CVS Health (a Fair360, formerly DiversityInc Noteworthy Company) has introduced Transform Diabetes Care, a new program available to help the company’s pharmacy benefit management (PBM) clients improve the health outcomes of their members, lower pharmacy costs through aggressive trend management and decrease medical costs by improving medication adherence, A1C control and lifestyle management.
This program, which will be available in early 2017, emphasizes tailored support for members with diabetes and incorporates both clinical care and cost management solutions, including a single-digit client trend guarantee for medicines in the antidiabetic category. In fact, participating clients could save between $3,000 to $5,000 per year for each member who successfully improves control of their diabetes.
“The Transform Diabetes Care program focuses on three key components to help improve outcomes and reduce overall health care spend in diabetes: medication adherence, A1C control and lifestyle management,” said Troyen A. Brennan, MD, Chief Medical Officer of CVS Health.
“What’s unique about this program is that at CVS Health we are able to marshal resources across our enterprise and provide a high level of personalized support and care via multiple touch points. What makes our face-to-face counseling and education at our more than 9,600 pharmacy locations and more than 1,100 MinuteClinic locations so effective is that it happens when patients are already thinking about their health.”
The Transform Diabetes Care program uses advanced analytics to identify unique improvement opportunities for enrolled members and leverages the company’s Health Engagement Engine to enable more effective outreach by identifying and prompting personalized counseling opportunities. Enrolled members will receive highly personalized support and coaching to help improve medication adherence, better track and control A1C levels and support healthy lifestyle behaviors through CVS Health consumer touch points.
These interventions will be delivered to enrolled members, at no extra cost, either in person at CVS Pharmacy, or by telephone, and members will also receive free comprehensive diabetes visits at MinuteClinic locationsat no out-of-pocket cost, including A1C checks. In addition, members will be offered a connected glucometer, which will share their blood glucose levels with a pharmacist-led team via a health cloud, enabling the team to identify potential issues and intervene with one-on-one coaching. Members also have access to digital tools within the CVS Pharmacy mobile app, such as medication refill reminders and the ability to refill a prescription via two-way text messaging, to help reduce the complexity of daily disease management.
“In 2016 antidiabetic drugs were the leading driver of gross costs for our clients,” said Jonathan Roberts, President of CVS Caremark. “The Transform Diabetes Care program will enable us to help our clients manage the unsustainable increases in the cost of diabetes care by maximizing the value and effectiveness of our engagement with patients to improve clinical outcomes, while also employing strategic approaches to actively manage and control costs.”
Clients enrolled in the Transform Diabetes Care program will have a year-over-year drug trend guarantee in the single digits for the antidiabetic drug category, which will vary based on the plan population’s demographics and current spend profile. In addition, the program has a managed pharmacy network for drugs to treat diabetes, which includes all CVS Pharmacy locations and CVS Caremark Mail Service Pharmacy. This will help simplify medication refills, improve coordination of care with the member’s primary care providers and help members stay engaged with their therapy and additional clinical services offered by the program.
The Transform Diabetes Care program, the first in a new suite of Transform Care programs focused on managing costly, chronic conditions, expands the suite of diabetes programs and services already provided by CVS Health. Studies have shown that through better lifestyle management, medication adherence and control of A1C, health can improve and medical costs can be significantly reduced. In fact, the CVS Health Pharmacy Advisor Counseling program has shown a nearly 10 percent increase in optimal medication adherence for enrolled members with diabetes.
