In the last two years, many health plans have turned an eye to health disparities magnified by the pandemic. But how do you actually address the impact of these structural inequities on people’s health?
CVS Caremark is starting by focusing on addressing inequities across three conditions: sickle cell disease, HIV and cardiovascular disease. The company’s goal is to improve awareness, access to health services and treatment.
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“What we see with health disparities is that there are structural challenges to helping people achieve their health outcomes,” CVS Caremark Chief Medical Officer Dr. Sree Chaguturu said in a discussion at HLTH’s engagement track. “They tend to be seen at race and ethnicity, but it’s broader than race and ethnicity — it’s about housing, transportation, food security…”
CVS’ approach has been to see how it can use the different components of its business, such as its pharmacists, insurance plans and in-store clinics, to help people achieve the health outcomes they want in spite of these barriers.
The company is also partnering with community organizations and patient advocacy groups to figure out the best approach, Chaguturu said.
When it started this initiative, CVS compiled more than 400 different data elements to help plan sponsors better understand the extent of social disparities in their population. It then focused on three initiatives to start:
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- Doubling the number of patients taking hydroxyurea, a generic medication for sickle cell disease, and increasing trait testing.
- Increasing awareness about HIV testing and prevention, and working with stakeholders to increase access to PrEP medication.
- For patients with high blood pressure, increasing the start of medication therapy among people facing health disparities, and ensuring those already on treatment are taking the optimal dose.
“These initiatives are really about bringing together stakeholders… working in communities to increase testing and awareness around the drugs, providing services, and measure the improvement in access to medications and treatments over time,” he said. “We just launched this initiative and we’re really excited about making this just part of what we do.”
CVS is also partnering with health plans sponsors in communities with high burdens of HIV or sickle cell disease to accelerate this work.
Although it’s too early to measure the results, in the future, it plans to expand the model to additional health conditions. CVS plans to do so by partnering with physician groups, patient advocacy groups and plan sponsors.
In particular, CVS is looking to address health conditions that disproportionately affect people of color in the U.S., that have significant disparities in health outcomes, and where CVS can use its different lines of business to improve people’s health.
“We didn’t get here in five or 10 years. It’s been decades, centuries of unfortunate destruction of our social safety net and barriers to access to care,” Chaguturu said. “My hope is that in five to 10 years that we’ve made substantial progress, but knowing this is going to be decades of work for us to address.”
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