Reprinted from DRUG BENEFIT NEWS, biweekly news and proven
cost management strategies for health plans, PBMs, pharma companies and
employers.
By Angela
Maas, Managing Editor
July 14, 2017 Volume 18 Issue 13
Cigna Corp. recently unveiled a partnership with CVS Health
through which the health plan says it hopes to provide more value to its
self-funded employer-sponsored health plans and their members. Industry experts
maintain that the program likely will be of interest to employers, as it should
help their members take more control of their own health care.
Cigna Health Works “aligns Cigna-administered health benefits with
CVS Pharmacy and CVS MinuteClinic retail health care services,” say the
companies. Among the services the partnership will offer are:
·
Health
Tag Messages included on prescription bags. These messages “will feature health action
messaging based on benefits information specific to their Cigna health plan,
such as reminders for when to use retail care vs. the ER or urgent care,
reminders of incentive-based health actions, such as getting an A1C test or
biometrics screening, as well as clinician- and pharmacist-provided
information, such as when to engage with a Cigna health coach or information to
find an in-network primary care physician,” explains Michele Paige, vice
president and general manager of Cigna Onsite Health.
·
Discounts
offered at MinuteClinics for certain types of services. “Through this collaboration, Cigna members
will receive contracted discounts for select preventive and acute care
services,” says Carolyn Castel, a spokesperson for CVS. “For example,
MinuteClinic practitioners can diagnose, treat and write prescriptions for
minor illnesses or injuries such as bronchitis, ear infections, pink eye, flu,
strep throat, urinary or bladder infections, minor burns and cuts, insect
stings and more,” as well as offer biometric screenings for blood pressure,
cholesterol and blood sugar.
·
20%
discount provided on CVS brand over-the-counter health products.
·
The
potential to “couple” the program with Cigna 90 Now, which provides 90-day refills for
maintenance prescriptions.
According to Paige, allowing Cigna’s customers to be able to get
routine care at locations they prefer will give them “a stronger connection to
their Cigna health plan benefits. This way we can share relevant health action
messages that can enable them to conveniently access health and wellness
incentives.”
Cigna’s clients will benefit “with a more wired experience at
retail pharmacy and routine care locations because Cigna can extend health
action messages to encourage their employees to be more aware and engaged in
lower cost services for the routine care, plus help their employees gain access
to a Cigna contracted primary care physician,” she says.
Similar efforts have been seen in the industry, say sources. “We
are aware of various efforts by some clients to create biometric screening
partnerships offered through CVS as well as some other retailers with health
clinics,” says Nick Taylor, senior pharmacy benefits consultant for The Segal
Group. “There also have been various offerings by companies to provide onsite
health clinics/coaches that would be similar in nature to what this partnership
is attempting to achieve. Some have very good outcomes while others view it as
a nice-to-have service.”
F. Randy Vogenberg, principal at the Institute for Integrated Healthcare,
points to similar collaborations between CVS and Aetna Inc. (DBN
5/5/17, p. 3), Prime Therapeutics LLC and Walgreens Boots Alliance (DBN
4/7/17, p. 4), and UnitedHealthcare and various partners, noting that “all
are trying out different combinations and selected partners strategically.
Nobody’s really sure who is the big winner, but the battle over lives has
heated up,” he maintains.
Josh Golden, area senior vice president, client development at
Arthur J. Gallagher & Co.’s Solid Benefit Guidance consulting arm, tells
AIS Health that “this is actually somewhat similar to the 90-day retail deal
that CVS struck with OptumRx, albeit with some additional bells and whistles
tacked on. It’s another example of CVS Pharmacy attempting to expand their reach
and presence in the supply chain. You could argue that this might empower Cigna
to challenge CVS Health a bit more on the PBM side. Like the OptumRx-CVS deal,
it puts some unique CVS retail offerings in the hands of yet another CVS Health
PBM competitor.”
“I think what you will find across the industry is companies that
specialize and/or offer components of this suite of services — but no one
organization that offers all of it,” maintains Vanessa Hatch, Pharm.D., vice
president of clinical solutions for PSG Insights & Consulting. “This is a
unique business model that currently only [CVS Health] can leverage ‘under one
roof’ per se. Typically, a health plan or employer would need to collaborate
with several companies if they wish to have a similar type of initiative in
place.”
Hatch tells AIS Health that “health plans have, however, looked to
lower-cost preventive and acute care channels before, for example telehealth.
Other similar partnerships could certainly materialize as insurers and
providers continue to seek cost-effective routine care options that appeal to
both employers and employees. It would be interesting to see a similar
collaboration that more directly addresses the component of health care
inflation that is increasing at the highest rate — prescription drug costs.”
For Cigna Health Works, “What’s unique in our approach is our
go-to-market strategy where we’re sharing our Cigna analytics to create a
better experience for our customers — and creating a more holistic approach
across all the ways a customer may access care within the retail drugstore —
across MinuteClinic, pharmacy, health purchases and engaging our customers for
a more connected health care experience,” explains Paige. “CVS can best add to
what they do with other carriers or Caremark in this regard. But for Cigna,
leveraging our health insights and actions that are directly connected to our
clients’ health care benefits plans is designed specifically to ensure their
employees/our customers have more value and a better experience when they
access care and services under their plan.”
Vogenberg, who is also founding partner of the National Institute
of Collaborative Healthcare, tells AIS Health that the partnership offers
existing clients value-added services, and “if looking to change, there is some
opportunity to show some value add.” The offering, he says, is “clearly
targeted against Walgreens by CVS,” adding that “bringing in the local
convenience of MinuteClinic could be attractive in selective markets.”
“From the consumer perspective, the ability to save some money
when accessing health benefits and/or purchasing ‘everyday’ products — i.e.,
vitamins, pain relievers — as well as having another, lower cost and
potentially more convenient option for routine healthcare via the MinuteClinic
versus an urgent care center is appealing,” says Hatch. “From the health care
industry perspective, there has been a paradigm shift toward consumerism and
having the consumer make more cost-conscious decisions for health care —
perceived as cost shifting by some. This collaboration puts the consumer in a
controlling position, but also facilitates decision making by providing access
to quality, cost-effective wellness, acute care and prescription drug
services.”
According to Taylor, “The most appealing part of this partnership
for me is the enhanced ability to engage patients and educate them about other
programs/services offered as part of their health care benefits. Patients trust
pharmacists, and if CVS is able to train their pharmacists to effectively
engage the patient and highlight the value of these other services like health
and wellness coaches, then you may see higher engagement rates from patients
without constantly chasing people on the phone or with text/email messages. One
of the biggest problems for carriers like Cigna is effectively engaging
patients, which is traditionally and primarily done on the phone or via
electronic or mail messaging.”
“This new level of collaboration with Cigna is a part of a growing
trend toward consumer-directed care,” Castel tells AIS Health. “By providing
information and cues for CVS customers and patients to help them get the most
from their Cigna-administered health benefits, we also help them improve their
health and reduce their health care costs in a way that’s easy and convenient.
CVS Pharmacy is in the midst of broadening its dialogue with PBMs and health
plans to demonstrate the value that we bring through our suite of enterprise
assets.”
How Should Employers Respond?
“This arrangement should be fairly well-received in the marketplace,”
says Golden. “Assuming Cigna offers up this arrangement without a fee, adoption
rates should be pretty high.” The payer did not respond to an AIS Health
question about whether there is a cost to participate in the program.
“We anticipate a fairly positive response,” says Hatch, who points
out that the program will allow employers “to demonstrate a vested interest in
the overall wellness and health of their employees by providing access to
health-related tools, services and benefits in a cost-effective,
consumer-friendly and convenient manner.” However, she adds, “on the flip side,
some employers may view the overall medical cost containment value of the
offering as somewhat limited given the specific types of conditions that can be
treated and the restricted accessibility to MinuteClinic locations.”
“Employers that are struggling with low engagement, rising health
care costs and high utilization of emergency rooms and urgent care for routine
preventative and acute care will be very interested in leveraging this
partnership,” Taylor tells AIS Health. “It all really depends on access to a
CVS store and stores that have MinuteClinics, as not all CVS locations include
MinuteClinics. Employers will like the sharing of information and the
collaboration to lower health care cost for select services and helping
patients to further understand what is available to them on their health care
journey.”
CVS and Cigna seem to have kept geographic considerations in mind
as they roll out the program. The partnership is starting “with a limited
market introduction,” says Paige, initially “targeting markets where there is
the most acute need and where there is a strong saturation of CVS pharmacies
and MinuteClinics.” She tells AIS Health there has been “immediate market
interest.”
https://aishealth.com/archive/ndbn071417-03?utm_source=Real%20Magnet&utm_medium=email&utm_campaign=114575909
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