Patient and Customer Well-Being and Safety

  • Focus: Better Health Outcomes

    One of the greatest contributions CVS Health can make toward improving health outcomes for the millions of Americans living with chronic health conditions is through educating people on the benefits of medication adherence. Some of the non-adherence facts are alarming. It is estimated that up to a third of prescriptions written are never filled and about half of all patients prescribed medications for chronic conditions stop taking them within the first year, the biggest drop-off occurring in the first month. Ultimately, patients who take their medications as prescribed have better health outcomes than those who do not. Non-adherence of essential medications leads to thousands of preventable hospitalizations and costs the U.S. health care system $300 billion annually in unnecessary medical costs.

  • Improving Medication Adherence

    In order to improve adherence, we focus on solutions that target the root causes of non-adherence. For instance, some patients simply forget to take their prescribed medications or to refill them when they run out. Cost of prescription drugs is another barrier for some patients. Others may not understand how or when to take their medicine, why it is necessary, or how to manage the side effects. We aim to increase the adherence of the patients we serve by 5% to 15% through new interventions by 2017.

    Making Pharmacy Easy and Convenient

    Our research shows that online and digital tools provide patients with greater convenience and improved adherence. We have focused on developing tools and encouraging patients and customers to leverage them. Examples of these include:

    • ScriptSync™ is an online tool introduced in 2015 to make managing multiple refills easier. Patients who sync their prescriptions can consolidate their pick-ups into one monthly trip to the pharmacy. More than 70% of eligible patients have already signed up. In 2016 this option will be available through CVS Caremark mail service as well.
    • ReadyFill® is a service patients can sign up for to ensure that their medications are automatically refilled and ready for pick-up according to dispensing instructions. This promotes adherence and provides added convenience to patients with chronic conditions.
    • Maintenance Choice® is designed for CVS Caremark plan members who are on long-term maintenance medications for chronic diseases. This service gives patients the choice of how to receive their 90-day supply of medicine, either through mail service or pick-up at CVS Pharmacy. Either way, patients benefit from the typically lower mail co-pay.
    • Text alerts are a simple way to notify patients when their prescriptions are ready and to remind them when it is time to refill their prescriptions. About one in three patients had signed up for text alerts by the end of 2015.
    • Mobile apps were recently introduced to help patients jump-start the prescription process by enabling them to upload a photo of their written prescription and send an image of their insurance card.

    Lowering Costs

    We know that cost can be a huge barrier to adherence. Research shows that prescriptions with higher co-pays are less likely to be filled, and the adherence of people who move to a high-deductible health plan tends to drop. “Dispense as written” (DAW) on a prescription also makes it less likely to be filled. DAWs often specify that a more expensive brand name medication be dispensed rather than a less costly but equally effective generic alternative.

    Our own analysis indicates that promoting lower-cost drug options, such as generics, can help overcome cost barriers. Our e-prescribing systems allow us to let doctors know that a drug they plan to prescribe is not on our formulary or has generic options. That way, a less costly alternative can be prescribed if the physician believes it is clinically appropriate. We can also communicate patient-specific savings opportunities directly into a patient’s electronic health record (EHR) so the physician or office staff can act on them.

    Educating Patients about Their Prescriptions

    Research has shown that face-to-face counseling by a pharmacist is two to three times more effective at increasing patient adherence than other interventions. Our Pharmacy Advisor program is helping us to achieve higher adherence rates by providing more than 5 million consultations in person and/or by telephone in 2015.

  • Focus: Integration and Coordination of Care

    CVS Health recognizes that collaboration among medical care providers is essential to ensuring the best health outcomes for patients. When care is not coordinated, it can lead to serious complications, including medical errors, preventable hospital re-admissions, and higher costs. In 2015, we continued to connect the dots to improve health care coordination by expanding our affiliations with health systems across the country and investing in new technologies.

  • Ensuring Integrated Care in the Medical Neighborhood

    MinuteClinic has become an integral member of the medical neighborhood, providing patients with access to convenient, affordable and quality medical care for non-emergent illnesses. MinuteClinic is not a substitute for primary care; instead it seeks to coordinate patient care with the patient’s medical home. This is evident by the growing number of affiliations MinuteClinic has formed with major health systems across the country – nearly 70 by the end of 2015.

    Technology plays an important role in the coordination of care. In 2015, we completed the implementation of the electronic health record (EHR), the most widely used EHR in the country for sharing information between entities. It allows us to securely communicate – with a patient’s permission – important health visit and prescription information with the primary care provider. As a result, care providers have a more informed picture of the patient’s health care needs.

  • Focus: Prescription Safety

    At CVS Health, the health and well-being of our patients and customers is our number one priority. Our commitment to best-in-class processes and technologies help us ensure that the prescriptions we fill are dispensed safely and accurately.

  • Enhancing Prescription Accuracy, Safety and Effectiveness

    All of our pharmacy operations follow comprehensive quality assurance processes. Every prescription we fill goes through a multi-step quality review by a pharmacist before it is dispensed to a patient.

    Our pharmacy teams are comprised of highly trained technicians led by licensed pharmacists who are dedicated to providing high-quality care. In our retail pharmacies, safety checks are built into our computer system and existing workflow to help ensure accurate dispensing. These include on-screen computer messaging, bar-coded prescription labels, electronic prescribing, automated prescription filling technology, electronic pill imaging, and quality assurance training for all pharmacy staff.

    Our mail order and specialty pharmacies also utilize extensive quality control measures when dispensing medications, including enhanced quality control, electronic imaging, quality procedures for compounded medications, drug utilization reviews (DUR) and final quality assurance checks. In addition, our specialty pharmacies have a further comprehensive review process for medication appropriateness. We also conduct a complete patient assessment to help prevent safety, administration or efficacy lapses with the prescribed medication.

  • Making Continuous Improvements in Quality Assurance

    In 2015, we introduced an enhanced DUR process as part of our overall prescription quality assurance program. Quality assurance is a mandatory procedure performed by the pharmacist with every prescriptionfilled.It requires the pharmacist to verify what the patient has been prescribed and ensure it matches the product selected, the directions for taking the medication, and the dosage and the quantity of medication. Our pharmacy computer system’s enhanced DUR process also alerts the pharmacist of any patient-specific concerns related to the prescribed medicines that may requireintervention.These might include the potential of an allergic reaction, a drug-to-drug interaction, any contraindications, or whether the dose is within a clinical dosage range.

    If the dosage falls outside the clinical dosage range, a simple but effective stop sign will appear on the pharmacist’s screen. These types of hard stops require the pharmacist to intervene, review and take corrective actions.

  • Promoting a Culture of Safety

    CVS Health employs about 30,000 licensed pharmacists. Each one is thoroughly and continually trained on our processes and procedures for the safe dispensing of prescription medicines. Our processes have been designed to anticipate and control all types of potential issues. The dispensing reports our pharmacists submit are routinely assessed, allowing us to quickly identify and address any emerging concerns.

    Beyond our internal assessments, we engage independent industry experts in patient safety to evaluate and help us advance our processes and procedures for the safe dispensing of prescriptions. Our quality assurance processes have undergone rigorous reviews by URAC, the leading U.S. health care accreditation organization for quality standards. In 2014, we became the first pharmacy to receive Community Pharmacy accreditation from URAC, and CVS Health is now accredited with five of URAC’s programs for pharmacy.

  • Focus: Quality of Service

    As we help people on their path to better health, our goals are to maintain a continued focus on quality and services, and to provide outstanding clinical and service performance. This encompasses all of the interactions our patients, customers, clients or plan members may have with our integrated health care business. Measuring satisfaction, logging feedback and engaging with patients and customers enables us to assess and build on areas of strength.

  • Enhancing the MinuteClinic Experience

    We collect feedback from our patients on their MinuteClinic experiences; results from 2015 indicated that 94% were satisfied with their providers. We also review other specific feedback to help us fine-tune the patient experience.

    For instance, after identifying opportunities to improve scheduling and wait times, we introduced a service that allows patients encountering wait times for MinuteClinic visits to enter their mobile phone number when they arrive. A text message is then sent to them when it is time for their appointment. Three million people used this service in 2015.

    Building on this success, we piloted a new program, to be rolled out in 2016, that allows patients to view wait times for various MinuteClinic locations and to sign up remotely for an appointment. They will receive a text or e-mail including a code to enter at the kiosk when they arrive. Our goal is to reduce wait times and improve access by showing the wait times of nearby clinics.

  • Listening to CVS Pharmacy Customers

    There are several ways that CVS Pharmacy customers and patients can provide feedback on their pharmacy or shopping experience. They can call a toll-free line, send us an email or submit comments through the mail. We log all customer contacts, analyze the nature and volume of comments, escalate issues that need immediate attention, and provide weekly reports to the field and company management.

    Feedback related to the pharmacy experience is especially helpful. We have learned that patients want us be more proactive about alerts and follow-up on out-of-stock medication, while they also want to know whether they can opt-out of reminder phone calls, if desired. Our retail customers want to get the full benefit of our rewards programs or to express their feedback on a particular promotion or their customer service experience. Ultimately, the feedback we receive enables us to continually improve the quality of the experience all CVS Pharmacy patients and customers expect.

  • Achieving CMS 4-Star Performance Ratings

    Our commitment to providing outstanding clinical and service performance extends to the Medicare Prescription Drug Plan options we offer through our SilverScript Insurance Company. In 2015, we announced two plans that offer $0 deductibles, lower premiums and low co-pays for frequently prescribed drugs. Equally as important, the plans earned an overall 4-star rating from the Centers for Medicare and Medicaid Services (CMS), in part for their high-quality, clinical outcomes and customer service. CVS Health is the largest Medicare Part D insurer to achieve this rating.

  • Focus: Prescription Drug Abuse Prevention

    Every day, our pharmacists support people on their path to better health, and that includes dispensing prescription medications. But when prescription drugs are abused, the consequences can be deadly. According to the CDC, 44 people die each day in the United States from an overdose of prescription painkillers and even more become addicted. 

    Prescription drug abuse is a national epidemic that needs to be addressed. By partnering with health centers, law enforcement, governments and non-profits to address prescription drug abuse, we are part of a coordinated effort to help prevent drug abuse and save lives. We have also adopted a policy that MinuteClinic practitioners will no longer prescribe opioids to patients.

  • Bringing Pharmacists into the Classroom

    Prevention begins with education. We believe our pharmacists are uniquely positioned to teach about the dangers of prescription drug abuse and the harm that is caused by abusing these drugs. In 2015, CVS Health launched a community outreach program called Pharmacists Teach, which brings local pharmacists into high school health classes to talk to students about the dangers of drug abuse. More than 15,000 students have already been part of the program. High schools across the country can learn more about bringing Pharmacists Teach to their school here.

  • Supporting Drug Take-Back Programs

    Creating opportunities for proper disposal of prescription medications is a key element of our drug abuse prevention strategy. There is another benefit to this as well: safeguarding the environment by preventing unused medications from being disposed of in the wrong way, such as flushing them down the toilet or putting them in the garbage. In collaboration with the Partnership for Drug-Free Kids, CVS Health created the Medication Disposal for Safer Communities Program, through which local police departments can apply to receive a drug collection unit. These receptacles enable community members to safely dispose of unwanted medications, including controlled substances. Since 2014, the program has donated more than 500 disposal units across the country and collected more than 28 metric tons of prescription drugs. Police departments can apply to receive a drug collection unit from the program here.

    CVS Pharmacy also continues to support National Drug Take-Back Day. In 2015, more than 200 locations provided local communities with safe and convenient ways to dispose of expired or unwanted prescription medications through law enforcement collection events held in store parking lots. This national effort collected a total of 350 tons of medications.

  • Expanding Naloxone Availability

    To address the alarming number of opioid overdoses and help save lives, CVS Pharmacy continued to support the expansion of naloxone availability in 2015. Naloxone, also known as Narcan, is a safe and effective antidote to reverse an opioid overdose, including heroin. We are participating in programs in the more than 15 states that allow pharmacists to dispense naloxone pursuant to a physician’s standing order to patients who do not have a prescription. We are expanding our participation in these programs as states adopt enabling laws and regulations, and anticipate rolling out this program to at least 20 more states in 2016. Naloxone is also available with a prescription at all CVS Pharmacy stores across the United States. 

    CVS Health is also partnering with the Boston Medical Center and Rhode Island Hospital to support a demonstration project on the distribution of pharmacy-based naloxone rescue kits to help reduce opioid addiction and overdose deaths. The study will track and analyze data from participating pharmacies in Massachusetts and Rhode Island to develop best practices for a national pharmacy-based program.

  • Focus: Tobacco-free Lives

    In 2015, CVS Health celebrated the one-year anniversary of the removal of tobacco products in our retail locations. We made this decision despite the estimated loss of approximately $2 billion in revenue of tobacco and associated sales because the sale of tobacco was inconsistent with our purpose of helping people on their path to better health. Taking this action has created new opportunities for CVS Health, such as building a more health-centered retail business, strengthening relationships with our PBM clients, and affiliating with new partners to support our role within the medical neighborhood – a clinical-community partnership that includes medical and social supports to enhance health. It has also allowed us to raise our voice and advocate for a tobacco-free generation.

    According to the CDC, each day in the United States, more than 3,800 children aged 18 and younger smoke a cigarette for the first time, and an additional 2,100 youth and young adults become daily smokers.

    We know that tobacco use significantly impacts health, and when smokers quit, their health improves. This prompts nearly half of smokers to try to quit each year, but the best approach is to dissuade youth from experimenting with tobacco in the first place.

    We are taking a stand by investing in today’s youth to inspire a tobacco-free generation. We have established four targets – to be achieved nationwide by 2020 – that will guide our charitable giving and community partnerships, measure our progress and send a strong message that we are serious about eradicating tobacco use. 

    These include:

    • Reach five million youth with tobacco-free messaging
    • Double the number of tobacco-free educational institutions
    • Achieve a 10% decline in new youth smokers
    • Achieve a 3% decline in the youth smoking rate
  • Investing in a Tobacco-Free Generation

    In March of 2016, we announced Be The First, a five-year, $50 million initiative to help deliver the nation’s first tobacco-free generation. Through this initiative, which is funded through CVS Health and the CVS Health Foundation, the company is extending its commitment to help people lead tobacco-free lives. Recognizing that tobacco use is the leading preventable cause of disease and death in the United States, and that use of some tobacco products among youth is on the rise, Be The First will focus on comprehensive education, advocacy, tobacco control and healthy behavior programming in partnership with organizations uniquely positioned to tackle this public health challenge.

    Leading up to the announcement, in February 2015 the CVS Health Foundation announced a five-year, $5 million commitment to the Campaign for Tobacco-Free Kids, launching the ‘Making the Next Generation Tobacco-Free’ grant program. Initial grants were made to support the following:

    • BREATHE California will reach approximately 8,000 third-to eighth-grade students in underserved communities in Los Angeles County as part of a No To Tobacco prevention program.
    • California School-Based Health Alliance will increase the capacity of school-based health centers to implement youth-led tobacco prevention programs, reaching 2,000 youth throughout California.
    • Health Promotion Council of southeastern Pennsylvania will expand its training for youth-led public health advocacy and increase its outreach to youth.
    • Ohio Public Health Partnership will implement tobacco-prevention and cessation programs that target youth, pregnant women and other high-priority individuals. It will also help educate lawmakers and the public to support an increase in the Ohio tobacco tax, equalize the tax on other tobacco products and designate 12 cents of every $1.00 of the proposed tax increase for tobacco use prevention and cessation.

    We also launched a joint initiative in 2015 with Scholastic Corporation, the global children’s publishing, education and media company, called Get Smart About Tobacco. The school-based program, which will reach nearly three million youth in grades three through seven during the 2015–2016 school year, teaches children about the health consequences of tobacco use. It includes resources for teachers, students and parents, as well as student engagement programs and incentives, such as scholarships and youth-focused community training.

    In addition, we provided $3.5 million to the American Cancer Society over three years to support 125 college and university campuses going tobacco free.

  • Partnering to Combat Tobacco Use

    CVS Health also continues to expand partnerships with organizations that are leading the fight against tobacco use and supporting those living with its health consequences. These include in-store fundraising initiatives to support the American Lung Association and Stand Up To Cancer, as well as programs to reach high-risk communities.

    Supporting High-Risk Communities with Smoking Cessation Programs

    According to the CDC, veterans and people with disabilities have a higher incidence of smoking than average. In 2015, the CVS Health Foundation provided Easter Seals with a $400,000 grant to support a new smoking cessation program designed to help veterans and people living with a disability to lead tobacco-free lives. Through the program, participants are directed to the American Lung Association’s Freedom from Smoking website, where they are guided through smoking cessation lessons and tips.

    We also committed to provide $1 million over four years to the National Urban League to support smoking cessation for African-American populations in underserved communities.

    Supporting Cancer Research with Stand Up To Cancer

    Nationwide, more than 1,600 people die from cancer each day. CVS Pharmacy has committed $10 million over three years to support the innovative cancer research funded by Stand Up To Cancer (SU2C), a program of the Entertainment Industry Foundation.  In November 2015, we held our second in-store campaign in support of SU2C, which raised more than $4 million through generous donations from customers and colleagues.

    Campaigning for American Lung Association’s LUNG FORCE

    Every five minutes a woman in the United States is diagnosed with lung cancer, the number one cancer killer in the country. In May, CVS Pharmacy raised more than $3 million through our second annual LUNG FORCE in-store fundraising campaign. As the national presenting sponsor of LUNG FORCE, our campaign supports research on better treatment options and improved methods of early detection.

  • Measuring Impact

    By removing tobacco products from all CVS Pharmacy locations, our research shows that we are having a measurable and positive impact on public health. In September 2015, one year after our tobacco exit, we released results from a study conducted in 26 states by the CVS Health Research Institute which showed a measurable reduction in cigarette purchases. The study evaluated cigarette pack purchases at drug, food, big box, dollar, convenience and gas station retailers in the eight months after CVS Pharmacy stopped selling tobacco products. The study found a 1% reduction in cigarette pack sales in states where CVS Pharmacy had a 15% or greater share of the retail pharmacy market, compared to states with no CVS Pharmacy stores. Over the same eight-month period, the average smoker in these states purchased five fewer cigarette packs and, in total, approximately 95 million fewer packs were sold. In addition, the study revealed a 4% increase in nicotine patch purchases in the states with a CVS Pharmacy market share of 15% or more during this same eight-month period. This indicates that there was also a positive effect on attempts to quit smoking.

    Additionally, in just over a year, participation in MinuteClinic’s Start to Stop® smoking cessation program almost doubled. CVS pharmacists also counseled more than 260,000 patients about smoking cessation and filled nearly 600,000 nicotine replacement therapy prescriptions. We also distributed millions of smoking cessation informational brochures and hundreds of thousands of Last Pack toolkits, and educated more than one million people on our online cessation website.

Learn about our other strategic priorities within our Health in Action pillar:

Support for Patients with Chronic Disease

Accessible Affordable Health Care

Read the full report:

2015 CSR Report