Best-in-Class Point Solutions

BRIEFING

June 30, 2022

Sree Chaguturu, MD

Executive Vice President & Chief Medical Officer, CVS Health

With the pandemic still a reality, and many plan members having avoided going to the doctor’s office because of safety concerns, digital solutions can help them maintain healthy habits and manage chronic conditions.

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. We continue to expand the range of services and solutions available through the program to help payors choose the ones best suited to their plan goals.

In total, CVS Health Point Solutions Management offers clients (and their members) access to 11 vendors:

	Carrum Health A value-based Center of Excellence platform that helps reduce plan sponsors’ surgical spend by over 45 percent through delivering quality care at upfront bundled prices. Request a demo and more information →
	Daylight Personalized digital program based on cognitive behavioral therapy for reducing worry and anxiety. Request a demo and more information →
	Hello Heart Helps members understand and improve their heart health. It offers a U.S. Food and Drug Administration-cleared 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. Request a demo and more information →
	Hinge Health A digital program designed to reduce pain, opioid use, and surgeries for preventative, acute, chronic and surgical musculoskeletal conditions. Hinge Health combines a clinical care team, advanced motion technology tracking, a wearable pain relief device, and education, while integrating with in-person providers to enable real-time interventions to prevent unnecessary utilization. Request a demo and more information →
	Progyny Progyny’s fertility solution provides a positive member experience, cost efficiencies, and greater success rates for members. Request a demo and more information →
	PrudentRx Innovative specialty cost management strategy and best-in-class member experience to optimize savings from manufacturer copay cards and reduce plan and member costs. Request a demo and more information →
	RethinkCare Evidence-based behavioral health and clinical support platform for working parents, caregivers, and their families. A global solution with the depth and breadth of content across the person, the family, and the workplace. Request a demo and more information →
	Sleepio A fully automated mobile and desktop app that uses cognitive behavioral therapy (CBT) to help plan members dealing with poor sleep. CBT is meant to assist members in changing unhelpful behaviors, improving emotional regulation, and developing personal coping strategies that target specific problems. Request a demo and more information →
	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. Request a demo and more information →
	Weight Watchers Reimagined Digital weight loss and wellness program based on nutritional and behavioral science for weight management, through coaching, community, customized food plans and tools to log food, activity and sleep. Request a demo and more information →
	Wondr Health A digital behavior change program clinically proven to improve physical and emotional health to prevent and reduce the impact of weight-related chronic conditions. Wondr teaches members practical mind/body skills to lose weight, sleep better, and move more. Request a demo and more information →

Would you like to receive more information on solutions offered through Point Solutions Management?

As always, 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.

CVS Health Point Solutions Management offers clients:

Rigorous Vendor Vetting

Comprehensive clinical, security and business review, including end-to-end plan member experience

Ease of Contracting

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 Member Eligibility Verification

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

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.

To do this, we developed a three-step process that:

Ranked clinical conditions by medical and pharmacy costs, highlighting areas of the largest health care spend
Reprioritized the ranking based on additional areas of need — and their biggest health care challenges — identified by a representative set of clients
Mapped the availability of point solutions against each area of need, noting where they could have the greatest positive impact on health and well-being outcomes

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

Submitted by sgerber on Fri, 03/06/2020 - 09:11

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. These further underwent rigorous clinical safety and outcomes review including:

	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
	Alignment with evidence-based clinical guidance: Solution provides recommended actions that are in line with existing clinical guidelines
	Validated outcomes: Vendor has performed randomized controlled trials demonstrating improved member outcomes

So far, eleven 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

Point Solutions Management is a simple, efficient way for plan sponsors to add carefully evaluated health and well-being point solutions to the traditional benefits they offer their members.

Originally published on March 11, 2020 and updated on June 30, 2022.

*For commercial clients.

Image source: Licensed from Getty Images, 2020.

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Best-in-Class Point Solutions

In total, CVS Health Point Solutions Management offers clients (and their members) access to 11 vendors: