Network Strategies

Managed Networks Can Help Reduce Plan Costs.

As payors look to manage plan costs in a very challenging marketplace, measures such as managed network designs can help eliminate waste and deliver savings by decreasing pharmacy redundancy without reducing access. Broad networks may be appropriate for some payors but most don’t need them to help ensure appropriate member access.

Our broadest National Network covers all national chains and most independent pharmacies. However, payors can maintain plan member access with a narrow network based on their specific plan population. Depending on the demographics of their plan population and geographic location, member-based networks and our Exclusive Choice Network can deliver savings.

Want to learn how our solutions can help amplify your cost management? Contact us
Want to learn how our solutions can help amplify your cost management?
 
Contact us

Member-Based Networks

Member-based networks are built around where members are located and are anchored by CVS Pharmacy stores and select independent pharmacies. Members can use one of our CVS retail locations or, if they don’t live close to a CVS Pharmacy, they can use pharmacies from our National Network. Such networks are based on proximity and access and can deliver significant savings. There are two types of member-based networks:

Checkmark CVS Pharmacy Proximity Network: A dynamic network in which members have access to different pharmacies based on their home ZIP code. It includes CVS Pharmacy stores while providing members who don’t live near a CVS Pharmacy access to the national network.
Checkmark CVS Pharmacy Access Based Network: One network in which all members have access to the same set of pharmacies. It includes CVS Pharmacy locations, plus the right number of independent pharmacies needed to provide access to all members.

Maintenance Choice Network

More than $2.6 billion in total client savings over the last three years.

A network that focuses on helping ensure members have access to long-term, maintenance medications can help payors cut costs while maintaining adherence. The Maintenance Choice Network delivers savings by encouraging 90-day fills for maintenance prescriptions and offering mail copays at both CVS Pharmacy retail locations and our mail service pharmacy. This network offers voluntary and mandatory fill requirements at our more than 9,900 retail pharmacies and through mail service.

More than $2.6 billion in total client savings over the last three years.

Exclusive Choice Network

Up to 3.3% gross pharmacy savings.

Designed for clients who want to focus on reducing the redundancy of a broad, 30-day national network, our Exclusive Choice Network is anchored by CVS Pharmacy and two nationwide grocery chains as well as independent pharmacies for a total of 19,000 pharmacies.

Up to 3.3% gross pharmacy savings

Want to learn more about how our managed network strategies can help your plan save money? Ask Us

Projections based on CVS Caremark data. Savings results will vary based on a variety of factors including demographics, plan design and other programs implemented by the client. Client-specific modeling available upon request.

Unless otherwise noted, all data is from CVS Health Enterprise Analytics.  

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