CVS Plans to Tackle More Diseases After Kidney Care Success
(Bloomberg) -- CVS Health Corp. sees its early success in caring for patients with kidney disease as a template for expanding into other therapeutic areas, as the pharmacy giant continues to look for ways to grow beyond drugstores.
Drawing on data from across CVS, including its Aetna insurance business and Caremark drug-benefits unit, as well as other sources, the company in 2019 created dozens of algorithms it says can predict which patients could develop kidney disease, and when. People with chronic ailments such as diabetes or hypertension can develop kidney problems, adding to the cost and complication of caring for them.
Health plans can enroll their members in CVS’s kidney-care program. CVS reaches out to the patients its algorithms identifies about having a doctor assess their risk of kidney disease. About half choose to do so, CVS pharmacy-benefits executive Alan Lotvin said in an interview.
Lotvin said CVS patients are roughly twice as likely to receive dialysis in their homes as typical kidney patients. A small test in one market showed enrolling people in CVS’s program cut the cost of hospitalization by $4,000 per person a year, according to Lotvin.
Even before patients are sick enough to need to go to the hospital, treating chronic kidney disease can be costly. Patients often need to travel as often as several times a week to dialysis centers to receive the blood-cleaning treatment. Dialysis costs roughly $90,000 per person annually, according to the U.S. Renal Data System 2019 annual data report.
However, home treatment options have expanded in recent years and they tend to be less expensive. Policy makers have tried to encourage at-home dialysis as a cost-saving measure; last year the Trump administration took steps to expand the types of home kidney care that Medicare will pay for.
Company executives plan to provide further details on its accelerating push into primary care at an investor day on Thursday, Lotvin said. For example, CVS wants to more closely link primary-care centers with its HealthHubs. CVS introduced the HealthHubs, which offer more medical services than its traditional CVS drugstores, in 2019 after closing its acquisition of Aetna.
While shifting into more areas of patient care could help better insulate CVS from competitive pressure in retail, where companies like Amazon.com Inc. are increasingly drawing away drugstore customers, muscular competitors loom elsewhere. Rival insurer UnitedHealth Group Inc. has been expanding its primary-care business, and dialysis is dominated by entrenched players like Fresenius SE and DaVita Inc.
Lotvin said CVS’s success in kidney care so far is gratifying because it is one of the most complex diseases to manage. That gives CVS confidence it can also help look after other less complex chronic conditions, such as high cholesterol.
“We’ve demonstrated that we can connect all the different parts of our organization -- care management, insurance, local network contracting, kidney dialysis expertise -- and create better outcomes,” Lotvin said.
©2021 Bloomberg L.P.