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NEW YORK and WOONSOCKET, R.I. — CVS Caremark has inked a three-year agreement with ActiveHealth Management, an independent subsidiary of Aetna, under which CVS Caremark will apply the evidence-based, clinical intelligence of the ActiveHealth CareEngine to healthcare claims for its PBM customers to identify opportunities for improved pharmacy care.
CVS Caremark will apply the CareEngine to more than 800,000 members beginning in April, with additional membership to be added as CVS Caremark consults with its PBM clients.
"The ActiveHealth CareEngine offers evidence-based information that can be used to improve the health care of our members and enables us to take our programs to the next level by seamlessly incorporating medical data," stated Troyen Brennan, EVP and chief medical officer of CVS Caremark. "This agreement will enhance our existing programs to identify issues related to gaps in care, potential drug-to-drug interactions and duplicative care — information that is important to bring to the attention of the member's physician."
As physicians, the founders and management team of ActiveHealth understand that given the frequency and amount of emerging clinical data, it is challenging for physicians to stay current on every issue that affects their patients. As a result, they created the CareEngine System to address that challenge. Today, ActiveHealth's team of physicians, pharmacists and registered nurses constantly review the latest clinical evidence and guidelines and build them into the CareEngine System. The CareEngine then reviews the available clinical data on patients, compares it with evidence-based guidelines and delivers care considerations, or "care alerts," that physicians can act on to improve care.
ActiveHealth's technology will help CVS Caremark identify and address gaps in care and other opportunities to improve care for its members. Research has shown that when acted upon, ActiveHealth care considerations have demonstrated quality improvements and lower costs. In a study of more than 39,000 individuals, ActiveHealth's clinical decision support technology identified potentially serious medical errors for nearly 1-of-every-20 people, and helped reduce hospitalizations among the study sample by 8.4%
"Initially, these messages will be shared only with members' physicians, but we believe there is an opportunity to improve member engagement and their compliance with pharmacy care recommendations by sharing that information directly with members. This is especially critical for patients with chronic or complex conditions who see multiple physicians and take multiple medications," stated Brennan of CVS Caremark.