We look at CVS Health’s rash of recent clinical affiliations and dig into the nuts and bolts of sharing patient data to improve access and cut costs.
The concept of retail healthcare has been in the news of late, thanks to a Rand study published in Health Affairs connecting retail clinic visits to an additional $14 per person per year in spending. Multiply that $14 by the more than 6 million patients these clinics care for annually and the costs really begin to add up.
The uptick seems to derive from the easier access to care. Patients who may have otherwise delayed care or suffered in silence are now taking advantage of less-expensive retail clinics around the corner, resulting in an increase in the total number of patient visits and thus spending.
The study also found that nearly 60 percent of retail clinic visits were made by first-time customers, a statistic that negates the much-hoped for idea that savvy healthcare consumers would turn to lower-cost retail clinics for common ailments in lieu of paying higher prices at primary care offices or the ED.
The number of nationwide retail clinics hovers around 2,000 and is expected to reach 2,800 by 2017. CVS Health MinuteClinics account for over half of this figure, meaning that the company has a big part to play in increasing access to care within and outside the four walls of its clinics – not to mention lowering that $14 figure.
Focusing on Family Medicine
Headquartered in Woonsocket, RI, CVS Health seems to be well aware of the part it can play in impacting access and costs. The company has made strides in its efforts to establish care coordination between its clinics and local PCPs. Last fall, it partnered with the “Health Is Primary” campaign to help patients understand how different parts of the healthcare system work in their “medical neighborhood” and to better enable to them to access those services – including finding a PCP – when appropriate.
“We know that patient health and outcomes improve when patients utilize the resources available to them throughout the medical neighborhood and when providers across the healthcare system are working together,” CVS Health EVP and Associate CMO Andrew Sussman, MD said in a release last fall. “By partnering with primary care and family medicine, we will continue to improve provider collaboration and help ensure all patients have access to primary care within a coordinated medical neighborhood.”
Looking for Larger Affiliates
CVS Health has not focused its care coordination efforts solely on family medicine. It has established over 70 clinical affiliations with major health systems and providers across the country, including relationships announced last year with St. Luke’s University Health Network (PA), TriHealth (OH), Tucson Medical Center (AZ), and Rush University Medical Center (IL). More recent affiliations include John Muir Health (CA), University of Chicago Medical Center (IL), Novant Health (NC), and University of Michigan Health System.
“We have been working with these leading healthcare organizations to establish clinical collaborations that improve access to care and overall community health, which ultimately also help to reduce healthcare costs,” says CVS Health Corporate Marketing Manager Christina Beckerman. “Now that the agreements are in place, we are pleased to begin working with our affiliates to improve chronic disease management and pharmacy care in the communities served by these healthcare organizations.”
The health system affiliations focus on an umbrella of care coordination, under which fall sharing patient health data between participant EHRs, improving medication adherence via collaboration with CVS pharmacists, ensuring that MinuteClinic patients follow up with their PCPs when needed, and planning strategies around chronic care and wellness.
“Now that the agreements with these organizations are complete, we are establishing timelines with each healthcare organization and working together to implement our plans,” says Beckerman. “In the near-term,” she adds, “our focus is working towards streamlining communication between our secured EHR systems. Over the long term, we believe that through this collaboration, our patients will have access to better pharmacy care and to coordinated, primary care support to help them on their path to better health.”
The Epic-ness Of It All
Froedtert & the Medical College of Wisconsin health network joined the CVS Health affiliate family last month. The regional organization is a partnership between Froedtert Health and MCW, both of which are based in Wauwatosa, about 90 minutes away from Epic headquarters in Verona. The network includes Froedtert Hospital, Community Memorial Hospital, and St. Joseph’s Hospital, plus 25 primary and specialty care clinics.
F&MCW’s decision to affiliate with CVS Health was based on the need to “meet people where they are,” according to Jonathon Truwit, MD, enterprise CMO at F&MCW. “Increasingly, people are getting healthcare services in places other than healthcare systems, from retail systems to shopping malls. We want to assure our patient care is coordinated no matter where they seek care because that’s best for our patients. By entering into this affiliation, we make healthcare more accessible, timely, and effective. CVS is a leader in retail healthcare and a natural partner for us.”
The IT nuts and bolts of such an affiliation seem straightforward, given that both CVS Health and F&MCW use Epic, as do all of the aforementioned affiliates. “The affiliation uses existing EHRs and is limited to certain portions that are securely integrated,” he explains. “When our systems are integrated, the secure data sharing between the F&MCW network and CVS MinuteClinics will enable a collaboration that will extend our approach to team care. The goal of this clinical affiliation is to assure care is coordinated and patients receive the right care at the right time, no matter where they are. It is likely our early work will involve efforts to help patients manage chronic conditions such as high blood pressure and diabetes.”
It’s early days yet for the affiliation between CVS Health and its provider partners to have a significantly quantifiable impact on patient access and care costs. Truly giant strides in care coordination seem inevitable if and when CVS Health chooses to affiliate itself with organizations outside of Epic’s client cluster, though some would argue it’s a moot point given the provider community’s currently headline-heavy preference for Epic systems.
Perhaps such partnerships will ultimately nudge that previously mentioned $14 down as a result of more educated patients, better care coordination, and fewer reasons to seek care thanks to improved outcomes. As Truwit reiterates, “[T]he intent of this affiliation is to enhance coordination of care for our patients.” A decrease in costs would seem like a natural – and welcome – result.