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We are lowering costs

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A focus on chronic disease management, avoidable hospital readmissions, and site-of-care management are core to our medical cost savings strategy.

Numerous studies estimate that up to $500 billion, or 25 percent, of the total annual spend on chronic conditions in the United States is avoidable. Through CVS Health’s combination with Aetna, along with our other integrated assets, we are developing solutions to meaningfully reduce that figure. For example, we have targeted better management of five common chronic conditions: diabetes, cardiovascular disease, hypertension, asthma, and behavioral health. We’ll accomplish this through, among other things, tighter integration of pharmacy and medical benefits, rich clinical data, and initiatives we are implementing in our CVS Pharmacy® locations.

In-store pharmacists have already started providing adherence outreach and counseling to Aetna members identified to be at high risk for an adverse health event. We’ve also launched a specialized program to help support Aetna members being treated for cardiovascular disease. We expect to make these offerings available to our health care partners as well as through an open platform model.

To reduce costly hospital readmissions, we are utilizing Aetna’s clinical programs to identify at-risk patients at the point of discharge and by engaging them in our stores. In one pilot, we are enabling Aetna care managers to facilitate the scheduling of MinuteClinic® follow-up visits within 14 days post-discharge when patients are unable to see their provider. And through our Coram® infusion services, we are increasing utilization of lower-cost sites of care, including the home where appropriate. The hospital readmission rate for Coram infusion patients nationwide is nearly half that of the national average for patients receiving care at inpatient settings.

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Approximately

60%

of American adults live with a chronic condition

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Nearly

90%

of health care spend is on people with a chronic condition

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Up to

25%

of chronic care spend is preventable

Aetna had

470,000

hospital discharges in 2017;

47,000

were readmitted at an average cost of

$14,000.

If readmissions were reduced by 50%, we’d remove

$300 million

in costs and create a better patient experience.

karen lynch

“Waste is pervasive in our health care system, and inefficiencies in the delivery of goods and services lead to avoidable health care costs. When you combine the strength of Aetna’s products and services with CVS Health’s local community footprint, we are in the strongest position to develop solutions that reduce spending, decrease complexity, and positively impact consumer health.”
Karen S. Lynch
Executive Vice President and President – Aetna