A better consumer experience has implications for clinical improvements, according to a new report from CVS Health.
The healthcare giant is putting a focus on innovation in this area, and to identify opportunities, conducted an analysis that compared Net Promoter System (NPS) scores with clinical outcomes. It found that, for example, patients who were highly satisfied with the experience at their pharmacies were more likely to be adherent to their medications.
The white paper notes that nonadherence to prescribed medications drives 16% of U.S. health spending each year, or about $500 billion.
Affordability, motivation and health literacy are all factors frequently discussed as to why patients would not take their medications, but the team wanted to dig further into how the consumer experience could intersect with adherence. It found that patients who were most likely to recommend CVS Pharmacy had the highest portion of days covered (PDC), which tracks a day's supply of medication over time, indicating whether they're taking a drug consistently.
Patients are considered adherent with a PDC over 80%, CVS said, but increasing that number further can have benefits. For example, raising PDC from between 80% and 90% to between 90% and 95% for individuals with diabetes and hypertension grew total cost of care savings by between $870 and $1140.
Patients with the highest promoter scores in the study had an average PDC of 91.7%.
"If we make it easier for you to get your scripts, and make that process something that's enjoyable, you're more likely to stay adherent to those medications," Srikant Narasimhan, vice president of enterprise customer experience at CVS Health, told Fierce Healthcare, "and when you're adherent to those medications, you have better health outcomes."
"You don't end up in the hospital. You don't end up in the ER. And all of those things contribute to you having a lower health care spend for yourself, and you're healthier and you're happier," he continued. "So I think when you put all that together, the benefit here is not just for CVS, not just for the patient, but societal."
He noted that about 50% of Americans are not adherent to their medications per their doctor's instructions.
Beyond the implications for pharmacy customers, the study also found that members who are very satisfied with their Medicare Advantage coverage through Aetna are more likely to receive flu vaccinations and visit their primary care providers.
They're also more likely to stick with Aetna for their insurance, according to the report.
Narasimhan said that one of the things the customer experience team at CVS focuses on is finding ways to make the healthcare journey easier, and part of the equation in solving that challenge is being more proactive in identifying customers' needs. For instance, someone calling about a prescription may need to transfer between business units to solve their query, extending the interaction into a long and negative one, he said.
"We have a tremendous amount of visibility into what is driving pain points or frustration into the experience," he said. "I think that that's the advantage of CVS Health ... we cover the entire ecosystem. In many ways, we can follow that patient through that journey and understand those pain points."
"We have the access and the information to know that this patient's likely going to face a problem, or they're going to have to go back to their provider, or they're gonna have to go get a re-auth. Let's just fix that," Narasimhan said. "So I think these are things that we're, we're bringing forward now that we have this connectivity across the businesses."
He said there's also a trust component that's key to making these customer experience improvements. At CVS, they're leaning on their pharmacists to help bridge those gaps, as patients often see these clinicians more frequently than other providers.
It also gets pharmacists out from behind the counter and offers more face-to-face time with patients.
"We've been trying to think about innovation that gets the pharmacist in front of the patient. That increases your engagement with a clinician, someone that you can talk to about the medications, that can speak intelligently about it, especially if you're on a new med," he said. "So that's just making it easier and more trustworthy to engage in the healthcare system."