Recognition cites measurable commitment to expanding equity in care through CVS Caremark® and CVS Specialty®
CVS Health is the first health care company to earn accreditation for Health Equity from URAC, specifically for the work done through CVS Caremark and CVS Specialty. URAC promotes health care quality by setting high standards for clinical practice, consumer protections, performance measurement, operations infrastructure and risk management. The accreditation validates the company’s comprehensive strategy to address inequity in health outcomes for the patient populations it serves. The recognition affirms our commitment to quality, process, safety and outcomes in reducing health disparities for underserved communities adversely impacted by social determinants of health (SDOH).
"Advancing health equity across our businesses is more than a moral responsibility, it’s a core business priority.” said Dr. Joneigh Khaldun, Vice President and Chief Health Equity Officer, CVS Health. “We’ve built a comprehensive strategy that leverages data to improve our products, programs and services, particularly for those who experience the greatest barriers to achieving optimal health.”
The CVS Caremark and CVS Specialty teams tangibly demonstrated the ongoing commitment to health equity by seeking URAC accreditation. Caremark’s proprietary Pharmacoequity* Tool helps clients better identify members at greater risk of poor health outcomes and proactively address disparities in care. Using pharmacy claims data and publicly available information, the tool’s analysis can be used for chronic conditions—such as breast cancer, cardiovascular disease, diabetes, Parkinson’s disease and more—to determine the areas where a client is most likely to see the largest health disparities for their member population and where interventions like tailored care management will be most impactful. Clients have seen widespread value in the tool, from improving HEDIS and STARS measures, to improving adherence for specialty conditions, to identifying opportunities for medical cost savings.
“We understand that for some, there are barriers to living longer and healthier, so we’re using this tool to lean into the clinical value of the PBM by connecting members to the medications and quality care management programs they need at the right time,” said Dr. Michelle Gourdine, Chief Medical Officer, CVS Caremark. “The biggest areas of impact we’re focusing on include medication adherence, treatment optimization and prescriber utilization management across a range of conditions like diabetes and hypertension.”
Research indicates that as much as 80% of a person’s health and well-being is shaped by SDOH, a wide range of non-medical factors that have a significant impact on community health outcomes, such as access to food, housing, education and transportation. CVS Specialty’s SDOH platform enables patients to receive support beginning with the identification of individuals at risk of worse health outcomes and referral to the team for screening and connection to community-based organizations. These organizations connect patients to essential services, such as transportation, meal delivery, childcare, financial guidance and mental health support. The platform tracks the effectiveness of interventions, helping to improve patient outcomes by monitoring and measuring their impact.
CVS Health has a comprehensive strategy aimed at addressing the root causes of health disparities nationwide. Internally, the company champions diversity and inclusion in the workplace by educating its colleagues on health care inequities and empowering them to partner on solutions, such as through cultural competency training to enhance patient care. Additionally, CVS Health established a quality management committee responsible for overseeing and measuring quality, while collaborating with stakeholders to uncover disparities and implement interventions aimed at reducing health inequities.
“These initiatives are all part of our larger Health Equity in Action strategy,” Dr. Khaldun explains. "By leveraging data, we can understand what our patients and members are experiencing and work to improve our programs. This information also helps us collaborate with employees and partners to help underserved communities."
URAC’s Health Equity Accreditation, which launched in 2022 in partnership with the National Minority Quality Forum (NMQF), was developed with input from key stakeholders across over 25 health organizations. The collaboration built a data-driven framework for organizations to advance health equity through assessing organizations ‘structure, program plans, and ways in which they provide access to services.
