- Programs & Services
- Cost Management
- Specialty Management
- Care Management
- Member Engagement
- Health Plan Client Engagement
Tailored support and targeted interventions improve engagement
People with complex chronic or rare conditions, have unique evolving needs, and often require additional support to help them manage complex regimens as well as symptoms and comorbidities. In fact, our analysis shows that care of patients with rare or complex conditions costs four times more than the average patient and twice as much as those with a common chronic condition. At CVS Specialty, we have built the technological infrastructure to deliver support to patients where and when they need it to better manage their condition and improve outcomes. Our industry-leading technology tools also enable CareTeams to offer targeted support tailored to each plan member’s unique needs, ultimately helping lower overall health care costs.
Specialty Expedite helps simplify the onboarding process, get members on the appropriate medication faster, and keeps them informed of the status of their prescription along the way. It also streamlines the prior authorization and benefits verification process and engages members from the very beginning of their therapy regimen.
Technology solutions such as secure messaging give members convenient ways to communicate with their CareTeam when and how they choose, as well as use digital ordering, or receive electronic refill reminders and shipment notifications. Such technologies also give clinicians access to a wider range of patients’ health data, and an in-depth view of their condition and needs so that clinicians can personalize care. Use of such tools is growing among members.
Secure Messaging available to members across 30 complex conditions
Since a successful pilot among chronic myeloid leukemia (CML) patients in 2016, we have expanded our secure messaging program to 29 other conditions. We also conducted a year-long pilot for multiple sclerosis patients using smart watches. Of the patients enrolled in the pilot, 96 percent uploaded health data, 86 percent reported their symptoms and 75 percent took a walk test — a critical measure of whether the condition is well managed.
Such technologies clearly help improve outcomes. Our analysis shows that for autoimmune conditions, which account for more than a third of our clients’ pharmacy spend, greater adoption of digital tools led to improved adherence.
Adherence represented by utilizing member medication possession ratio for those enrolled in specialty digital program.
Nurse-led Care Management Improves Outcomes, Lowers Costs
Our care model is based on ongoing, targeted support from nurses and pharmacists with disease expertise. Specialized AccordantCare teams – comprised of registered nurses, pharmacists, social workers, and a medical director, all backed by a medical advisory board – offer holistic support for members with rare conditions through targeted interventions designed to meet each patient’s unique needs.
|In the first year, AccordantCare Rare provides clients up to:||Over the course of the program, clients can realize up to:|
|$2,496 savings per engaged member per year||$2,158 savings per engaged member per year|
|10% reduction in ER admits 9% reduction in hospital admissions||11% reduction in hospital admissions|
Members who receive nurse care management are highly satisfied.*
92% agree Accordant helped them understand and follow doctor’s advice
96% are satisfied with service
91% agree the program helped them set health goals and make good choices
95% are satisfied with help they received managing their conditions
|*AccordantCare Patient Satisfaction|
Data source, unless noted otherwise, CVS Health Enterprise Analytics, 2020.
Savings will vary based upon a variety of factors including things such as plan design, demographics and programs implemented by the plan.
Image source: Licensed from Getty Images, 2020.
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