Best-in-Class Point Solutions

Rigorous Clinical, Security & Business Review to Help Minimize Spend, Maximize Benefits

BRIEFING
March 11, 2020
Senior Vice President, CVS Health and Chief Medical Officer, CVS Caremark

New technological advancements and care models are disrupting the traditional health and wellness sectors. Novel tools that can assist patients in managing a wide range of conditions — from insomnia and lower back pain, to meeting fitness goals and staying adherent to medications — are emerging at a rapid pace.

This means that for payors looking to add point solutions to the benefits they offer, navigating the large and ever-evolving landscape of available products can be challenging. This is especially true for digital health solutions, which continue to grow in volume and complexity. An estimated 97,000 digital health solutions are available for smartphones and tablets.https://www.healthworkscollective.com/mobile-medical-apps-a-game-changing-healthcare-innovation/.

In 2018, the average employer offered 14 supplementary health care solutions from different sources.https://www.castlighthealth.com/press-releases/castlight-releases-first-of-its-kind-report-on-digital-health-in-the-workplace/.

Point Solutions Management from CVS Health is a full-service offering that can help plan sponsors simplify contracting, secure lowest price and monitor ongoing performance of third-party health care point solutions.

Request more information on solutions offered through Point Solutions Management.

CVS Health Point Solution Management offers clients:

Rigorous Solution Evaluation

  • Comprehensive clinical, security and business review, including end-to-end plan member experience
  • Evaluation report for each vendor, available to clients upon request*

Secure and Simple Contracts

  • Full contract negotiations, including agreement to terms that are critical for our clients — across security, indemnification, data sharing, privacy protections, etc.

Lowest
Price

  • Vendors obligated under their contract to offer most competitive pricing for clients
  • Billing integrated with pharmacy benefit management (PBM) invoice

Real-time Billing Verification

  • Clients pay only for utilization that aligns with their criteria
  • Client can focus usage based on clinical criteria

Selection of vendors for our offering is based on a detailed process of identifying solutions that are most relevant to plan sponsors, and which utilize the latest technology and engagement tools to offer a clear clinical value, are cost-effective, and can provide outcomes tracking.

Prioritizing Areas of Need, Curating a Vendor List

Our rigorous vendor evaluation and selection starts with identifying what specific areas of health and well-being meet the needs of our clients and where vendor point solutions are most likely to have a positive impact.

Based on the findings, we identified three major categories of client need:

Best-in-Class Point Solutions

Areas of high medical cost, where digital tools can improve clinical outcome:
  • Metabolic condition management across diabetes, hypertension, and cardiovascular health
  • Musculoskeletal health
  • Respiratory health, to a lesser degree

6 out of 10 Americans have a chronic condition, accounting for 90 percent of the nation’s annual health care expenditures.https://www.cdc.gov/chronicdisease/about/costs/index.htm.

Areas of productivity and member quality of life, which can be impacted by improved health habits and clinical coaching including:
  • Mental health/stress reduction and sleep management
  • Prediabetes management, weight management, fitness and nutritional support
  • Substance abuse and addiction counseling
  • Social determinants of health — factors preventing at-risk individuals from having access to care and services that help close economic and social gaps
Areas of care complexity, where clients seek improved member engagement and ease of member navigation to maximize their health benefits:
  • Caregiver support — for members who act as primary and secondary caregivers to their elderly or preadolescent dependents who have special care needs
  • Women’s health and fertility solutions
  • Symptom and care triaging

Based on these priorities, we identified a list of more than 300 available vendor solutions. These were vetted by multiple sources including review of public literature, opinions from subject matter experts, and early adopter feedback, leaving a preliminary list of 30. These further underwent rigorous clinical safety and outcomes review including:

Checkmark Clinical safety: Solution has been evaluated for potential direct harm as well as corresponding responsibility to address emergency situations when members provide alarming information such as low blood sugar, elder abuse, or suicidality.
Checkmark Alignment with evidence-based clinical guidance: Solution provides recommended actions that are in line with existing clinical guidelines
Checkmark Validated outcomes: Vendor has performed randomized controlled trials demonstrating improved member outcomes
So far, six vendors have completed the evaluation process and passed the final step comprising demonstrations of their solution, actual usage testing by in-house clinical and product experts, a thorough examination of their clinical evidence, and return on investment and outcomes data.
So far, six vendors have completed the evaluation process and passed the final step comprising demonstrations of their solution, actual usage testing by in-house clinical and product experts, a thorough examination of their clinical evidence, and return on investment and outcomes data.

Lowest Cost, Ongoing Monitoring

Vendors who are selected for the Point Solutions Management offering are obligated under their contract to offer the most competitive pricing for clients. We have also made significant investments to ensure a truly seamless administrative experience for our clients. During onboarding, vendors connect directly to the CVS Caremark system for automated and accurate real-time eligibility verification.

Rigorous Vendor Vetting, Evaluation and Ongoing Performance Monitoring

Arrow pointing to the right, indicating that the cells below in this table are a sequence of steps.

Vendor Scan
Identifies solutions based on:

  • Client priority
  • Impact to health care spend
  • Health care technology trends

Clinical Review
Tested by CVS Health clinicians:

  • User safety review
  • Clinical trial results
  • End-to-end member experience

Security Review
Ensures compliance with:

  • Applicable regulations
  • User privacy (HIPAA)
  • CVS Health third-party data security policy

Business Review
Evaluates model to ensure:

  • Ability to support CVS Health clients at scale
  • Financial viability
  • Review of ROI claims (if applicable)

Ongoing Monitoring
Oversight of:

  • Member-eligibility and real-time billing verification
  • Clinical and security standards
  • Performance and outcomes

CVS Health Point Solutions Management offers clients access to:
 

Hello Heart
Helps members understand and improve their heart health. It offers an FDA-approved blood pressure monitor coupled with an app that tracks blood pressure readings, weight and physical activity, alerts for out-of-range hypertension, and has patient-enabled medication adherence reminders.

Hinge Health
A coach-led digital program for members with musculoskeletal conditions such as chronic back or joint pain. Hinge Health combines wearable sensor-guided exercise therapy with behavioral change through 1-on-1 health coaching and education to reduce chronic pain, opioid use, and surgeries.

Sleepio
A fully automated mobile and desktop app that uses cognitive behavioral therapy (CBT) to help patients dealing with poor sleep. CBT is meant to assist patients in changing unhelpful behaviors, improving emotional regulation, and developing personal coping strategies that target specific problems.

Torchlight
A caregiver support solution that guides families through the complexities of educational, financial, social, health, and legal demands related to caring for a loved one, no matter the age, stage, or concern. With a digital platform and team of expert advisors, Torchlight helps reduce stress and enhance caregiving outcomes.

Whil
A digital training platform for mindfulness, stress resilience, mental well-being and performance. It addresses 12 different aspects of well-being and performance through 5-minute daily sessions and more than 250 mini-courses. Users have access to more than 2,000 video and audio sessions on demand, reinforced with ongoing tips, exercises and articles to improve employee health and happiness.

Request more information on solutions offered through Point Solutions Management.

We continue to evaluate additional solutions for future inclusion.

Want more information on point solutions that can help improve health and well-being for your members? Ask Us
BRIEFING
March 11, 2020
Senior Vice President, CVS Health and Chief Medical Officer, CVS Caremark

*Available Q2 2020.

†For commercial clients.

Image source: Licensed from Getty Images, 2020.

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