Meeting Women’s Health Care Needs

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CVS Health works vigorously to expand access to high-quality, convenient and affordable women’s health care services through our MinuteClinic, retail pharmacies in communities nationwide and online or in the palm of their hand. As part of our focus on transforming the consumer health care experience, we are committed to providing women with access to the coordinated services and care they need to manage conditions and determine what is best for their health.

Providing Convenient Access to High-Quality Women’s Care

Women, who are often key in maintaining healthy families, access the health system more frequently than men, both for themselves and on behalf of their children. In turn, this means that their own health care can take a backseat to the needs of others.

Many women may find it difficult to receive care at a convenient time and location. For example, a survey conducted by Morning Consult and sponsored by CVS Health revealed that 90 percent of women consider the convenience of location important when accessing health services, while 85 percent consider flexible and extended hours important when selecting a health care facility.Morning Consult poll conducted from October 25-26, 2018, among a national sample of 2,201 adults

Our more than 1,100 MinuteClinic locations offer a full range of essential women’s health services. These services include access to birth control, the human papillomavirus (HPV) vaccine, treatment for yeast infections and pregnancy, urinary tract and bladder infection testing. Additionally, MinuteClinic providers also help women better understand their reproductive health options and provide referrals to primary care physicians or OB/GYNs, as needed.

CVS Health also launched a MinuteClinic University Health program, aimed at addressing the health care gap when young adults leave home for school. Our MinuteClinic locations in certain geographic areas near universities and campuses offer additional services for sexual health, women’s health and well-being screenings.

Increasing Patient Access to Birth Control

Ensuring accessible and affordable medications, including birth control, is a priority at CVS Health. For example, CVS Pharmacy patients can pick up prescriptions ordered through the CVS app on their phone, online, in person at CVS retail pharmacies, or they can have their medications delivered through our home delivery program. Additionally, CVS Caremark Members can receive their prescriptions through our mail order pharmacy, and throughout our network of 68,000 retail and mail order pharmacies.

We also work with public health advocates across the country to ensure that women can be obtain a birth control prescription from their local pharmacist. Pharmacists are currently allowed to prescribe oral birth control medications through Prescriptive Authority and Collaborative Practice Agreements in 13 states and the District of Columbia – covering 2,464 CVS Pharmacy locations. And we will be able to do so in 14 more states by the end of the year.

Affordable Access in the Community

Through community partnerships and philanthropies, we are able to address some of the health challenges women face locally. The CVS Health Foundation has partnered with a variety of groups who are on the front lines of improving access to women’s health services.

For example, we’ve established a multi-year partnership with the National Association of Free & Charitable Clinics (NAFC) with grants awarded to free and charitable clinics to increase access to care, improve health outcomes and lower overall health care costs. Today, 58 percent of NAFC patients are women – and they rely on 1,400 clinics nationwide for services including breast and cervical cancer screening, maternal and infant health and much more.https://www.nafcclinics.org/sites/default/files/NAFC%202019%20Infographic.pdf Since launching the partnership, the CVS Health Foundation has delivered a total of more than $4.5 million in funding to free and charitable clinics across the country.

Addressing Women’s Heart Health

Cardiovascular disease remains the number one killer among women and accounts for one-third of deaths annually.https://www.heart.org/-/media/data-import/downloadables/heart-disease-and-stroke-statistics-2018---at-a-glance-ucm_498848.pdf To address the widespread impact of this disease, we help women understand their risk for heart disease and empower them to take the next best action for their health. Throughout February 2019, we provided preventive heart health screenings at no cost in which women learned their five key personal health numbers that help determine their risk for heart disease: total cholesterol, HDL (good) cholesterol, blood pressure, blood sugar and body mass index.

Additionally, our support of the American Health Association Go Red for Women campaign, includes a new three-year, $15 million commitment to life-saving cardiovascular research and education.

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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Aetna Brings Doctor ‘House Call’ Service to Metro Atlanta

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As consumers drive transformational change in health care, Aetna is responding by making the health care experience easier through connected health systems, services and digital tools to help simplify care for members and their families.

The latest example is in Atlanta, where Aetna is offering members another simple, convenient, and local care option. Heal, the market leader in doctor house calls, has joined Aetna’s robust network of high-quality providers in the metro Atlanta area, including Gwinnett, Forsyth, Fulton, Cobb, DeKalb, and Clayton counties.

Effective immediately, Aetna Commercial members in Atlanta can schedule house calls with pediatricians, internists and family practice physicians for the same co-pay as a primary care doctor’s office visit. Between 8 a.m. and 8 p.m., seven days a week, 365 days a year, a patient can be seen by a Heal doctor at their home, office, or location of choice within two hours with the touch of an app.

“We like the simplicity and convenience of this new service option for our Commercial members,” said Frank Ulibarri, Aetna’s market president in Georgia. “Our offering with Heal reflects Aetna’s commitment to creating a more accessible, simple and patient-centric health care experience.”

This is Heal’s second major market launch. The company has provided 100,000 house calls across California and the Washington, D.C. area in less than four years, reducing unnecessary Emergency Room and Urgent Care visits by up to 71 percent and generating more than $62 million in healthcare cost savings.

“We’re eager to work with Aetna in metro Atlanta to continue the success we’ve experienced in other markets,” said Nick Desai, co-founder and CEO at Heal. “Heal and Aetna share the same dedication and vision to transforming health care in our local communities, particularly for patients with the greatest need.”

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Aetna’s New Cancer Support Center Connects Members to Personalized Information

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“Take a deep breath.”

That’s how the section of Aetna’s digital oncology hub regarding “navigating treatment” begins – no medical terms or insurance jargon, just a simple reminder.

Dealing with cancer can be an overwhelming experience for patients, families and caregivers. The lack of centralized information about the disease and effective treatments can pose a real challenge both for patients, who must cope with their own personal cancer diagnosis and journey, and their families.

While there is information available online for those dealing with cancer, it can be confusing, contradictory or even downright dangerous when patients rely solely on “Dr. Google” for information.

Aetna is stepping into that information gap by providing members with a comprehensive, user-friendly resource for cancer treatment education and support. A digital oncology hub called the Cancer Support Center is now part of Aetna’s library of online-based member resources.

“Cancer diagnosis and treatment is often the most difficult and physically, mentally and financially stressful time in a person’s life,” said Dr. Roger Brito, senior medical director on the Aetna oncology solutions team. “We made it our mission to try to make that journey a little easier.”

The project was developed as an enterprise-wide initiative, involving medical and content experts from across Aetna who worked together to create easy-to-understand materials that are location-specific and catered to a member’s diagnosis. The information on the hub is structured in a way that reflects a holistic view of the cancer patient journey – from screening and prevention, to diagnosis, to treatment, recovery and beyond.

One of the key benefits of making this kind of information available online is that it can be easily updated to reflect new treatments, standards and best practices. As Dr. Brito points out, many medications used today weren’t even available just a few years ago, so the oncology hub can be continually revised to reflect the latest medical guidance.

“It’s just a constantly changing and evolving state,” he said. “The treatments in two to three years will likely be very different from those we use today.”

The Aetna team identified breast cancer as the type of cancer that affected the most members across all ages and backgrounds (with more than 120,000 claims per year) and chose to launch the hub around this topic. However, the Cancer Support Center will continue to evolve and grow as more information is added for different cancers, including ovarian and prostate cancers.

The support center has been an early success in terms of member and caregiver engagement, according to Dr. Brito, with many visitors coming back to the site repeatedly.

“The goal is to continue to expand the hub so that we can provide the right mix of resources and education,” said Dr. Brito. “We will continue to look for opportunities to support our members and their caregivers to help ease the challenges of this difficult journey.”

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From California to Connecticut, Investing in Health at the Local Level

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In Davidson, North Carolina, chronically ill community members will have increased access to essential services. In West Chester, Pennsylvania, more of the local uninsured population will be able to participate in a non-opioid pain management program.

Those city’s free health clinics, along with nearly 130 others from California to Connecticut, will be better able to meet their community’s health needs thanks to nearly $3 million in grants from CVS Health and its Foundation to the National Association of Free & Charitable Clinics (NAFC) and their members.

The grants furthers Aetna and CVS Health’s commitment to building healthier communities by investing in health at the local level, as these clinics will help better manage chronic disease, provide more wraparound services to address the social determinants of health, support treatment and prevention of substance abuse, including opioids and tobacco, and more.

Ranging from $10,000 – 20,000 each, the grants will be distributed to Free & Charitable Clinics in California, Connecticut, Florida, Georgia, Illinois, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Virginia and Washington.

“Taking on these root causes of poor health will help us create lasting change towards health equity in America,” – Nicole Lamoureux, President & CEO of the NAFC.

The new funds bring the company and the CVS Health Foundation’s total contribution to NAFC to nearly $8 million since 2015.

Supporting Aetna and CVS Health’s combined goals of improving outcomes and lowering costs, more than 17,000 patients across the country had access to needed health care in 2018 as a result of last year’s NAFC grants funding. Two grantees alone saved their local hospitals $9.7 million by providing primary care to patients who would otherwise rely on the emergency room.

For more information on how the Free and Charitable Clinics will be utilizing their grants to improve community health, visit www.cvshealth.com/NAFC.

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AetnaCare’s Personalized Approach Making a Difference for Members

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Managing a chronic condition like diabetes or high blood pressure can be a difficult, confusing and complex process. For members of AetnaCare, however, a personalized care approach is simplifying their health journeys and helping them to feel better quicker.

Launched in New Jersey in 2017, AetnaCare uses analytics to identify members who need the most help and connects them with local health and wellness services. Nurse case managers provide members with an integrated care plan as well as the knowledge, motivation and confidence to manage their own health.

“This is really a first-of-its-kind initiative centered on personalized health,” said Dr. Hal Paz, Aetna executive vice president and chief medical officer. “In the 14 months since we launched the program, we’ve curated a unique health ecosystem around medically complex members with both traditional and nontraditional care approaches.”

Getting the Right Help at the Right Time

By helping to coordinate care that members may receive via retail clinics, healthcare devices, pharmacy services, behavioral health and social services, AetnaCare nurse case managers help to simplify and clarify the best care path for each member.

“As the program has evolved, we’ve identified four key health events—inpatient admission, use of the emergency room, a new diagnosis or new medications added to a member’s regimen—that trigger our outreach to members in the program,” said Dr. Sunny Ramchandani, Aetna deputy chief medical officer. “By engaging with members at these critical health points, we provide help to our members right when they need it.”

The program has fostered collaborative relationships with the treating physicians, most of whom help with member outreach, according to Ramchandani, which helps to boost engagement rates. “We found that if a nurse case manager reaches out by phone, members don’t always respond,” he said. “But if a personal physician reaches out, it’s a different scenario completely.” This targeted scenario has improved member engagement rates to more than 70 percent.

Mapping a Member’s Health Care Journey

Divided into key health events, care maps reinforce the most up-to-date clinical, social and wellness practices. Each care map has various objectives, such as ensuring that members stick to their treatment plans and medication regimens, ensuring that members who have critical health needs receive the support they need and reinforcing healthy behaviors.

AetnaCare nurses, who meet with members at their homes, local coffee shops, by phone or wherever the member is most comfortable, use the care maps to educate members about their conditions. The nurses work closely with the members’ own health care team, making sure members have the resources and support to achieve their health goals. Regular check-ins to see where members are on their personalized plans are also features of the plan.

Paz noted that AetnaCare is seeing exceptionally high rates of engagement in members’ homes. “One of the unique aspects of the program is that we work directly with members’ primary care doctors,” he said, adding that AetnaCare is achieving positive outcomes. “We are seeing early evidence of reduced emergency room visits and hospital admissions as well as better medication adherence among our members.”

Ramchandani believes that patient outcomes, in large part, depend on the role of the nurse case managers.

“We injected a little bit of that doctor ethos into the nurse training… moving beyond symptom management toward actually getting the patient healthier,” he said, adding that AetnaCare nurses are now accountable for outcomes in the same ways that doctors are. “That requires nurses to learn new skills, and they are very excited to impact a member at that level… to be the lynchpin of care for a member.”

Caring Approach Helps AetnaCare Member Get Active Again

AetnaCare nurse case manager Nicole Taylor is using those new skills every day and is seeing the positive effects of the program on members’ health first-hand. Her personal, caring approach was particularly effective with Marshall Cummings, an Aetna member with diabetes, heart disease, and liver cancer.

Cummings, 67, lives alone in Elizabeth, NJ, and didn’t want to burden his family and friends as he struggled to manage his health. Nicole became his lifeline, going to doctors’ appointments and surgeries with him, educating him on the right foods to eat, improving his medication regimen, getting him active again and generally lifting his spirits. “She was the right person at the right time,” says Marshall. “Nicole helped me get my strength back.”

“I think being able to meet with Marshall in person, in his home, was a great change for him,” Taylor said. “After our time together, he is now much more health literate and feels confident asking his doctors questions now.”

Taylor also encouraged Cummings to join a gym and get involved in his community to boost his overall wellbeing. She now checks in with him on a quarterly basis to encourage him and continue reinforcing health-related messages.

“As AetnaCare nurse case managers, we’re very involved in all decisions related to our clients, and we’re given a voice in the care they receive,” Taylor said. “As case managers, we’re constantly moving, shaking and changing… looking for new opportunities to help members. It’s very cool.”

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Bringing health care to the underserved: A weekend in Wise, Virginia

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On a scorching day in July, Larry walked 30 miles in 90-degree heat to Wise, Virginia, just to get basic dental services — and he was grateful for that opportunity.

If it wasn’t for the clinic provided by Remote Area Medical (RAM), he wouldn’t be able to get health care of any kind.

Unfortunately, Larry’s story is not unique. Every year, nearly 1,300 individuals travel to Wise to access free, high quality services offered through RAM, a non-profit provider of mobile medical clinics for underserved and uninsured populations. RAM provides patients with dental, vision and medical services, ranging from dental extractions and mental health screenings to women’s health exams.

For the last 19 years, RAM has operated clinics at the Wise County Fairgrounds, oftentimes, providing Wise and surrounding communities with the only health care they’ll receive all year. Leading up to the three-day event, volunteers transform barns into exam rooms and cars fill the massive empty field. An event of this scale and scope requires months of planning, experienced volunteers from a range of medical professions and public-private collaboration.

Aetna previously supported RAM, but deepened its commitment this year as a major sponsor. The Aetna Foundation contributed $40,000 to the Health Wagon, RAM’s local community partner. Working with Feeding America Southwest Virginia, Community Activation and Local Marketing, Aetna Better Health of Virginia, Capitol Market and National Accounts teams contributed $26,500 to fund food boxes packed with healthy, non-perishable items for RAM attendees.

Aetna’s participation in the Wise event reflects the company’s strategy in action. Aetna knows that social determinants of health, like where someone lives, have a significant impact on their health. And when someone lives in a remote area like Wise, accessing quality health care and healthy food can be a challenge.

“There’s affluence and wealth in many of our communities in the Capitol Market but southwest Virginia stands out,” said Mike Bucci, president of Capitol Market. “It’s an area devastated by a lack of jobs and there is a great need for basic things like food, clothing and health care. It made sense for us to invest time, talent and resources from across Aetna to make a meaningful difference in this area.”

In just one weekend, RAM clinicians provided 1,349 patients with nearly $750,000 in free medical, dental and vision services.

In addition, nearly 30 Aetna volunteers from across the country and several lines of business provided on-site support at the Aetna tent.

From 5 a.m. to 6 p.m., they distributed 1,500 food boxes along with information on healthy eating and Medicaid services. A few volunteers also managed the registration process to help ensure patients were triaged in a timely manner.

“The people of Wise have more heart and hope… despite their lack of access to jobs, health care and other resources that are readily available to many of us,” said Aetna volunteer Leila Nowroozi. “In three days at Wise, I encountered virtually every chronic medical condition currently plaguing our nation.”

Even though the RAM clinic is over, the work is just beginning. Looking ahead, Health Wagon will follow up with every single patient throughout the year and connect them to local resources and quality health care.

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Aetna’s Compassionate Care Program Lends a Hand During Difficult Times

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Life is unpredictable, and the end of it can be even more so. Advanced age and/or serious illness can feel like it arises suddenly, leaving patients and their families unprepared and in crisis. That’s why Aetna has worked for over a decade to find empathetic and supportive ways to help people make difficult choices about end-of-life care.

“Nothing is more personal than how we want to face the end of our lives,” said Alena Baquet-Simpson, M.D., Senior Director of Medical Health Services for the Aetna Medicare team. “We are committed to ensuring that individuals receive the kind of timely and compassionate care that they wish for and deserve.”

Aetna’s Compassionate Care program provides not only help with coordinating needed services, but also the empathy members and their families need during these trying times. The program offers members and families comprehensive care management and caregiver support that allows the critically ill member to face end of life on their own terms–without unnecessary stress or discomfort.

Importantly, the Compassionate Care program expands the window for many members in Commercial lines of business to receive hospice care from the typical six months to a full year. It also allows these members to receive medical treatment such as chemotherapy along with palliative care or hospice services.

The Importance of Knowing Your Options

According to Baquet-Simpson, patients or loved ones often only learn about their hospice options after a medical crisis or hospitalization. In fact, according to recent research,https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0175 only 1 in 3 adults has done any advanced planning to cope with end-of-life matters.

Aetna hopes to change that dynamic by using sophisticated predictive modeling to identify patients who may be at risk for advanced illness and are candidates for advanced care planning. Highly trained professionals at Aetna then reach out to those members or their families to start a conversation about available options, information and support. Nurse case managers then work closely with members to help them understand their care options, the philosophy behind and services offered under hospice and how everything may fit with their end-of-life wishes.

For example, one member was returned home after hospitalization and a lengthy skilled nursing facility stay. The Aetna nurse case manager educated the member and his family about covered services, including home health care to help with changing wound dressings. She also ensured his questions concerning copays and network providers were answered in a timely way and engaged an Aetna social worker to identify additional community resources.1

After much discussion, the member and his family came to realize that the care he required exceeded the family members’ abilities, and he was subsequently placed in an assisted living facility. At that point, he began considering hospice. After the member passed away peacefully under hospice care, his daughter reached out to the Aetna nurse to share the family’s gratitude.

“When you are making these huge life choices, you want emotional and medical support to allow you to get your affairs in order,” said Nancy Snyder, Aetna Case Manager RN. “If things turn bad, not only do you have time to prepare, but to make sure your wishes are met. Aetna has a very forward-thinking attitude that has helped many families deal with one of life’s hardest periods.”

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Helping Members Avoid Unnecessary ER Visits

Helping Members Avoid Unnecessary ER Visits
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At an average total cost per visit of $1,900, the emergency department, or ER, is one of the most expensive places to receive medical care.https://www.beckershospitalreview.com/eds/cost-of-er-visits-increased-31-between-2012-16-5-findings.html Not surprisingly, consumer out-of-pocket costs are also high. According to one study, patients with upper respiratory infections personally paid an average of $377 per ER visit.https://www.bcbs.com/sites/default/files/file-attachments/health-of-america-report/BCBS.HealthOfAmericaReport.Retail.pdf

Despite these high costs, there were nearly 137 million ER visits in 2015.https://www.cdc.gov/nchs/fastats/emergency-department.html A sizable portion of these visits are for conditions that clearly merited emergent care — trauma, fractures, chest pain — but many others could be successfully treated at easier-to-access and more affordable sites of care. In fact, it’s estimated that 30 percent of ER visits could potentially be treated in walk-in clinics like MinuteClinic.https://www.bcbs.com/sites/default/files/file-attachments/health-of-america-report/BCBS.HealthOfAmericaReport.Retail.pdf

The emergency department is a critical component in our health care system, and crowding has become a concern among hospitals, policy makers, providers, and payors. Avoidable use among patients with low-acuity problems contributes to long ER wait times and suboptimal care. Avoidable visits cost the system $38 billion a year.http://wellness.totalaccessmedical.com/blog/the-consequences-of-emergency-department-overuse

Why People Choose the ER

In a survey, most ER users cited the severity of their medical problem as the primary reason they sought care in the emergency department. However, 7 percent cited lack of access to a primary care provider, and 12 percent went to the ER because their provider’s office was closed.https://www.cdc.gov/nchs/data/nhsr/nhsr090.pdf With extended hours and walk-in care, retail clinics are a convenient choice for these groups. Retail clinics are a particularly attractive option for younger people who may not have established a relationship with a primary care provider.

The Neighborhood Option for Care

Many of the concerns that bring people to a hospital emergency department can be effectively treated in walk-in medical clinics. Earaches, sprains, skin conditions such as rashes or poison ivy, sore throats and infections of the respiratory system or urinary tract can all be treated at MinuteClinic. In fact, MinuteClinic can treat more than 125 different conditions in patients above 18 months of age.

Helping plan members and plans avoid unnecessary ER visits remains a part of CVS Health’s vision for building a better, more affordable health care system. MinuteClinic, with 1,100 locations in 33 states and the District of Columbia, offers care seven days a week, including times when many physician offices are closed. Most services at MinuteClinic cost approximately $100. A visit to MinuteClinic — as opposed to an urgent care center or hospital emergency department — costs as much as 90 percent less.

Read the full article at CVS Health Payor Solutions.

For more information about CVS Health’s efforts to improve access to quality care across the nation, visit our Quality & Access information center and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our bi-weekly health care newsletter.

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Leaders on the Road: Key Themes from 2018 Events

Leaders on the Road: Key Themes from 2018 Events
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Throughout 2018, CVS Health leaders participated in industry-leading events and public forums to address some of the most pressing issues in our health care system. From Washington to Los Angeles, our leaders shared their vision for transforming the consumer health experience by making health care more local, easier to navigate and more affordable.

Key themes included:

Bringing Care Closer to Home

Serving as the front door to health care in 10,000 communities nationwide, CVS Health has long been committed to connecting patients to care when and where they need it. In 2018, our leaders highlighted how our combination with Aetna will build on this commitment by integrating care delivery at a local level and making our touchpoints to care more accessible and convenient.

Improving Care Coordination and Connectivity

Health care can be fragmented for many Americans, which can impose barriers for patients across various settings. In 2018, our leaders emphasized the need to improve connectivity and communication across the care continuum to help patients and their providers better manage conditions. 

  • Larry Merlo at Town Hall Los Angeles: “Today, nearly 70 percent of Americans across the country live within three miles of a CVS Pharmacy. You can walk right in and see a pharmacist to get information about your prescription or a nurse practitioner at one of our more than 1,100 MinuteClinics to get chronic condition monitoring or a lab test, with the results sent directly to your primary care doctor.”
  • Tom Moriarty, EVP, Chief Policy and External Affairs Officer, and General Counsel, at a POLITICO Health Care Innovators event: “Health IT is key to getting past the fragmentation we see in health care. If you come into a MinuteClinic or are seen anywhere else in the CVS world, we can port that information back to your physician, or back to the health care system that serves as your primary care center.”

Addressing Rising Drug Costs

Nearly eight in ten Americans express concerns about prescription drug costs and the impact on their families’ budgets. At CVS Health, we recognize that one the most important things we can do is to help people take their medications, which improves overall health and lowers costs. Our leaders emphasized why integrating digital tools that enhance price transparency and expanding access to generics and biosimilars are key in our efforts to connect patients to the right medicine at the lowest possible cost.

  • Larry Merlo at the Aspen Ideas Festival, Spotlight Health: “We’re in the process of embedding our patients’ plan designs into [their] EHR so when the physician goes and puts a prescription in, he or she will be able to see the patient’s out of pocket costs, and up to five alternative [prescription medications] and the costs associated with each.”
  • Tom Moriarty at the POLITICO Pro Summit: “There are a number of solutions that we can implement today within the existing statutory and regulatory framework to reduce overall prescription drug costs in the system and for patients while also driving improved health outcomes through increased adherence.”

For more information about CVS Health’s efforts to improve access to quality care across the nation, visit our Quality & Access information center and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our bi-weekly health care newsletter.

General Counsel Tom Moriarty speaks at a POLITICO event
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On Target: What the New Hypertension Guidelines Mean

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Nearly half of all American adults now have high blood pressure. This is according to the latest hypertension guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC), which now define high blood pressure as 130/80 mmHg, down from 140/90 mmHg. As a result of this change, the total number of adults with high blood pressure is expected to increase from 72 million to 103 million.https://www.nytimes.com/2017/11/13/health/blood-pressure-treatment-guidelines.html

High blood pressure is the most significant modifiable risk factor for cardiovascular disease (CVD), which is the leading cause of death for both men and women in the U.S. It is also one of the most costly diseases. In fact, it is estimated that in 2016 the cost to treat CVD in the U.S. topped $555 billion, and by 2035 spending is expected to rise to more than a trillion dollars.https://www.heart.org/idc/groups/heart-public/@wcm/@adv/documents/downloadable/ucm_491543.pdf

While new guidelines mean a greater number of Americans now have elevated blood pressure, for the majority of patients, lifestyle changes will be sufficient to bring their blood pressure under control. This can include following a heart-healthy diet, reducing sodium intake, increasing regular physical exercise, weight loss and limiting alcohol intake.

In addition, the number of people requiring a prescription, such as an anti-hypertensive drug, to help manage their blood pressure will likely increase. For example, the new guideline could result in an additional 39 million blood pressure medication prescriptions each year for CVS Caremark™ pharmacy benefit management (PBM) members, taking into account that not all those who are newly diagnosed will require medication therapy.

Fortunately, the majority of drugs in this class are available as generics. Therefore, out-of-pocket costs for patients, including CVS Caremark members should be low, and the increase in cost to payors is also estimated to be relatively small. Some experts also believe that the lower blood pressure targets could encourage more people to keep their blood pressure under control, which could lead to fewer costly events such as heart attacks, strokes and hospitalizations. In fact, research shows that for every dollar spent on medication, adherence to blood pressure therapies can result in more than a $10 savings in avoidable downstream health care costs.http://www.healthaffairs.org/doi/full/10.1377/hlthaff.2009.1087 Based on the number of new patients who may now be on blood pressure medications under the new guidelines, that could result in a total savings of nearly $21 billion annually across the health care system.CVS Health Analytic Consulting Services, 2017.

CVS Health Can Help

While lowering high blood pressure can help reduce a person’s risk of CVD,https://www.nytimes.com/2015/09/12/health/blood-pressure-study.html?_r=0 lifestyle modifications and medication therapy can be hard to manage. CVS Health can help.

For example,

  • CVS Caremark PBM members can take advantage of the Pharmacy Advisor® counseling program. This includes in-person or telephonic support from CVS pharmacists who can help answer questions about a patient’s medications or other chronic, co-morbid conditions as well as offer lifestyle management support. This can help patients stay on track with their medications, which can help to keep their blood pressure in check and under control.
  • Regular blood pressure readings are very important to help track blood pressure over time. In nearly every CVS Pharmacy™, patients can find a free blood pressure monitoring machine to help. In addition, MinuteClinic® is also a heart-healthy resource. Nurse practitioners and physician assistants can perform the five biometric screenings that can determine a patient’s risk for heart disease: total cholesterol, HDL (good) cholesterol, blood pressure, blood sugar and body mass index. They can also answer questions about blood pressure readings and educate patients about their condition and management options. Plus, a copy of the MinuteClinic visit records can also be sent to patients’ primary care physicians, with patient permission, to help connect care and keep patients’ health records up to date.
  • CVS pharmacists also play an important role in helping patients manage their blood pressure. Pharmacists are on the front lines of health care and have frequent interactions with patients filling prescriptions for chronic conditions such as high blood pressure. They can help coordinate care with the patient’s health care providers and also offer solutions such as prescription refill reminders to encourage patients with chronic conditions to stay adherent to their medications. In fact, research shows that patients with chronic conditions who receive support from pharmacists are more likely to reach their clinical targets.http://annals.org/aim/article/2517407/pharmacist-led-chronic-disease-management-systematic-review-effectiveness-harms-compared

CVS Health is a national sponsor of the American Heart Association’s Go Red For Women, an annual campaign designed to raise awareness of heart disease and stroke as the number one killer of women and to empower women to take charge of their heart health. As a sponsor, CVS Health has pledged to raise a minimum of $10 million over three years to support life-saving cardiovascular research and education.

 MinuteClinic patients gets blood pressure checked
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