Cardio wellness support: a new approach to pharmacy networks


Wednesday, October 2, 2019 | By Justin Kaiser, SVP Pharmacy Network and Analytics

Cardio wellness support: a new approach to pharmacy networks

According to the CDC, one in every four U.S. deaths can be attributed to cardiovascular disease (CVD).1  Couple that with the tremendous cost—about one in every six U.S. healthcare dollars is spent on CVD2—and it is safe to say that CVD is a devastating, nearly ubiquitous issue in our society. No single drug, procedure, exercise regimen, stress-relief technique or diet is going to eliminate CVD. It’s going to take creative thinking and teamwork to make an impact.

That’s why, when the healthcare community collaborates across unexpected vantage points, it’s exciting. Collaboration paves the way for possibility…new paths that can reduce the burden that conditions like CVD place on us all. Where will the next collaboration come from?

Dieticians and Pharmacists: Joining Forces in the fight against CVD

It’s a well-established fact that diet is a risk factor for CVD, and that registered dieticians are highly qualified to support patients with CVD-related conditions. When registered dieticians work with patients at risk for CVD, they focus on the role nutrition plays in limiting or reversing disease progression.

Another risk factor for CVD is medication nonadherence.3 Factors that influence nonadherence can include everything from the fear of side effects, to an incomplete understanding between patient and physician, to prohibitively high out-of-pocket costs3. Like dieticians, pharmacists are highly qualified to support patients at risk for CVD. However, pharmacists often focus on CVD through a different lens, which involves dispensing prescribed medications safely and supporting adherence through patient-care to help control disease.

Clearly, patients can find valuable support from each discipline separately. Imagine what could happen if they had access to both through their health plan: A patient who is working with a pharmacist and a dietician has the opportunity to gain an understanding of how medications and diet work together to improve health and quality of life while reducing the risk of CVD complications.

The SS&C Health Cardio Wellness Network is a limited pharmacy network that offers specialized services to help identify and mitigate risk for members with high blood pressure, high cholesterol and diabetes—all conditions that lead to CVD, a major driver of drug and medical spend for health plans.

We partner with major retail stores that offer grocery and pharmacy-embedded solutions and provide access to registered dieticians as part of corporate wellness divisions. Through the pharmacy benefit, targeted members get to meet with these registered dieticians to receive customized, condition-specific support such as:

  • grocery store tours designed to help them find the foods best for their condition
  • nutritional planning
  • goal-setting support
  • label-reading education
  • personalized product recommendations

Concurrently, in-store pharmacists are able to offer screenings and biometric testing services. Each targeted member may receive a Comprehensive Medication Review (CMR) where the pharmacist gains a fuller understanding of the patient’s health history and monitors for harmful drug interactions and barriers to adherence.

The SS&C Health Cardio Wellness Network is a creative approach to limited pharmacy networks because it leverages in-store expertise and resources in a new way. It allows pharmacists and dieticians to join forces on behalf of patients, enhancing the positive impacts that each can bring to improve member health. Further, it allows plans to offer a powerful and unexpected combination of services and perks designed to improve adherence, reduce the total cost of care, and increase member satisfaction.

Learn more about the SS&C Health Cardio Wellness Network.

 

1. Centers for Disease Control, Heart Disease Facts, https://www.cdc.gov/heartdisease/facts.htm Accessed July 2, 2019.

2. CDC Foundation, Heart Disease and Stroke Cost America Nearly $1 Billion a Day in Medical Costs, Lost Productivity, https://www.cdcfoundation.org/pr/2015/heart-disease-and-stroke-cost-america-nearly-1-billion-day-medical-costs-lost-productivity  April 29, 2015. Accessed July 2, 2019.

3. American Heart Association, A Tough Pill to Swallow: Medication Adherence and Cardiovascular Disease, https://www.heart.org/idc/groups/heart-public/@wcm/@adv/documents/downloadable/ucm_460769.pdf, Accessed July 2, 2019.



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