- Programs & Services
- Cost Management
- Specialty Management
- Care Management
- Member Engagement
- Health Plan Client Engagement
Our success in helping people on the path to better health depends on how well we engage members and encourage them to take the right steps.
Our mission is at the heart of everything we do at CVS Health. Our success, and yours, comes down to how well we engage members, encourage them to care about their health, and take action to improve it. And to truly engage members, it is important to recognize that each member is on a unique journey that changes and evolves over time.
With the ongoing increase in health care costs, payors need opportunities to improve outcomes and better manage costs. Whether that involves starting on a new pharmacy benefit plan, making a formulary change or moving to a performance-based network, such moments of change are some of the best opportunities to engage members. For smooth transitions at every point in the member’s experience, we concentrate our efforts on the right communications that achieve the greatest impact. And we recognize that one size does not fit all.
Our member engagement approach is carefully designed to target every key moment of transition — when a member is new to CVS Caremark, when there’s a change in their pharmacy benefit plan, and when a member receives a new diagnosis and starts a new prescription.
For every transition we integrate what we’ve learned from our experience with tens of millions of members over the years. We know that the first 90 days are critical in influencing a member’s decisions about many things: where to fill their prescriptions, whether to continue therapy after their first fill, even whether to use digital tools to manage their prescriptions. That’s why we concentrate on early outreach for a great start.
When welcoming new members, we work with clients to understand their plan members and their needs. For members with complex regimens — including those using specialty medications – our high-touch program is designed to conduct early, proactive outreach to help minimize concerns and ensure a seamless experience.
Benefit Plan Changes
Changes to formulary or network design can help reduce costs, but may also be disruptive to some members. Targeted communications can help members understand the benefit change and why it’s being made. That way, they are more likely to make the best use of their benefit with minimal interruption to any ongoing therapy.
Our Differentiated Approach
Every member’s health care journey is unique. That means the engagement approach needs to be personal. Our engagement programs and processes leverage our many touch points and the expertise and skill of CVS Health staff. We’ve also invested in technology and integration that allows us to connect with members at the moment they are thinking about their health — the right time to influence behaviors – through a channel of their choosing.
Digital technologies and devices are where many of us are the most engaged today. More than 64 percent of patients use a digital device to manage their health, and 71 percent believe it would be helpful for their doctor to have access to their information.
About 45 million members engage with us digitally using our tools to manage their prescriptions, find lower-cost alternatives and stay on track with their drug therapy. Our data indicates that digitally engaged members are as much as 7 percent more adherent, have lower costs, and make fewer calls into Customer Care.
Predictive Analytics for Better Results
We utilize data and predictive analytics to understand which members are likely to need extra help and how often, as well as the best time and what channels to use. We also regularly conduct interviews and focus groups with members to ensure that communication materials are clear and effective.
We have invested in systems and resources to enable appropriate outreach. The Health Engagement Engine is a powerful clinical rules engine that integrates our enterprise assets, providing real-time, actionable health care information. It aggregates data from internal and payor sources, and enables our more than 30,000 pharmacists and clinicians to have important conversations with members to help improve health outcomes.
A short video about how the work CVS Health is doing is so meaningful to so many. Watch Video
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Savings, trend changes and clinical results will vary by client depending on member demographics and other factors. Client-specific modeling available upon request.
Unless otherwise noted, all data is from CVS Health Enterprise Analytics.
CVS Health uses and shares data as allowed by applicable law, and by our agreements and our information firewall.