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CVS mobilizes integrated model for chronic care

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Transform Diabetes Care program leads off new solutions suite


WOONSOCKET, R.I. — Early next year, CVS Health plans to launch a diabetes care program for its pharmacy benefit management (PBM) clients that provides clinical services and cost management solutions.

Called Transform Diabetes Care, the program offers members tailored support to improve the health outcomes, reduce pharmacy costs via trend management, and lower medical costs through better medication adherence, A1C control and lifestyle management, CVS said Tuesday. The support is delivered at CVS Pharmacy locations, MinuteClinic health clinics or by telephone.

In addition, Transform Diabetes Care includes a single-digit client trend guarantee for antidiabetic medications. CVS said participating PBM clients could save $3,000 to $5,000 annually for each member who improves control of his or her diabetes.

The diabetes care offering is the first in a new suite of Transform Care programs designed to help manage costly, chronic health conditions, CVS noted.

Transform Diabetes Care centers on medication compliance and A1C and lifestyle management to improve health and rein in the cost of care, according to CVS Health chief medical officer Troyen Brennan.

“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,” Brennan said in a statement. “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.”

Leveraging CVS’ Health Engagement Engine, Transform Diabetes Care employs advanced analytics to identify improvement opportunities for enrolled members and prompt them for personalized counseling. The interventions are provided through CVS Health consumer touch points: in-person at CVS Pharmacy or via phone, at no extra cost. Members also get free comprehensive diabetes visits at MinuteClinics, including A1C checks.

Members, too, are offered a connected glucometer that can share their blood glucose levels with a pharmacist-led team via a health cloud, enabling the team to flag potential issues and intervene with one-on-one coaching. Members can access to digital tools within the CVS Pharmacy mobile app as well, including medication refill reminders and refill orders via two-way text messages.

“In 2016, antidiabetic drugs were the leading driver of gross costs for our clients,” noted 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 Transform Diabetes Care 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, CVS said.

For diabetes medications, the program has a managed pharmacy network that includes all CVS Pharmacy locations and CVS Caremark’s mail service pharmacy. The company said the network will simplify prescription refills, improve coordination of care with primary care providers, and help members stay engaged with their therapy and other clinical services offered by the program.

Studies have demonstrated that better lifestyle management, medication adherence and A1C control can lead to better health outcomes and reduced medical costs, according to CVS. The company said its Pharmacy Advisor counseling program has shown a nearly 10% increase in optimal medication adherence for enrolled members with diabetes.


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