A COMPREHENSIVE APPROACH TO PHARMACY PRESCRIPTION SERVICES

CVS Health has a rich data foundation, starting with the data from pharmacy claims that get processed every year, combined with data on the customer visits to its pharmacies and MinuteClinics, along with payor data from Aetna. Essentially, all these data are connected and organized, linked to events and encounters that help to provide context, making it very useful in determining recommendations and next best actions.  

CVS Health has a deep healthcare understanding with the members in its care, which comprises not only clinical knowledge about care processes but also an understanding of members' benefit design. For instance, an intervention or recommendation that conflicts with a member’s benefit design, or does not reflect where the member is in his care journey, is not helpful.  

CVS Health has invested in artificial intelligence and machine learning processes that power deep analytics, going far beyond risk stratification and predictive models. CVS Health wants to look at the combination of factors that impact the effectiveness of its outreach and support, and the best way to drive action.  

CVS Health has the ability to deliver curated messages to the right people, creating meaningful care encounters for a member when the member is already part of a familiar care team, a way to directly enhance the power of the human touch. The approach also incorporates a feedback loop so that CVS Health can monitor and learn more about what works and what does not.