Using Data to Drive Value to Our Members

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From opioid misuse, gene therapy and chronic care management to end-of-life issues and hospital acquired infections, our Clinical Insights and Analytics (CIA) team is using member data and medical knowledge to make an impact on the lives of the people we serve and set them on a path to better health.

CVS Health’s Clinical Insights and Analytics (CIA) team is using member data and medical knowledge to make an impact on the lives of the people we serve and set them on a path to better health.
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“We are a clinical think tank,” says CIA team member Rebecca Smith, a senior program manager. “We have the clinicians, the project management, the operational expertise and the data analysis all in one place, all working cohesively.

“We're all working towards the same goal, which is to drive better value of care for our members.”

Watch the video above to learn more.

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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For Diabetes Patients, a Care Coach Is Just a Click Away

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CVS Health pharmacist Matthew Scarnecchia could see the concern on the face of his patient. Richard, a 59-year-old man who suffered not only from Type 2 diabetes but also high blood pressure and high cholesterol, was alarmed by the results of his latest blood-sugar test. His A1c was 7.5 percent — above his goal range of below 7 percent.

With a few questions, Scarnecchia learned that Richard was worried about also getting low blood sugar from his diabetes medication. It turned out that Richard was taking his diabetes medication in the morning, but not eating until he was at his workplace after a long commute. “I recommended that he take his Glipizide with his breakfast at work to see if that would help,” Scarnecchia says. It did. Just a few months later, Richard’s A1c had dropped to 6.3 percent and he was no longer having low blood sugar readings.

Nearly as satisfying, this one-on-one consult took place without either man leaving his desk, even though they were 2,000 miles apart – one in Arizona, one in Florida. Through his insurance provider, the patient had signed on to CVS Health’s Medication Therapy Management program and met with Scarnecchia face-to-face via an online app that can be accessed through any computer or mobile device.

Personal Consultations from Anywhere

Once enrolled in the program, patients can slot in a video consultation from anywhere. In addition to their regular doctor’s appointments, they can talk with a specialized pharmacist who can advise on medication compliance, interactions and side effects, and, most importantly, suggest some everyday adjustments, such as diet and exercise, that can make an immense difference in controlling diabetes.

CVS Health’s Medication Therapy Management program provides patients with one-on-one care with a specialized pharmacist who can help them better manage their chronic condition from the comfort of home.
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A video meeting benefits patients and pharmacists alike. A patient can show his or her latest blood-sugar results or other medical reports without needing to mail them. If a patient is having issues injecting insulin, the pharmacist can point to possible alternative injection sites on a visual model. The one-on-one view also allows pharmacists to pick up on nonverbal cues. “I can see if a patient seems confused about their results and give explanations that might be helpful,” says Scarnecchia.

Patients can take advantage of this face-to-face coaching even before they might need medication. With diabetes tied to so many other health concerns — high blood pressure, nerve damage, heart disease — it’s especially vital to try to halt or slow down the condition’s progress.

Small Changes Can Make a Big Difference

When an A1c of 5.8 percent tipped him into the prediabetic range, 60-year-old Jeff welcomed the chance for video chats with pharmacist Brian O’Halloran, and has kept those appointments every three to four months. “During our visits, we’ve discussed healthy lifestyle changes,” says O’Halloran. “Jeff decided to stop drinking diet sodas, and reported, nine months later, that he’d stayed off them.” 

Small but attainable goals are easier to meet, explains O’Halloran.

“In March 2018, Jeff said he wanted to lose 5 pounds before his next time we talked. I told him ‘Don’t shop the aisles.’ That’s where grocery stores stock all the processed foods. Instead, I suggested he shop the perimeter — where he could pick up fresh vegetables and meats. When we spoke again in July, he’d lost 6 pounds.”

Both pharmacists find that patients look forward to the on-screen sessions, which often last for 30 minutes. Even a patient’s family member may stop by to wave hello, says Scarnecchia. Patients can also contact the pharmacist in between scheduled sessions. When a patient shares good news about improved bloodwork, O’Halloran warmly congratulates them on their success.

For diabetes patients, a video visit is part of the “big picture” of managing of their condition. Patients can ask questions that may not have occurred to them while in their doctor’s office. “It’s more like a conversation,” says O’Halloran, “and more comfortable for the patients.”

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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Helping Patients Better Manage Diabetes

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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.
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“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.

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

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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.
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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.

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Supporting the Fight Against HIV/AIDS

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This World AIDS Day, CVS Health is recognizing the progress made in the fight against HIV/AIDS and is teaming up with the U.S. Department of Health and Human Services (HHS) to help further reduce the spread of the HIV virus.

Reducing transmission of HIV

Currently, there are an estimated 1.1 million people in the U.S. living with HIV, and approximately 38,000 people diagnosed annually. Scientific advances over the past few decades have changed the paradigm for the prevention and treatment of the disease. For example, an HIV diagnosis is no longer a death sentence and can now be effectively managed through maintenance medications. In addition, more recent medical breakthroughs have brought to market pre-exposure prophylaxis (PrEP) medications that can prevent at-risk populations, including those who could contract the virus through sexual contact or drug use, from ever getting HIV.

HHS estimates that more than one million people in the U.S. could benefit from taking PrEP medication, however only 100,000 actually have a prescription. That is why CVS Health is teaming up with HHS to help make PrEP medication more accessible and affordable through a new HHS program called Ready, Set, PrEP, which is a key component of the Ending the HIV Epidemic In America initiative, which aims to reduce the number of new HIV infections in the U.S. by 90 percent over the next 10 years.

How it works

The HHS Ready, Set, PrEP program provides at-risk and HIV-negative individuals who do not have prescription drug coverage access to PrEP medication at no cost.  In addition, the program is providing education and awareness materials to help individuals gain more information about PrEP and learn how to access the Ready, Set, PrEP program. Once approved, and with a valid PrEP prescription from a health care provider, individuals can fill the medication at a participating pharmacy, including CVS Pharmacy and CVS Pharmacy Specialty Services locations or by mail. CVS Health has donated prescription dispensing services to HHS as part of Ready, Set, PrEP program. Those interested can learn more about Ready, Set, PrEP and apply online at GetYourPrep.com or calling toll-free 855-447-8410.

CVS Health has donated prescription dispensing services to HHS as part of Ready, Set, PrEP program. Those interested can learn more about Ready, Set, PrEP and apply online at GetYourPrep.com.
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Our enterprise commitment

This is one more way that CVS Health is working to prevent the spread of HIV and help those living with HIV better manage the virus and prevent disease progression.

This includes an ongoing partnership with the Centers for Disease Control and Prevention (CDC) to help Act Against AIDS, which brings mobile HIV screening and testing services to CVS Pharmacy locations throughout the country.

In addition, through the CVS Specialty HIV Care Management program, patients can receive whole-patient management and support from nurses specially trained in HIV care.Nurse support is available to CVS Caremark members whose plans including Accordant Care Management (including CareTeam Choice or CareTeam Advanced) Comprehensive, continuous care can help promote medication adherence, improve outcomes, and reduce overall health costs. Further, at several CVS Pharmacy Specialty Services locations in New York City, HIV patients can receive proactive outreach to improve adherence to and management of HIV medications. This includes face-to-face counseling and/or telephonic outreach for all new-to-therapy patients; refill reminders; and additional co-morbidity and financial support and assistance, as appropriate.

Across CVS Health, we help support the HIV/AIDS community every day. Through high-touch support, screening and care management services, we help those who are at at-risk for or living with HIV/AIDS on their path to better health.

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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Re-Training Providers to Achieve Proper Blood Pressure Measurement

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Getting your blood pressure checked is a familiar experience at the doctor’s office, but recent research suggests that it may not always be accurate.

According to the American Heart Association (AHA), nearly half of all U.S. adults have high blood pressure, which is a leading risk factor for heart attacks, strokes, and preventable death.  Accurate measurement of a patient’s blood pressure is vital to providing accurate diagnoses and quality care.https://www.ama-assn.org/system/files/2019-11/market-research-survey-bp-measurement.pdf

Given the importance of accurate blood pressure readings, clinical guidelines recommend that health care providers be periodically re-trained on proper BP measurement; however, recent market research conducted by the American Medical Association (AMA) and the AHA indicated this may not always be the case.

Based on this research, the AMA and AHA partnered with MinuteClinic, along with a leading health care organization and leading academic medical centers, to test a new e-learning module. The module, called Achieving Accuracy: BP Measurement, was designed to provide all front-line health care providers with access to consistent training on proper BP measurement and is now available for health care professionals through the AHA.

In the survey of more than two thousand health care providers, half of the physicians and physician assistants (PAs) who responded, and a third of nurse respondents, said they had not received BP measurement re-training since their initial training in school. However, there seems to be broad support among the survey respondents for BP refresher training, with three-quarters or more of the nurses, PAs, primary care providers and pharmacists surveyed noting that it should be required.

Some common BP measurement errors that can result in pushing a patient’s diagnosis from normal to elevated, include:

  • Taking a reading while a patient is sitting with their legs crossed, which can raise systolic pressure by 5 to 8 mm Hghttps://www.ncbi.nlm.nih.gov/pubmed/17496470

  • Using the wrong cuff size, which can raise systolic pressure by approximately 10 mm Hghttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911816

“Being able to test this new BP measurement re-training module with our providers on the front lines reinforces our long-standing commitment to advancing heart health and providing high quality care for our patients,” said David Fairchild, M.D., Chief Medical Officer, MinuteClinic. “Our providers appreciated the opportunity to be involved in this effort and we look forward to integrating this training into our clinical standards moving forward.”

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Fighting Pneumonia With a Toothbrush: New Program Is Yielding Results

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A woman smiling with a toothbrush in front of her mouth.

A first-of-its-kind CVS Health initiative to combat hospital-acquired pneumonia through better oral health is improving outcomes and receiving rave reviews from patients. Launched earlier this year, the Rush to Brush program has supported more than 10,000 Aetna members undergoing surgery with kits containing high-quality oral care products, education and a personalized ‘get well soon’ card.

“The program has allowed us to offer members a simple health care solution right at their fingertips,” said Daniel Knecht, M.D., Vice President of Health Strategy and Innovation for CVS Health. “It also shows the power of bringing key industry stakeholders together to solve a problem unearthed by member data.” 

Leveraging the information contained within surgery pre-certifications, the kits arrive in-home to members approximately one week before their scheduled hospital admission. The effort is designed to help reduce the incidence of pneumonia, the number one hospital-acquired infection and one of the most life-threatening illnesses patients can contract. 

Oral care is critically important in the post-operative setting because the mouth is filled with bacteria. “We want to shift the paradigm around oral health in hospitals. It’s actually more important to take care of your teeth and mouth when you go in for surgery, not less,” said Mary Lee Conicella, DMD, Aetna’s Chief Dental Officer. One study found disease-causing bacteria—especially those linked to pneumonia—present in 90 percent of patients within 72 hours of being admitted to the hospital. Those bacteria don’t just stay in the mouth, however; they are often inadvertently inhaled into the lungs.https://www.aha.org/2018-03-29-what-your-hospital-doing-about-1-hospital-acquired-infectionhttps://msphere.asm.org/content/1/4/e00199-16https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4414413https://aricjournal.biomedcentral.com/track/pdf/10.1186/s13756-016-0150-3

Brushing one’s teeth greatly reduces the population of bacteria in the mouth, according to nurse-researcher Dian Baker, Ph.D., professor at California State University, Sacramento. “When patients brush their teeth, they’re basically taking their bacterial count from hundreds of millions down to just a few, and this greatly reduces their risk of pneumonia.”

Dr. Baker’s research inspired the Rush to Brush program, which is paying dividends in terms of clinical results, member satisfaction and reduced health care costs. Early results demonstrate decreases in the incidence of pneumonia among members who received the Rush to Brush kit when compared to those who did not.Data based on early observations of pneumonia claims within 90 days of procedure, not yet statistically significant. Additionally, estimates project that the program will yield substantial savings in avoidable medical costs across Aetna’s commercial and Medicare business.

A note from a patient who took part in the Rush to Brush program.
A note from a patient who took part in the Rush to Brush program.

And members love it. Seventy percent took the kit with them to the hospital, and 95 percent have expressed positive feelings toward the program and Aetna. Members who received the kit have been effusive, saying the initiative “shows that Aetna is caring and considerate” and that “the fact that Aetna took a vested interested in my recovery meant so much.” One member noted that the kit “took the guesswork out. All items were needed, all items were used – this was better than flowers!”

In addition to collaborating with Dr. Baker, Aetna worked with plan sponsor Johnson & Johnson as well as Colgate-Palmolive and IntelliDent to outfit the kits with Colgate Total toothpaste, a soft-bristled toothbrush, Listerine Zero mouthwash, disposable toothbrush shields and tips on good oral health.

The program illustrates CVS Health’s and Aetna’s unique ability to use clinical and member data insights to unlock members’ health care needs, allowing us to bring together the resources to meet our members on their road to recovery and better health.

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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Innovating Health Care

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Milken Institute Facilitates Meaningful Discussion on the Social Determinants of Health

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Research shows that your environment can be more important than your genetic code when it comes to improving your health. In fact, 60 percent of our life expectancy is determined by social and environmental factors.

To address this issue, Tom Moriarty, chief policy and external affairs officer, and general counsel at CVS Health, recently joined a panel discussion at the Milken Institute Future of Health Summit to discuss how players across the health system can implement solutions that address the personal and financial impact of the social determinants of health, including housing, food and transportation. Moriarty was joined by representatives from the American Public Health Association, BUILD Health Challenge, DC Green and Socially Determined who shared best practices and innovations to tackle the social determinants of health locally.

Health experts hold a panel discussion at the Milken Institute.
CVS Health Chief Policy and External Affairs Officer Tom Moriarty (center right) talks about the ways we’re addressing the factors that impact overall health at the Milken Institute Future of Health Summit.

Below are three key takeaways from the panel discussion.

  • A New Center of Care to Support Patient Needs: Most of our health and well-being happens outside of the doctor’s office – where we live, learn and work. The panel emphasized the importance of understanding the needs of each patient and why local innovations can help address the factors that impact overall health. According to Moriarty, this is where CVS Health can make a difference. Currently, 71 percent of patients live within a five mile radius of a CVS Pharmacy and we utilize our community footprint to expand access to high-quality health services.

  • Improving Local Access to Care is Key: Consider, for example, that 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 the facilities. According to Moriarty, our MinuteClinic offering can help fill this gap in care. Our extended hours and broad community reach increase access to care. Data shows that up to 50 percent of patients who visit a MinuteClinic don’t have a primary care provider. Furthermore, patients visit on nights and weekends – when other sites of care are closed.

  • Public-Private Partnerships Deliver Value: Panelists agreed that housing and food insecurity have the greatest impact on community health and well-being and additional support is needed for vulnerable patients. To meet these needs, the panel highlighted the value and promise of collaboration across the government, nonprofit and private sectors. Moriarty shared the example of how CVS Health is helping to improve access to safe housing in Philadelphia, Pennsylvania. We recently contributed $4 million to the Inglis Methodist Gardens project to support the development of a four-story, 47-unit apartment building in West Philadelphia – serving a mixed population of long-term care recipients and people at risk for homelessness.

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.

Health experts hold a panel discussion at the Milken Institute.
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Multi-Dose Packaging Is Making It Easier to Take Medications

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Lee Ann Pace was having trouble keeping up with her multiple prescriptions, sometimes running out of her medications before she got them refilled.

She’s not alone. Taking medications as prescribed is one of the best ways to control chronic diseases like high blood pressure, diabetes and high cholesterol, but with dose changes, regimen changes, manufacturer changes and other barriers, keeping up with multiple medications can be a challenge.

That’s why we offer no-cost multi-dose packaging, making it easier for customers and members to take their medications and stay on their path to better health.

“Everything they need for each time of day is there packed together with their name, the information about the medication, the prescriber, lot numbers, expiration dates…all there for the patient,” says Lynn Parker, CVS Pharmacy manager.

Watch the video to learn more.

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.

A photo of a woman examining mediations in her CVS Pharmacy® multi-dose packaging.
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