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.