CVS Health statement on Arkansas Insurance Department audit

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“This report from the Arkansas Insurance Department (AID) relies on incomplete and misleading data for several findings that do not accurately represent our work on behalf of consumers in the Arkansas Works program.

“This first-of-its-kind audit was originally intended to focus on spread pricing. And, under that remit, the results of the audit are sound, reinforcing what we have long said: we did not use spread pricing in the Arkansas Works program.

“We fully support and comply with all formalized pharmacy benefit manager (PBM) audits, as long as they are conducted fairly, designed with a clear objective, and utilize a standardized and unbiased methodology. Unfortunately, in this case, the scope of the audit was expanded to include additional analyses using methodologies that simply don’t hold up to scrutiny. As the report itself notes, CVS Health raised a number of concerns with the expanded scope, the methodologies used and its additional findings. It is disappointing that the auditors have not addressed these flaws, and it is equally concerning that the report seems to attempt to reinforce several false narratives about PBMs from the independent pharmacy lobby.  In fact, the report validates that CVS Caremark reimburses Arkansas’ independent pharmacies up to 33 percent more than CVS Pharmacies in their network.

“For decades, CVS Health has proudly served Arkansas families and communities. We will continue the critical work of lowering prescription drug prices for patients in the Arkansas Works program and the rest of our clients across the state.”

Additional points include:

  • CVS Health strongly supports transparency that helps deliver better health outcomes and lowers drug costs at the pharmacy counter for patients – and we recognize that audits are one way for clients, government regulators and the public to have confidence in the integrity of our services.

  • However, this audit does not adhere to standards established by the National Association of Insurance Commissioners (NAIC) for market conduct and financial examinations, and the findings suffer as a result.

  • The analysis surrounding a standard and contracted reconciliation process between independent pharmacies and CVS Health relies on an insufficient data set: one contract. It is not possible, or methodologically sound, to rely solely on a single contract, which cannot be extrapolated to demonstrate how reconciliations are done across a CVS Caremark network of more than 700 pharmacies and hundreds of contracts in Arkansas.

  • Contrary to their misleading claims about PBMs, local, independent pharmacists make up an outright majority of CVS Caremark’s network in Arkansas. We reimburse them fairly and at a significantly higher rate on average than our own pharmacies, in accordance with the terms of the contracts we sign with them and their PSAOs, which they enter freely.

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Battling food insecurity one meal at a time

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Aetna Medicare again sponsored the annual Philabundance Agency Appreciation Event to honor Southeastern Pennsylvania and Southern New Jersey community partners that fight hunger. Philabundance, the area’s largest hunger-relief organization, presented 2020 Hunger Hero Awards to outstanding individuals from five member agencies.

Because of COVID-19 restrictions, this year’s event couldn’t be held indoors. Instead, Aetna Medicare Community Lead Generator Desaree Jones and Olivia Edwards from Philabundance surprised the winners by travelling to their agencies to distribute the awards.

“People in these community organizations aren’t always publicly recognized for their efforts, so it was a great opportunity to share our thanks for the work they do,” said Jones. “Besides the awards, we brought balloons, a boxed lunch and a bag of Aetna and CVS Health goodies: hand sanitizer, face shields, face masks, shower gel and bubble bath. I really enjoyed interacting with the agencies and seeing their food pantries.”

Aetna’s National Director of Medicare Community Engagement Ricardo Maldonado joined Jones at the awards presentation at Liberti Church, as he lives nearby. Although he no longer works in the Philadelphia market, Maldonado wouldn’t have missed this event. He was also one the driving forces behind creating and sponsoring last year’s inaugural event.

Six people standing on the steps of Liberti Church holding a sign that reads, "hunger heroes"
Honoring Liberti Church Director Vito Baldini (third from left) are (from left) Aetna's Desaree Jones, Philabundance's Emily Glick and Margarita Cruz, and Aetna's Ricardo Maldonado and Jessica Velez.

“Despite COVID-19, we wanted to acknowledge these agencies’ efforts to support their communities during these difficult times,” Maldonado emphasized. “We know how much the neighborhoods appreciate the agencies’ work, because hunger doesn’t go away. That’s why I’m so grateful CVS Health recognized Philabundance earlier this year, awarding a $25,000 grant to support its food bank.”

Like Maldonado, Jones draws energy from community service. Before joining Aetna, she created neighborhood events in Philadelphia and Delaware County for the Pennsylvania State Senate for 12 years.

“It’s important to give back,” affirmed Jones, who shared that she received help from a food bank years ago while battling an illness. “I always say ‘How can I be of assistance?’ because I know what it’s like when you need food. Sometimes I can’t believe it’s real, that I’m doing work I love to help others. My job is a blessing and a great opportunity to develop relationships for Aetna Medicare throughout the Philadelphia area.”

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Path to Better Heath Study 2020: Increasing appetite for technology-enabled care

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The use of technology across the health care continuum has been rising at a rapid rate. As a result of COVID-19, the pace of technological transformation will only quicken and greatly influence the future of care delivery.

Read the full Path to Better Health Study 2020.

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Path to Better Heath Study 2020: Importance of accessibility and affordability

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Delivering accessible, high-quality care at any time is a key health care priority — and has become even more significant during the COVID-19 pandemic. According to our study, consumers agree, with 92% indicating that it was very or somewhat important that health care be convenient.

Read the full Path to Better Health Study 2020.

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Lynn University engages CVS Health for on-site rapid result COVID-19 testing

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At Lynn University in Boca Raton, Florida, campus life is different this semester. Masks are required everywhere; signs are posted all around — even by the pool — discouraging close or crowded gatherings. “And you're not allowed to have anyone in your dorm room, aside from your roommate,” says Rorie Good, a second-year psychology student.

She’s been living on campus since late August and says several factors played into her decision to return in person, which included Lynn’s plan for COVID-19 testing on campus.

“I decided to come to this school for a reason,” she says. “A lot of it had to do with having the full college experience — being on campus in person. After weighing the risks and feeling like Lynn was handling it pretty well, I decided that it would be good to come back.”

A nationwide challenge

The challenges colleges and universities face this year are clear: COVID-19 outbreaks have become a public health threat on and off campuses. In September, 19 of the nation’s 25 worst outbreaks occurred in communities with large numbers of college students, USA Today reported.

Eighteen- to 25-year-olds also represent around 26% of new COVID-19 infections — more than any other group — according to Robert Redfield, the director of the Centers for Disease Control and Prevention.https://www.cnn.com/webview/politics/live-news/fauci-senate-hearing-09-23-20/h_d81e99c6d98ad5e568f7658a17f8547d And while young people are less likely to become seriously ill than older people, they can still spread the virus, he says.

“The main challenge … is balancing safety and health with the expectations of students to still have an academic experience that reflects what college life is all about.” 

– Christian Boniforti, Chief Strategy and Technology Officer, Lynn University

At Lynn University, Chief Strategy and Technology Officer Christian Boniforti spent the spring and summer weighing all of these issues with the needs of his university community in mind.

“The main challenge that I think is unique to colleges and universities is balancing safety and health with the expectations of students' desires to still have an academic experience that reflects what college life is all about,” he says. “Making sure that we had testing was critical, and that's where CVS Health came in with a critical component for us.”

Public health experts say that when a communicable disease outbreak occurs, testing is key. Early identification of cases, quick treatment and immediate isolation are what prevent spread.

Lynn University makes a plan

Lynn University’s leadership team, including Boniforti, took a community approach to the challenge, talking to many stakeholders and drafting a reopening plan that included having fewer students on campus, scheduling classes to accommodate social distancing, limiting use of common spaces and creating new sanitation protocols. The university also asks all students and employees to perform a daily COVID-19 self-check.

The plan also includes an on-campus rapid testing program for those who report COVID-19 exposure or symptoms.

“We have a great student health center here on our campus, but they're not experts in conducting COVID-19 testing,” Boniforti says. “We quickly realized that we needed a professional partner who knew how to conduct the testing and make sure that it's regulated and that proper communication to the Department of Health is done.”

So Lynn signed on with Return Ready™, a customizable, scalable COVID-19 testing solution provided by CVS Health for college campuses and businesses.

It allows Lynn students and employees to schedule a test anytime, at no cost, and get results in minutes. “If a person tests positive on campus, we notify individuals who may have been exposed,” Boniforti says.

The Return Ready program also allows Lynn to do surveillance testing when there are positive cases — a particular residence hall, classroom, or sport, for instance. “Because the testing results are done so quickly, it allows us to make decisions earlier, which ultimately helps control outbreaks and reduce the quarantine times.”

For student Rorie Good, the continued testing has been essential to feeling safe on campus. “If you feel like you could've been exposed or you're anxious about it, you can always get the test. You can always know where you're at in terms of your health, and so that is very, very comforting,” she says. Also comforting: Seeing how seriously fellow students are taking the guidelines and wearing masks.

CVS Health’s testing initiative for colleges and businesses

The Return Ready program, designed for employers and colleges and their specific needs for safely returning to work sites or campuses, builds on CVS Health’s nationwide community-based COVID-19 testing infrastructure. The company has administered more than five million COVID-19 tests since March and has about 4,000 testing sites across the country.

With Lynn — as with every Return Ready partner — they started with a consultation, says Sree Chaguturu, M.D., chief medical officer, CVS Caremark, and senior vice president, CVS Health, to answer: Where do you want to test? Which tests do you want to use? Who do you want to test and how frequently?

The program can make use of CVS Health’s nationwide retail network for testing, bring testing on-site or use a combination. “We also work with a client to ensure that all of the reporting and analytics are provided to local and state health authorities as needed for regulatory compliance, as well as reporting back to the client so that they have timely analytics to help them understand testing trends,” Dr. Chaguturu says.

Return Ready also works with businesses, offering clinical consultation, end-to-end testing and workforce analytics to help offices.

“Return Ready has allowed us to become more proactive … to focus our efforts on continuing to provide a safe learning environment for student activities and education.”

– Christian Boniforti, Chief Strategy and Technology Officer, Lynn University

To meet the various needs of each college and business, the program prioritizes flexibility. “For example, as we worked with an airline, we recognized there is an inherent unpredictability with schedules and operations.  In order to accommodate for fluctuations, we customized the workflows, number of hours and testing machines,” Dr. Chaguturu says.

At Lynn University, Boniforti says they’ve had some positive cases — as expected — but have avoided an outbreak, thanks in large part to testing protocols. The Return Ready program immediately notifies the student health center when there is a positive case on campus so that person can begin isolating on campus or at home.

“Return Ready has allowed us to become more proactive because we don’t have to schedule the testing, conduct the testing, report on the testing and make sure that staff are there to do the testing,” Boniforti says. “Having a partner to do those things really allows us to focus our efforts on continuing to provide a safe learning environment for student activities and education.”

Start planning your return.

Let us partner with you to implement your organization’s testing strategy. Contact us today to get started.

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Keeping students safe

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At Lynn University in Boca Raton, Florida, campus life is different this semester. Masks are required everywhere; signs are posted all around — even by the pool — discouraging close gatherings. 

Second-year psychology student Rorie Good says several factors influenced her return, including a chance to have the full college experience — and Lynn’s plan for COVID-19 testing. “After weighing the risks and feeling like Lynn was handling it pretty well, I decided that it would be good to come back,” she says.

Colleges and universities face clear challenges this year: Across the country, COVID-19 outbreaks have become a public health threat on and off campuses. Eighteen- to 25-year-olds also represent around 26 percent of new COVID-19 infections — more than any other group — according to the Centers for Disease Control and Prevention.

Lynn University Chief Strategy and Technology Officer Christian Boniforti says his school’s main challenge is balancing safety and health issues with students’ expectations for an academic experience that reflects college life. 

Lynn University Chief Strategy and Technology Officer Christian Boniforti wearing a mask in conversation with a woman wearing a mask and social distancing.
Chris Boniforti says Lynn University has avoided a COVID-19 outbreak in part because of testing protocols

Testing was critical, so Lynn signed on with Return Ready, a customizable, scalable COVID-19 testing solution provided by CVS Health for college campuses and businesses. It allows students and employees to schedule a test anytime, at no cost, with results in minutes. The program also allows Lynn to do surveillance testing when positive cases arise.

“Because the testing results are done so quickly, it allows us to make decisions earlier, which ultimately helps control outbreaks and reduce the quarantine times,” Boniforti says.

Return Ready builds on CVS Health’s nationwide community-based COVID-19 testing infrastructure. The company has administered over five million COVID-19 tests since March and has about 4,000 testing sites across the country.

With Lynn — like every Return Ready partner — they started with a consultation, says Sree Chaguturu, M.D., chief medical officer and senior vice president for CVS Caremark. “We also work with a client to ensure that all of the reporting and analytics are provided to local and state health authorities as needed for regulatory compliance, as well as reporting back to the client so that they have timely analytics to help them understand testing trends,” he says.

While Lynn University had some positive cases, Boniforti says the school has avoided an outbreak, thanks in large part to testing and protocols: “Having a partner to do those things really allows us to focus our efforts on continuing to provide a safe learning environment for student activities and education.”

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CVS Health’s response to COVID-19 delivers solutions for current and future customer needs

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At the 2020 HLTH virtual conference, CVS Health President and Chief Executive Officer Larry J. Merlo and Karen S. Lynch, CVS Health Executive Vice President and President of its Aetna business unit, who led our COVID-19 response, discussed how the organization quickly mobilized, operationalized and scaled its resources to ensure our 300,000 employees, 22 million medical members and millions of customers received the care they needed whether in their community, their home or the palm of their hand.

Debra Richman, Karen S. Lynch, and Larry Merlo speaking via video conference during the HLTH 2020 virtual conference.
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Heart At Work: Crystal Ring – helping non-English speaking patients

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Sophia*, who speaks Spanish, was admitted to the hospital multiple times for cellulitis and extremely high blood pressure. Although she was surrounded by medical professionals, she couldn’t easily convey what she was feeling or understand the care needed until Crystal Ring reached out. 

Crystal is an Aetna American Health Holding (AHH) case management nurse who advocates for patients with Limited English Proficiency (LEP). Using an interpreter from Aetna’s language services program, she helps AHH members like Sophia overcome linguistic, cultural and health literacy barriers. 

“When I first spoke to Sophia she was frustrated, scared and overwhelmed. She felt pushed aside and didn’t feel she was getting better. Because of this, Sophia wasn’t attending her follow-up appointments and refused to take her high blood pressure medicine,” explains Crystal. “I calmed Sophia down and shared with her the medical rationale behind the physician’s instructions so she could understand the potential danger of stopping her treatment.” 

According to the U.S. Census Bureau, over 21 percent of the population speaks a language other than English. As these numbers rise, nurses like Crystal play a critical role meeting challenges related to care and education for this diverse population. 

Along with patients who have high blood pressure, Crystal works with patients with diabetes, heart disease, kidney failure and wounds. Her case load varies from 30 to 45 patients. 

“I just love to help people. At the end of the day, I want to know that I did everything I could for my patients,” says Crystal, adding that some of her patients cried when their case was closed. 

Thanks to Crystal’s dedication and thoughtful approach, Sophia is doing well and her blood pressure is no longer in the danger zone. Crystal even recommended changing Sophia’s medication, which improved her cellulitis and allowed her to become a candidate for vascular surgery. In fact, Sophia’s physician sent Crystal a note thanking her for her knowledge and leadership: “We are very appreciative of the amazing work you are doing for our patients.”

So are we! Thank you, Crystal, for bridging the communications gap and bonding with your patients. Your care makes all the difference. 

*Name changed for privacy purposes

Heart At Work recognizes CVS Health heroes across the country who bring their hearts to work, helping people on their path to better health. Read their stories, watch their videos and celebrate our CVS Health Heart At Work heroes along with us!

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Preparing for this year’s flu season

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COVID-19 is continuing to affect communities across the country, and yet, we have another potentially harmful virus to worry about – the flu.

Health care providers are busy meeting pandemic-related demands, including COVID-19 testing occurring at medical offices and drive-thru locations like CVS Pharmacy stores. In addition, America’s emergency rooms and critical care units are stressed with caring for COVID-19 patients, and that’s likely to get worse as we head into the winter months. Because of this, it’s crucial that we reduce the number of cold and flu cases and flu-related hospitalizations as much as possible to preserve our much-needed health care resources.

The good news is, there are simple things we can all do to help protect ourselves from the flu and boost our immunity during the fall and winter months. This begins with getting your annual flu vaccination. If you have not yet received your flu shot, it’s important that you get vaccinated right away.

Adopting a healthy lifestyle helps to promotes your ability to fight off seasonal illnesses like influenza, pneumonia and the common cold. Improving your diet, expanding your exercise routine and getting plenty of rest are all important ways to keep up your immunity.

Eating a well-balanced diet that includes foods that are rich in vitamins and minerals is also important, including fruits and vegetables. It is also important to maintain a healthy weight as being obesity puts people at risk for many other serious chronic diseases and increases the risk of severe illness from the flu. https://www.cdc.gov/flu/highrisk/index.htm.

Now more than ever it is important to wash your hands for at least 20 seconds. Stay home if you feel ill and try to avoid large crowds. The same things that can help slow the spread of COVID-19 are also important actions in reducing transmission of the flu, as well.

Most flu vaccinations available – including the primary vaccine provided at MinuteClinic and CVS Pharmacy locations nationwide – are the quadrivalent vaccine, which protects against four different flu strains – two types of influenza A and two types of influenza B.  Some other flu vaccines protect against three or two strains of the flu. For those 65+, the high-dose version of the quadrivalent influenza vaccine is recommended because it produces more than 4x the antigens to fight off the virus. Those 65+ should also receive a pneumonia vaccine, if they have not done so recently.

Learn more about how CVS Health is making flu shots safe and convenient, or make an appointment to get a flu shot.

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Tobacco-free for five years

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

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

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

cvs heart

In 2014, we quit tobacco.

Nearly 65%

of Americans agree that our decision to stop selling tobacco reduces the risk of chronic diseaseStatistics from an August 2019 Morning Consult poll of 2,200 adults

62%

of adults agree that retailers have an obligation to limit access to tobacco and e-cigarette productsStatistics from an August 2019 Morning Consult poll of 2,200 adults

81%

of adults support improving community education about the dangers of smokingStatistics from an August 2019 Morning Consult poll of 2,200 adults

Beyond tobacco: Taking steps to transform health care

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

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

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

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

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

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

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