Tailored support and targeted interventions can help avoid costly adverse events
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 for patients with rare or complex conditions costs seven times more than the average patient and more than four times as much as those with a common chronic condition.
At CVS Specialty, we have built the technological infrastructure to provide support for patients where and when they need it, helping them better manage their condition, improve outcomes, and prevent unnecessary spending. Our innovative tools also enable our CareTeams to offer targeted support tailored to each patient’s unique needs, ultimately helping lower overall health care costs.
Digital solutions such as Secure Messaging give patients convenient ways to communicate with their CareTeam when and how they choose, use digital ordering, or receive electronic refill reminders and shipment notifications. In general, 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.
Technology supporting care
It’s no longer enough to connect with patients using one channel. An estimated 85 percent of adults in the US own a smartphone, which opens up the possibility of using apps, texts and email.
Connectivity — the ability to share health information, either self-identified, collected by an app or as a result of a provider visit — is also an important part of the conversation around technology.
The use of electronic health records enables data sharing across platforms. For example, we use Epic, one of the largest electronic health record vendors in the industry, to help improve connectivity with health systems and more than 372K providers.
Improved digital connectivity for providers can also mean improved support for patients. For instance, symptom tracking is an effective tool to help patients with chronic and complex conditions understand how they are responding to their medication. Our oncology solution, for example, gives patients whose conditions may not be well managed the ability to securely track their symptoms, and we’ve seen an over 31 percent engagement rate with our symptom tracker. Based on patient reported metrics, one of our CareTeam members can reach out and offer support targeted to their unique needs. We can also connect with their provider to provide insights. If treatment isn't working or if a patient is experiencing serious side effects, this may prompt a change in therapy, helping improve clinical outcomes and avoid wasteful spend.
Test-and-learn approach to evolving tools
We take a test-and-learn approach to digital tools and functions such as Secure Messaging and symptom tracking. First, we conduct pilots to identify the most effective solutions and the ones that make the biggest difference in member engagement and outcomes. Then we expand the features and solutions that are found to be most effective in improving outcomes and lowering costs to additional conditions, while continuing to test additional tools and capabilities.
- A year-long pilot for members with multiple sclerosis (MS) used smart watches to help them better track and report their symptoms and key measures of whether their condition was well managed.
- Of the members 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.
Smartmonitor Apple Watch Survey Results, March 2019. Pilot study with 27 participants conducted for one year. Actual results may vary depending on benefit plan design, member demographics, programs implemented by the plan and other factors. Our oncology symptom tracking tool is built on the findings of the original MS pilot. - We also tested a digital solution for members with hemophilia that provided real-time medication management support through digital tracking via smartphone. Members were able to document bleeding episodes, track infusions, and report symptoms directly to their CareTeam from the app. Real-time clinical data sent to the CareTeam helped to enable timely interventions and improve therapy management for better outcomes, a better member experience, and lower costs.
Greater adoption of digital tools helped to improve appropriate adherence
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Less than 1% digital opt out by CVS Specialty members |
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92% of specialty patients have opted into receive email or text notifications. |
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Less than 1% digital opt out by CVS Specialty members |
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92% of specialty patients have opted into receive email or text notifications. |
Supporting technology with care management expertise
Our care model is based on ongoing, targeted support from nurses with disease expertise. Specialized AccordantCare teams – comprised of registered nurses, social workers, and a medical director, all backed by a medical advisory board – offer whole person support for members with rare conditions through targeted interventions designed to meet each member’s unique needs. The AccordantCare program is supported by more than 300 specially trained nurses licensed in 50 states.
| Over the course of the AccordantCare program, clients can realize up to: | |||
|---|---|---|---|
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>$2,100 estimated savings per engaged member per year |  |
11% estimated decrease in hospitalizations |
| Over the course of the AccordantCare program, clients can realize up to: | |
|---|---|
|
>$2,100 estimated savings per engaged member per year |
|
11% estimated decrease in hospitalizations |
Members who receive nurse care management are highly satisfied.* |
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96% are satisfied with the help that the program has given them toward better managing their condition |
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98% feel they had adequate condition understanding after starting the program, up from 86% before starting the program |
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92% agree it has helped them improve their overall health, set health goals, and understand and follow their doctor's advice |
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~90% agree the program has helped them think about reasons to make good health choices, reach their health goals, feel more productive and change their behavior |
| *AccordantCare Patient Satisfaction Survey, 2020 | |
The combined power of digital member engagement, proactive nurse support and ongoing innovation helps members self-manage their conditions, improve clinical outcomes and avoid downstream costs such as adverse events and hospital visits.
Updated on June 15, 2022
Originally published: 106-51850C (052120)
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.