we have an opportunity to improve health outcomes by creating meaningful touchpoints to care.

Expanding Access to Care Locally

Access remains a key challenge in helping patients manage their conditions. According to Moriarty, community health care access can be defined by two tracks: the availability of primary care and the ability to get to where care is offered.

To demonstrate how CVS Health can address these tracks, Moriarty shared an example of “Diane,” a single mother of two who recently received a diabetes diagnosis. There could be a number of obstacles in her way. First, it may be hard for her to take time off during business hours for appointments. Next, she may face difficulties in getting the testing and labs she needs for diabetes. Research shows 40 percent of physician-ordered lab tests aren’t completed—oftentimes as a result of facilities not having extended hours and the patient lacking access to public transportation to that facility.

According to Moriarty, this is where CVS Health is making a difference. Today, 71 percent of Americans live within five miles of a CVS Pharmacy location. And people come to their pharmacy frequently: whereas a patient with diabetes like “Diane” might only see her physician four to five times a year, she will likely see her pharmacist as many as 18-24 times in the same year.

Moriarty highlighted how we’re utilizing our community footprint to provide timely and targeted interactions with patients like “Diane.” For example:

  • Our MinuteClinic offering is complementary and collaborative to primary care—and helpful to the system overall. We offer treatment for 125 conditions from trusted providers. Furthermore, our extended hours and broad community reach can help address gaps in care.

  • To build on our MinuteClinic services and improve care coordination, we recently piloted HealthHUB—a new, first-of-its-kind concept offering new product categories, digital and on-demand health tools and trusted advice. This concept will be brought to the Philadelphia and Southern New Jersey market in the coming months.

Improving Health Care Affordability

Along with access to care, affordability is a top health care priority for patients. Moriarty emphasized how CVS Health is doing more to help ensure patients get the medications and care they need at the best possible cost.

For example, data show that 40 percent of patients do not pick up their prescriptions when out-of-pocket costs per prescription exceed $200. Moriarty noted that if patients are unable to afford their medications, they get sicker and their care becomes even more expensive. CVS Health has developed solutions to change that.

  • 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. More than 100,000 prescribers are using this program—leading to an average of $90 savings per prescription.

  • We’ve also pioneered digital tools, including the Rx Savings Finder, which help our retail pharmacists find patients savings when they do reach the pharmacy counter.

We look forward to continuing to address the social determinants of health in the communities we serve.

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.

Hide Media Contacts (Sidebar)
No
Article
Hide Share
Off
"Likes" Count
0
Display Hero
Off