Taking Cues on Mail Service from Medicare Beneficiaries

Americans are living longer. As they age, they are more likely to have a chronic condition and to be prescribed medication to manage that condition. In fact, prescription drugs play an important role in managing health for 59 million seniors and people with disabilities.http://www.kff.org/infographic/10-essential-facts-about-medicare-and-prescription-drug-spending/ About four out of five Medicare beneficiaries take maintenance medications. Many of these users take multiple prescribed medications, with an average of five maintenance prescriptions per user.*

Given the potential savings and convenience for people using maintenance medications, home delivery of 90-day supplies seems like it should be a natural fit for Medicare beneficiaries. However, use of mail service pharmacy among Medicare beneficiaries lags behind that of other demographic groups. To understand why, CVS Health conducted focus groups with SilverScript members aged 59 to 81. Participants included current and past mail pharmacy users, and those who had never used mail service pharmacy. Most participants filled two or more prescriptions, and the pharmacies they used included retail chains, independents, supermarkets, and big box stores, as well as CVS Caremark Mail Service Pharmacy.

Common Themes

Whether participants were filling prescriptions at a retail store or through our mail service pharmacy, they valued convenience and consistency, although how they interpreted those attributes differed.

Beneficiaries who used retail pharmacies said they did so because the stores were close to their home or within walking distance. They picked up prescriptions while shopping or doing other routine errands. Mail pharmacy users liked not having to leave the house, go to the store or make repeated trips. They indicated that auto refills and renewals, as well as mail, text and phone notifications, made it easy to ensure their prescription supply.

Retail users’ perception was that using a retail pharmacy meant “less margin for error” and easy resolution of any issues. Mail pharmacy users cited auto refills and renewals, consistent reminder communications and routine delivery timing as evidence of consistency. They also said they felt confident about product availability, meaning that the mail service pharmacy would not run out of product or not have it in stock.

Comments from mail users in our focus groups were very similar to those from beneficiaries who routinely use CVS Caremark Mail Service Pharmacy. In independent surveys, 98 percent of our Medicare mail users indicated they would continue to use the mail pharmacy, with 99 percent satisfied with the condition of their delivered order, 98 percent with order accuracy, and 95 percent with delivery at expected times.^** These survey scores suggest that significantly more Medicare beneficiaries could become routine mail pharmacy users if they tried the service.

Better Adherence, Higher Satisfaction

Despite these concerns, many retail user participants said they were open to trying mail pharmacy if they had more information regarding the service, including answers to questions like those listed above. Increasing utilization of mail service pharmacy could have several advantages for Medicare plans. Depending on plan design, both beneficiaries and plan sponsors may be able to save on prescriptions for a 90-day supply dispensed by mail. Moreover, like other users of 90-day fills, beneficiaries using mail tend to be more adherent. Multiple studies have shown that better adherence can help enhance health outcomes and reduce overall spend.http://vbidcenter.org/wp-content/uploads/2014/11/Medication-Adherence-Leads-To-Lower-Health-Care-Use-And-Costs-Despite-Increased-Drug-Spending_Health-Affairs_JAN_2011.pdf High satisfaction among CVS Caremark Mail Service Pharmacy users indicates there may be other important advantages: Satisfaction and adherence are important Star measures for Medicare plan sponsors, and satisfied members may be less likely to change plans.

3 Principles for Effective Messaging Keep it professional, not overly promotional Make it simple; provide easy-to-understand next steps Focus on member benefits and concerns

	In order to help more plans and beneficiaries benefit from these advantages, CVS Health carefully reviewed the insights gained from the focus groups and surveys and applied the findings to the development of a toolkit of communications custom designed to respond to beneficiary concerns and questions. Content includes emails, web banners, a video, and templates for printing. Messaging addresses savings, safety and convenience with options for personalization, such as a list of prescriptions eligible for mail pharmacy. The toolkit also introduces our digital tools for easy prescription management. Research shows that a majority of Medicare beneficiaries access information online and are familiar with using online tools.*** Toolkit materials incorporate our learnings from research with other members: keep it simple, provide clear next steps, focus on member benefits and advantages.
	Insights from these focus groups also reinforced our commitment to make starting a prescription through the mail pharmacy as easy as possible. If beneficiaries want to transfer a prescription, all they need to do is contact us. We contact the physician to change the prescription to a 90-day supply dispensed through the mail pharmacy.
	From this research, as well as our other research into member engagement, we know that times of transition are particularly important and impactful for members. That’s why we encourage our payor clients to be sure to deploy toolkit materials at the beginning of a plan year. We also recommend that plans include mail pharmacy messaging throughout the year in member newsletters and mailings and on their website. Keeping mail pharmacy top of mind helps beneficiaries recognize — and remember — it as an option and a desirable solution.

From our focus groups and utilization data, we know that not every beneficiary is a candidate for mail pharmacy. Mail may not be the best fit for people with more complex conditions or those who rely on their pharmacist for help in managing their therapy. But many beneficiaries are highly satisfied with CVS Caremark Mail Service Pharmacy and find it convenient, reliable and cost effective. In our survey of CVS Caremark Mail Service Pharmacy users, 98 percent of current mail pharmacy users planned to continue to receive their prescriptions through the mail. Encouraging mail service trial could be a win for plans and beneficiaries both.