CVS Health had a big year in 2019, combining with health insurer Aetna following its $69 billion merger and expanding a new store concept with expanded healthcare services. For 2020, the company has laid out a number of trends in the industry and several challenges it will work to address in the communities served, including chronic kidney disease care, social determinants of health, poverty and lack of healthcare access, and consumer preferences and engagement.
These trends were outlined in CVS Health’s Trends Report 2020, which states that the national conversation has been engrossed by healthcare as the 2020 election looms.
“These forces will help shape the profession in the front line of hospitals and clinics and also every organization that helps to coordinate and support consumer wellness,” the report reads.
Here are the health trends of 2020 as identified by CVS:
Digital revolution expands
Data, called “the new oil,” will continue to be a valuable resource for healthcare providers still learning how to make use of it. CVS is using data in many ways, but also to improve patient behavior, such as sending text messages with medication information to help patients remember to refill their prescriptions and be aware of their side effects. And data-driven medicine is a top priority of the National Institute of Health. Wearable devices can also provide great insights that can be leveraged to improve health outcomes in the years to come.
However, interoperability remains a challenge, and providers still have to figure out ways to sort through all the data they are collecting. This is where machine learning and AI can help. CVS, for example, is using machine learning to calculate “the next best action for a healthcare consumer,” such as suggesting examinations and ways to manage chronic conditions. Companies dealing with sensitive healthcare data also need means to protect the data and be responsible stewards of the information, preferably with guidelines that build trust with consumers and keeping abreast of cybersecurity threats.
“The future of digital medicine has already arrived, and the next steps are to make sure that it rolls out with maximum benefit—and minimum risk—to the consumer,” the report reads.
Kidney care changes
Chronic kidney disease is a huge issue in the U.S., affecting about 30 million Americans who often need costly treatments, such as dialysis. For many years, reimbursable dialysis could only be performed in treatment centers, but regulations are changing and offering more options for kidney care and transplants. The Trump administration recently finalized kidney care rules that will provide more options to Medicare patients when it comes to receiving care and more transplants could become available in the future under new rules and standards.
CVS, as well as other healthcare providers including Humana, are jumping on the opportunity to be a provider for these new types of care. CVS has created a home hemodialysis device, HemoCare, which can filter a patient’s blood at home with proper patient support and safety features. The device is currently in clinical trial.
CVS also aims to improve kidney care by helping patients sooner with earlier interventions through identification, telephonic care coordination and face-to-face nurse education. As the rules around kidney care change, it is likely more healthcare providers will seek ways to better serve patients and lower costs in one of the most expensive areas of the healthcare system.
Connection to combat social isolation
Social isolation has been associated with lower health outcomes and higher care costs, which is why CVS is leveraging community resources to connect identified patients to social programs.
“If we want to help people achieve their best health, we have to look at the whole person, not just their symptoms,” Karen Lynch, president of the Aetna Business Unit and executive vice president of CVS Health, said in the report. “That means understanding and addressing all dimensions of well-being, including mental health and social connectedness.”
Loneliness and social isolation are particularly rampant among older adults, which can be dangerous to their health and longevity. To combat these feelings, Aetna created a Social Isolation Index, which uses claims data and multidimensional information to identify high-risk Medicare patients who may benefit from proactive social programs. The insurer also is involved in other programs, including Meals on Wheels, and CVS launched the Building Healthier Communities initiative to address social determinants of health alongside local partners.
Bridging health gaps with pharmacies
CVS Health wants to leverage its pharmacy touchpoints to do more with consumers, specifically addressing a health gap cause by social determinants of health. Recent research found the richest 1% of Americans like more than a decade longer than the poorest 1% on average, with the growth of income inequality corresponding with the gap in life expectancy.
Access to high-quality healthcare is one cause of this gap, which is why CVS wants to make its retail touchpoints more accessible to consumers. Adding services like education and behavioral counseling to the pharmacy can help with medication management and improved adherence to care plans. CVS’ program Project Health to deliver free healthcare services and screenings to help CVS customers become aware of a health concern or condition that can be better managed early.
“The pharmacist has been an underutilized health care resource and that’s changing in a very meaningful way,” Christine Cassel, an adjunct professor of medicine at the University of California, San Francisco School of Medicine, and a past president of the National Quality Forum, a Washington, D.C.-based nonprofit, said in the report.
Cost transparency to lower drug prices
Rising drug prices are a top concern of Americans and legislators, and the issue will likely be a big topic for the 2020 election. While some efforts have been made by the Trump administration to lower drug prices, hundreds of drug prices shot up again in 2020. However, some new rules, including cost transparency, could help keep drug costs down through increased competition, according to CVS.
“With more transparency about out-of-pocket prices, the public can make smarter choices about their treatments and providers, just as they would when shopping for groceries or an airline ticket,” the report reads.
In particular, doctors should start to give patients estimates of their costs for medications and treatments at the point of care so they can make better decisions for their care plan. High costs play a role in the one-third of prescriptions that never get filled, but knowing the price ahead of time could improve that figure if people were more knowledgeable to ask for a lower-cost option.
Self-care market scrutiny
While self-care has been trending for the last few years, a crackdown on the unregulated market is due, CVS predicted in the report. As more money is spent on fitness, wellness and personal care products and services, retailers need to ensure standards are in place for consumers by testing products. CVS’ Tested to Be Trusted program did just that and reviewed 1,400 supplement products through third-party testing. Some of the products didn’t pass initial testing, with inaccurate claims on the label and other issues, and were pulled from shelves.