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CVS Launches Analytics-Based Diabetes Mgmt Program For PBMs

Posted on December 29, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

CVS Health has launched a new diabetes management program for its pharmacy benefit management customers designed to improve diabetes outcomes through advanced analytics.  The new program will be available in early 2017.

The CVS program, Transform Diabetes Care, is designed to cut pharmacy and medical costs by improving diabetics’ medication adherence, A1C levels and health behaviors.

CVS is so confident that it can improve diabetics’ self-management that it’s guaranteeing that percentage increases in spending for antidiabetic meds will remain in the single digits – and apparently that’s pretty good. Or looked another way, CVS contends that its PBM clients could save anywhere from $3,000 to $5,000 per year for each member that improves their diabetes control.

To achieve these results, CVS is using analytics tools to find specific ways enrolled members can better care for themselves. The pharmacy giant is also using its Health Engagement Engine to find opportunities for personalized counseling with diabetics. The counseling sessions, driven by this technology, will be delivered at no charge to enrolled members, either in person at a CVS pharmacy location or via telephone.

Interestingly, members will also have access to diabetes visit at CVS’s Minute Clinics – at no out-of-pocket cost. I’ve seen few occasions where CVS seems to have really milked the existence of Minute Clinics for a broader purpose, and often wondered where the long-term value was in the commodity care they deliver. But this kind of approach makes sense.

Anyway, not surprisingly the program also includes a connected health component. Diabetics who participate in the program will be offered a connected glucometer, and when they use it, the device will share their blood glucose levels with a pharmacist-led team via a “health cloud.” (It might be good if CVS shared details on this — after all, calling it a health cloud is more than a little vague – but it appears that the idea is to make decentralized patient data sharing easy.) And of course, members have access to tools like medication refill reminders, plus the ability to refill a prescription via two-way texting, via the CVS Pharmacy.

Expect to see a lot more of this approach, which makes too much sense to ignore. In fact, CVS itself plans to launch a suite of “Transform Care” programs focused on managing expensive chronic conditions. I can only assume that its competitors will follow suit.

Meanwhile, I should note that while I expect to see providers launch similar efforts, so far I haven’t seen many attempts. That may be because patient engagement technology is relatively new, and probably pretty expensive too. Still, as value-based care becomes the dominant payment model, providers will need to get better at managing chronic diseases systematically. Perhaps, as the CVS effort unfolds, it can provide useful ideas to consider.

How Will Patients Choose Healthcare?

Posted on May 19, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In a recent conversation with Medhost CEO, Bill Anderson, he asked the question that’s the title of this blog post: “How Will Patients Choose Healthcare?” He then proceeded to answer his question by saying, “Healthcare will buy on brand like they do in their other purchasing decisions.” It’s worth adding that Bill and Medhost are working to build their YourCare Everywhere brand in healthcare. You can decide if their business efforts are skewing his perspective or not.

For me, I find the question absolutely fascinating and an extremely important question for healthcare organizations. This question is becoming more and more important since the shift to high deductible plans is forcing patients to be more selective in how they choose their healthcare provider. Will brand be the way that people choose healthcare?

One challenge I have with this idea is that healthcare is a complex decision. I don’t know many people who make impulse healthcare provider decisions. I wonder if there are other complex decisions we could learn from. What is true is that healthcare decisions are often crisis decisions. In a crisis, where do people turn? I think the answer is the brands they know.

As I look at healthcare, which organizations have a true national healthcare brand? The first one that comes to mind is Mayo Clinic. Cleveland Clinic seems to be working down a similar path. Are their others? There are very few national healthcare brands that are trusted.

There are many local healthcare brands. Dignity Health has been pouring money into commercials in Vegas to build their brand. I assure you the commercials are all brand. Intermountain has a brand in Utah and Partners Healthcare has a brand in Boston. We could argue whether they have good or bad brands since they are both so dominant in their region. There are many other examples of local healthcare brands.

On the other side of healthcare brands is the CVS Minute Clinic, Walmart, and all the other retailers trying to make a space for themselves in healthcare. Also competing for brand recognition with a similar direct to consumer, retail healthcare play are the telemedicine providers like MD Live.

Long story short, we’re seeing patients having more power when it comes to selecting their healthcare provider and we see a ton of brand competition. Will a healthcare organization be able to survive without a major investment in their brand? What does this mean for small physician practices?

I’d love to hear your thoughts about what’s happening with healthcare brands. Do they matter? In what ways will they matter? What should a healthcare organization be doing to shore up its brand?