Accordant expands rare disease support | CVS Health
A patient holds their prescription while speaking with their doctor on a video chat via tablet.

Accordant expands rare disease support

Comprehensive new support program helps plan members manage pulmonary arterial hypertension and lower costs

Primary pulmonary arterial hypertension (PAH) is a rare but serious lung disorder in which the blood vessels in the lungs narrow, raising blood pressure in the pulmonary artery far above normal levels. Since this artery carries oxygenated blood to the lungs, untreated PAH can have serious repercussions, including heart failure.

CVS Health is now providing critical support to PAH patients who are members of the AccordantCare Rare program. Accordant team members work with payors and providers to help make sure members living with rare, complex diseases have the support they need, which can translate into happier members and lower costs. Members have access to a personalized care team with a dedicated registered nurse, as well as medical professionals who understand the challenges of complex disease management, all backed by the expertise of a medical advisory board.

Challenges in treating and managing PAH

PAH is a complex condition with serious, detrimental impact on the daily routines of those who live with it — and treatment regimens are complicated and expensive. For patients already dealing with the challenges of a serious pulmonary condition, the realities of treatment — complex dosage instructions, possible side effects, and navigating a complicated health system — can be overwhelming, and can lead to lower treatment adherence, worsened outcomes, and unnecessary costs.

People living with PAH face steep health care costs, with the average yearly spend totaling over $40,000. Emergency department visits for serious complications including arrhythmias, pulmonary embolisms, and cardiac arrests account for 36 percent of this total. Proper condition management can help avoid such dangerous and expensive complications. Visits to the emergency department are all too common, with nearly 70 percent of all patients needing emergency care within the last two years.Accordant Data Warehouse, 51 clients, 2018-2020 data. While the total number of people living with PAH is small, such high health care costs can add up quickly for payors and members.

People living with PAH can benefit from a support structure that provides consistent, frequent touchpoints to help ensure treatment adherence and early identification of potential complications. When PAH is properly and consistently managed, people living with it can feel better, see improved health outcomes, and may be less likely to experience dangerous events that require costly emergency care.

AccordantCare’s skilled care management nurses work with members and their providers to set mutually agreed-upon health goals and provide the support and guidance needed to help manage PAH symptoms and keep up with complicated treatment regimens.
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They can also help explain how medications work, identify side effects and provide resources to help address barriers such as lack of transportation to doctor’s appointments and lack of funds to cover their out-of-pocket costs. In addition, we also know that members managing conditions like PAH need support in other ways, so we utilize trained social workers to help members find community resources, negotiate payment of utility bills, connect to support groups, and find financial support to help pay for modifications that make their homes more livable given their special health needs.

When members feel supported, they are more equipped to manage their health and that can mean lower chances of complications and their related costs, and lower levels of stress. Accordant’s whole person care management approach not only leads to a better experience for members, but also may save the payor up to $2,158 per engaged member per year by preventing avoidable complications and slowing progression of PAH.CVS Health Analytics, 2020. Based on Accordant client evaluations conducted in Q1‐Q2 2019, and Accordant Opportunity Analysis savings assumptions. Actual results may vary depending on benefit plan design, member demographics, programs implemented by the plan and other factors. Client‐specific modeling available upon request.Adherence results may vary based upon a variety of factors such as plan design, demographics and programs adopted by the plan. Client-specific modeling available upon request. Savings will vary based upon a variety of factors including things such as plan design, demographics and programs implemented by the plan.

06.07.21