Providing Greater Cost Transparency For Plan Members And Providers

Transcription

Providing greater costtransparency for planmembers and providersReal-time prescription benefitsprovide visibility to memberplan and cost information acrossmultiple points of careDecember 8, 20201 2020 CVS Health and/or one of its affiliates. Confidential and proprietary.

Formulary and plandesign strategies aredriving lower costs formembersNearly 85% ofmembers spent less than 300 on their medicationslast yearCVS Health iscommitted to helpingmembers find themost affordableoptions to keepthem healthySticker shock at thepharmacy can stillhappen The source for data in this presentation is CVS Health Enterprise Analytics unless otherwise noted.Please see the disclaimer page at the end of this presentation for more information.2 2020 CVS Health and/or one of its affiliates. Confidential and proprietary. 53406AGrowth in high deductible health plansmeans consumers shoulder theresponsibility of navigating health andprescription benefit plans to make themost cost-effective choices

Real-time prescriptionbenefits provide greatercost transparency formembers and providersGreater visibility to planmember out-of-pocket (OOP)costs, lower-cost alternativesand benefit informationHelps providers and membersmake more informedtreatment decisionsIntegrated into prescriber’selectronic health record (EHR)and workflow3 2020 CVS Health and/or one of its affiliates. Confidential and proprietary. 53406A

Informing decisions through plan and costtransparency across all member touchpointsWith real-timeprescriptionbenefits, membersand providers will:Our proprietary engine, Script Intelligence, powers our unique database ofclinically mapped therapeutic alternativesKnow if the drug iscovered and the memberOOP costSee up to five clinicallyappropriate alternativesspecific to themember’s plan designPrescribers can alsosee which optionsrequire priorauthorization (PA) orhave other restrictions4Originallysearched drug 18.29Prescribers 2020 CVS Health and/or one of its affiliates. Confidential and proprietary. 53406ACVS pharmacistsCustomer CarerepresentativesAlt 1 4.33Alt 2Alt 3 31.70 6.10Alt 4 22.50PA RequiredDirectly tomembers

Appendix5 2020 CVS Health and/or one of its affiliates. Confidential and proprietary.

Ease of use for prescribersA response on alternativetherapies within1 second on averageAn approval decision onan electronic PA request inas little as 6 secondsThis helps get moreaffordable medications tomembers faster6 2020 CVS Health and/or one of its affiliates. Confidential and proprietary. 53406AReal-time prescription benefitshelp ensure the right prescriptionis written from the start

Access and utilization snapshot – HPP Medicaid/CHIPPrescriber Adoption September 2020Your total numberof prescribersYour total number ofprescribers using real-timeprescription benefits% of your prescribersusing real-timeprescription benefitsvs. CVS Health average(% of prescribers usingreal-time prescription benefits)11,0781,63814.79%30.12%Your totale-prescribedclaimsYour e-prescribed claimsimpacted by real-timeprescription benefits% of your e-prescribedclaims impacted by realtime prescription benefitsvs. CVS Health average (% ofe-prescribed claims impacted byreal-time prescription benefits)300,86325,2338.39%7.04%Your detailed report breaks this information down by market segment,physician geographic location and different time periods.7 2020 CVS Health and/or one of its affiliates. Confidential and proprietary. 53406A

Access and utilization snapshot – HPP MedicarePrescriber Adoption September 2020Your total numberof prescribersYour total number ofprescribers using real-timeprescription benefits% of your prescribersusing real-timeprescription benefitsvs. CVS Health average(% of prescribers usingreal-time prescription benefits)3,96029810.05%30.48%Your totale-prescribedclaimsYour e-prescribed claimsimpacted by real-timeprescription benefits% of your e-prescribedclaims impacted by realtime prescription benefitsvs. CVS Health average (% ofe-prescribed claims impacted byreal-time prescription benefits)84,4883,3343.95%7.10%Your detailed report breaks this information down by market segment,physician geographic location and different time periods.8 2020 CVS Health and/or one of its affiliates. Confidential and proprietary. 53406A

Legal disclaimersThe source for data in this presentation is CVS Health Enterprise Analytics unless otherwise noted.All data sharing complies with applicable law, our information firewall and any applicable contractual limitations.Adherence results and savings projections are based on CVS Caremark data. Actual results may vary depending on benefit plan design, member demographics, programs implemented bythe plan and other factors. Client-specific modeling available upon request.The Maintenance Choice program is available to self-funded employer clients that are subject to ERISA. Non-ERISA plans such as fully insured health plans, plans for city, state orgovernment employees and church plans need CVS Caremark legal approval prior to adopting the Maintenance Choice program. Prices may vary between mail service and CVS Pharmacydue to dispensing factors, such as applicable local or use taxes.Specialty Expedite is available exclusively for providers who use compatible electronic health record (EHR) systems, includin g Epic Systems and others that participate in the CarequalityInteroperability Framework.Specialty delivery options are available where allowed by law. In-store pick up is currently not available in Oklahoma. Puerto Rico requires first-fill prescriptions to be transmitted directly tothe dispensing specialty pharmacy. Products are dispensed by CVS Specialty and certain services are only accessed by calling CVS Specialty directly. Certain specialty medication may notqualify. Services are also available at Long’s Drugs locations.ExtraCare Health program availability subject to Legal and Tax approval. Client adopts the ExtraCare Health Card as part of its plan benefit. Clients must meet Underwriting criteria toimplement the ExtraCare Health Card.Patient stories and patient names are presented for illustrative purposes only. Any resemblance to an actual individual is co incidental. Unless otherwise specified, images contained withinare licensed or the property of CVS Health or one of its affiliates.This presentation contains trademarks or registered trademarks of CVS Pharmacy, Inc. or one of its affiliates; it may also co ntain references to products that are trademarks or registeredtrademarks of entities not affiliated with CVS Health.9 2020 CVS Health and/or one of its affiliates. Confidential and proprietary. 53406A

Real-timebenefitsLauren Doty, Director, Prescriber TechnologySolutionsKevin Smith, Senior Advisor, PrescriberTechnology SolutionsDecember 8, 2020

Real-time benefits at the point of care with tionEnteredNew Steps Highlighted in RedPA (Prior authorization). 2018 Epic Systems Corporation. Used with permission.2 2020 CVS Health and/or one of its affiliates. Confidential and proprietary.53406B2Real-Time BenefitsInformationDisplayed3PrescriptionWritten forAlternative Drug4

Epic real-time benefits overviewPrescriber Completes Script andReal-Time Benefits is Launched The prescriber chooses a drug and completes the scriptby selecting a pharmacy Upon signing, real-time benefits is automatically launched 2018 Epic Systems Corporation. Used with permission.3 2020 CVS Health and/or one of its affiliates. Confidential and proprietary.53406B

Epic real-time benefits overviewPrescriber Reviews Real-Time Benefit Results The real-time benefits screen will clearly show:– Alternative medication options– Member out-of-pocket costs for all medications– Member-specific utilizationmanagement restrictionsfor each drugMember CostAlternativeDrugs 2018 Epic Systems Corporation. Used with permission.4 2020 CVS Health and/or one of its affiliates. Confidential and proprietary.53406B

Epic real-time benefits overviewPrescriber Selects an Alternative Medication The real-time benefitsscreen will allow theprescriber to chose analternative medicationand complete the newscript 2018 Epic Systems Corporation. Used with permission.5 2020 CVS Health and/or one of its affiliates. Confidential and proprietary.53406B

Epic real-time benefits overviewRestrictions Will Be Clearly Visible (if required) There will be red text to indicate the type of restriction andadditional information is available on hover12 Quantity LimitPrior Authorization 2018 Epic Systems Corporation. Used with permission.6 2020 CVS Health and/or one of its affiliates. Confidential and proprietary.53406B

Legal disclaimersThe source for data in this presentation is CVS Health Enterprise Analytics unless otherwise noted.All data sharing complies with applicable law, our information firewall and any applicable contractual limitations.Adherence and health outcome results, savings projections and performance ratings are based on CVS Caremark data. Actual results may varydepending on benefit plan design, member demographics, programs implemented by the plan and other factors. Client-specific modelingavailable upon request.The Maintenance Choice program is available to self-funded employer clients that are subject to ERISA. Non-ERISA plans such as fully insuredhealth plans, plans for city, state or government employees and church plans need CVS Caremark legal approval prior to adopting theMaintenance Choice program. Prices may vary between mail service and CVS Pharmacy due to dispensing factors, such as applicable local oruse taxes.Specialty Expedite is available exclusively for providers who use compatible electronic health record (EHR) systems, including Epic Systems andothers that participate in the Carequality Interoperability Framework.Specialty delivery options are available where allowed by law. In-store pick up is currently not available in Oklahoma. Puerto Rico requires firstfill prescriptions to be transmitted directly to the dispensing specialty pharmacy. Products are dispensed by CVS Specialty and certain servicesare only accessed by calling CVS Specialty directly. Certain specialty medication may not qualify. Services are also available at Long’s Drugslocations.Patient stories and patient names are presented for illustrative purposes only. Any resemblance to an actual individual is co incidental. Unlessotherwise specified, images contained within are licensed or the property of CVS Health or one of its affiliates.This presentation contains trademarks or registered trademarks of CVS Pharmacy, Inc. or one of its affiliates; it may also co ntain references toproducts that are trademarks or registered trademarks of entities not affiliated with CVS Health.7 2020 CVS Health and/or one of its affiliates. Confidential and proprietary.53406B

Saving PatientsMoneyReal-Time Prescription BenefitsInformation at the Point of CareGet more affordable medications to your patients faster. When you write aprescription using your electronic health record (EHR) system, for each individual patientyou can instantly:Know if the drug is covered andthe patient’s out-of-pocket cost 4.50 31.27 10.15See up to five clinicallyappropriate lower-costbrand or genericalternativesFind out if your EHR is enabled forreal-time prescription benefits.See other side for details.PriorAuthorizationKnow if a therapy requiresprior authorization (PA) or hasother restrictionsProcess a PA in real-time fromthe EHR – decision in as little assix seconds

The following systems and versions are providing real-time prescriptionbenefits. There’s no charge for the service; however, you will need the latestversion of your EHR.EHR Systems and Versions Enabled- AdvancedMD AdvancedEHR- Allscripts Professional- Aprima (v2016 – 16.0.1612.2146)- Cerner Millennium (v2015.01.25)- Claimat- Comtron Medgen EHR- eMedicalNotes (v3.0)- Enabledoc Enablemypractice EHR- Epic EpicCare (Epic2018)- MD Office Manager GeeseMed EHR- Medical Office Solutions Adaptamed- MedNet Medical Solutions emr4MD- Modernizing Medicine EMA- MTBC ChartsPro- Office Ally EHR 24/7- Practice Fusion- Quest Quanum EHR- Waiting Room Solutions WRS Health (v5.0)e-Prescribing Solutions Enabled- Allscripts ePrescribe- DrFirst- eazyScripts (v3.0)- InstantDx OnCallData (v5.0)- MD ToolboxSpecialty Portal/Hub Solutions Enabled- Asembia- United Biosource- VirMedicaDon’t see your EHR vendor or versionlisted?Contact your EHR vendor or your EHRsystem administrator to request real-timeprescription benefits information.Not on the latest version?Contact your EHR vendor or your EHRsystem administrator to ensure real-timeprescription benefits information will beincluded in your next upgrade. For Epicusers, contact your Epic account managerto confirm your 2019 upgrade go-livedate and determine whether additionalinterfaces are needed.Having trouble accessing real-timebenefits information in your EHR?Contact your EHR vendor or systemadministrator.Savings will vary based upon a variety of factors including things such as plan design, demographics and programs implemented by the plan.CVS Health uses and shares data as allowed by applicable law, and by our agreements and our information firewall.This page contains trademarks or registered trademarks of CVS Pharmacy, Inc. and/or one of its affiliates. 2019 CVS Health. All rights reserved. 106-47195B 102119

electronic health record (EHR) and workflow 53406A. 4 2020 CVS Health and/or one of its affiliates. Confidential and proprietary. Originally searched drug 18.29 Alt 1 4.33 Alt 2 . Medgen EHR - eMedicalNotes (v3.0) - Enabledoc . Enablemypractice EHR - Epic . EpicCare (Epic2018) - MD Office Manager . GeeseMed EHR