CVS Caremark Study: Employers seek to change patient behavior to reduce healthcare costs

WOONSOCKET, R.I. Many employers are focused on ways to change health plan participant behavior and improve engagement, rather than achieving overall savings simply by shifting costs to the members, according to the results of CVS Caremark's annual client survey.

"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," stated Tom Ryan, chairman, president and CEO. "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."

In fact, the research found that 65% of employer clients that participated in the survey indicated that plan design incentives to change behavior were a high priority and 56% mentioned wellness and disease management programs while only 15% of respondents focused on employer cost-share shifting.

The survey was conducted online between Nov. 1, 2008 and Dec. 31, 2008 and includes responses from current CVS Caremark clients representing nearly 300 employers and 10.5 million lives.

The findings, according to CVS Caremark, validate its Proactive Pharmacy Care model, which is designed to help engage members in their healthcare decisions in order to keep them healthier and reduce overall healthcare costs. This approach helps CVS Caremark's PBM clients improve outcomes and manage costs by leveraging such programs as Progressive Plan Design strategies, Maintenance Choice, ExtraCare Health, Specialty Guideline Management, outbound engagement strategies to promote mail 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," Ryan stated.

• Progressive Plan Design: Many of these plan designs incorporate strategies to focus on increasing the use of less expensive generic medications as well as OTC products, where appropriate. In 2008, the CVS Caremark PBM improved its generic dispensing rate from 60% to an average of 65%, which many of the company?s best-in-class clients already achieving rates of more than 70%.
• ExtraCare Health Card: This program provides plan participants with access to discounts on more than 1,300 CVS/pharmacy brand items. Since the beginning of 2009, an additional one million ExtraCare Health Cards have been issued to help plan participants realize savings on their OTC purchases, bringing the total number of cards in circulation to more than seven million since the launch of the program in 2008.
• Maintenance Choice: This program provides clients and their plan participants with the opportunity to realize the cost-savings of mail, along with the flexibility to select the most convenient way to receive medication ‹ either via mail or at a local CVS/pharmacy. There are currently more than 200 clients, representing 2.4 million lives, participating in this program.
• Specialty Guideline Management: This program is designed to prevent inappropriate utilization of highly specialized and expensive medications outside of approved guidelines and indications. This program has helped CVS Caremark clients avoid in excess of $150 million in annual specialty pharmacy costs in 2008.