Most of CVS Caremark Corp.’s employer clients say they are more interested in changing health plan participants’ behavior and improving engagement than in programs that save them money by simply shifting costs to members, according to the company’s latest client survey.


CVS Caremark, CVS, Tom Ryan, Proactive Pharmacy Care, PBM, ExtraCare, Maintenance Choice, Specialty Guideline Management program, Geoff Walden












































































































































































































































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CVS Caremark works to increase patient engagement

April 20th, 2009

WOONSOCKET, R.I. – Most of CVS Caremark Corp.’s employer clients say they are more interested in changing health plan participants’ behavior and improving engagement than in programs that save them money by simply shifting costs to members, according to the company’s latest client survey.

Nearly two-thirds of respondents (65%) indicated that plan design incentives to change behavior are a high priority, and 56% mentioned wellness and disease management programs. Only 15% focused on employer cost-share shifting.

“The current economic environment has understandably created a sense of urgency for companies to evaluate their benefit designs in order to meet financial goals, with 74% of our employer clients telling us that reducing overall health costs is their No. 1 measure of success in the coming year,” notes CVS Caremark chairman, president and chief executive officer Tom Ryan.

“Furthermore, our research indicates that our clients are looking to CVS Caremark to help them accomplish these savings by increasing plan participant engagement in their health care rather than simply increasing their share of the cost.”

The CVS Caremark Proactive Pharmacy Care model is designed to help engage members in their health care decisions in order to keep them healthier and help reduce overall health care costs. CVS Caremark’s pharmacy benefits management clients can improve outcomes and manage costs by leveraging such programs as Progressive Plan Design, Maintenance Choice, ExtraCare Health, Specialty Guideline Management, outbound strategies to promote mail order, and adherence-to-care programs.

“As the largest integrated pharmacy health care provider, we are able to leverage our multiple touch points across the continuum of pharmacy care and provide our clients with the most innovative programs to help them manage cost while improving health outcomes,” says Ryan.

Progressive Plan Design strategies are intended to help drive positive behavior change. Many plan designs incorporate strategies to encourage the use of less expensive generic medications and over-the-counter products where appropriate.

In 2008 the CVS Caremark PBM improved its generic dispensing rate from 60% to an average of 65%, and many of the company’s clients achieve rates above 70%. Furthermore, most employer clients in the CVS Caremark client survey indicated they were either already using options to drive generic and O-T-C use in 2009 or were strongly considering implementing these plan designs in the future.

The ExtraCare health card gives plan participants access to discounts on more than 1,300 CVS brand items. The program allows employers to move branded medications with O-T-C equivalents to the highest tiers, thus reinforcing the incentive to use lower-cost drug options.

Since the beginning of 2009, an additional 1 million ExtraCare cards have been issued to help plan participants realize savings on O-T-Cs, bringing the total number of cards in circulation to over 7 million since the program was launched in 2008.

The CVS Caremark Maintenance Choice program lets clients and their plan participants save money by using the mail, while providing flexibility to select the most convenient way to receive medication — either via mail or at a local CVS. Well over 65% of plan participants live within five miles of a CVS store.

This program addresses clients’ priorities concerning convenient access for members (78% of employer clients indicated that having a pharmacy available within five miles is a high or medium priority). It also allows plan participants the opportunity for a face-to-face consultation with their local pharmacist to improve medication adherence (74% indicated that this is a high or medium priority).

Specialty pharmacy costs continue to outpace traditional pharmacy costs, and managing specialty pharmacy is a priority for many clients.

The CVS Caremark Specialty Guideline Management program is designed to prevent inappropriate utilization of highly specialized and expensive medications outside of approved guidelines and indications. The program helped CVS Caremark clients save more than $150 million in specialty pharmacy costs in 2008.

The client survey was conducted online from November 1 through December 31, 2008, and included responses from CVS Caremark clients representing nearly 300 employers and 10.5 million lives.

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