Three Targets, Four Tools to Improve Outcomes

With our local presence, CVS Health can help improve outcomes by complementing the care of the primary physician

VIDEO (6:39)
May 24, 2018
Executive Vice President, Chief Medical Officer, CVS Health

Chronic disease is growing, and our ability to pay for it is shrinking. We expect to hit a crisis point in the next decade. That’s why we’re taking steps now to try to provide better quality care and, as a result, lower overall health care costs.

We’ve identified three initial targets. First is five common chronic diseases: diabetes, hypertension, hyperlipidemia, asthma, and depression. We know these conditions are not being managed very well, and what’s missing is often basic primary care. We believe we can help people better manage these conditions.

Our second target is the fragile patient. In any employer group, we find that a small fraction of the population accounts for a disproportionate amount of spending. Using advanced analytics, we can identify these individuals and identify when they may be entering a stage at which they’re going to incur much greater spending than they have in the past. By staying in touch with these individuals and doing the appropriate outreach, we believe we can help these individuals avoid costly adverse events.

Our third target is to better manage transitions in care. We want to reduce unneeded emergency department (ED) visits and readmissions to the hospital. The average ED visit costs about $1,200. Over 25 percent of these visits are preventable.“How Much Will I Get Charged for This?” Patient Charges for Top Ten Diagnoses in the Emergency Department. Published February 27, 2013. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0055491. By expanding urgent care services at MinuteClinic and identifying people at risk of unneeded ED visits, we can help them seek more appropriate care settings and avoid unnecessary use of the ED.

Most of the people who are readmitted to the hospital never see or talk to a health care provider between leaving the hospital and being readmitted. We want to identify individuals at risk for readmission while they are still in the hospital, and make sure that they’re on the appropriate medications. In some cases, we may send them to MinuteClinic so we can make sure the everything is set up for them at home and that they understand their recovery instructions. Such steps can help them remain at home and avoid readmissions.

The tools we’ll use to effect these changes are based in our enterprise assets. In our retail locations, we’ll continue to add more areas of healthcare such as audiometry and optometry, but we will also focus on care coordination services, complementing the care of the primary physician. Our MinuteClinic nurse practitioners will take on more of the role of a population health management nurse, and we’re going to expand the information available to the pharmacist. We will also enhance our digital outreach to patients and expand telemedicine services. Using connected technology, we’ll be able to better monitor how patients are managing their conditions.

Across all these areas, we will make sure we stay connected to the provider. Information from our interventions will go into the electronic medical record, so the primary care physician can follow what’s going on. We see our role as complementing the care provided by the patient’s primary care physician.

Overall, we intend to fuse digital engagement with face-to-face support enabled by our locations. We’re focused on helping to reduce cost by improving quality of care.

View more 2018 Forum highlights here.

Could complementary care help your members manage chronic conditions? Ask Us
VIDEO (6:39)
May 24, 2018
Executive Vice President, Chief Medical Officer, CVS Health

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Image source: CVS Health, 2018.