Cigna Corp. recently unveiled a partnership with CVS Health through which the health plan says it hopes to provide more value to its self-funded employer-sponsored health plans and their members. Industry experts maintain that the program likely will be of interest to employers, as it should help their members take more control of their own health care.

Cigna Health Works “aligns Cigna-administered health benefits with CVS Pharmacy and CVS MinuteClinic retail health care services,” say the companies. Among the services the partnership will offer are:

  • Health Tag Messages included on prescription bags. These messages “will feature health action messaging based on benefits information specific to their Cigna health plan, such as reminders for when to use retail care vs. the ER or urgent care, reminders of incentive-based health actions, such as getting an A1C test or biometrics screening, as well as clinician- and pharmacist-provided information, such as when to engage with a Cigna health coach or information to find an in-network primary care physician,” explains Michele Paige, vice president and general manager of Cigna Onsite Health.

  • Discounts offered at MinuteClinics for certain types of services. “Through this collaboration, Cigna members will receive contracted discounts for select preventive and acute care services,” says Carolyn Castel, a spokesperson for CVS. “For example, MinuteClinic practitioners can diagnose, treat and write prescriptions for minor illnesses or injuries such as bronchitis, ear infections, pink eye, flu, strep throat, urinary or bladder infections, minor burns and cuts, insect stings and more,” as well as offer biometric screenings for blood pressure, cholesterol and blood sugar.

  • 20% discount provided on CVS brand over-the-counter health products.

  • The potential to “couple” the program with Cigna 90 Now, which provides 90-day refills for maintenance prescriptions.

According to Paige, allowing Cigna’s customers to be able to get routine care at locations they prefer will give them “a stronger connection to their Cigna health plan benefits. This way we can share relevant health action messages that can enable them to conveniently access health and wellness incentives.”

Cigna’s clients will benefit “with a more wired experience at retail pharmacy and routine care locations because Cigna can extend health action messages to encourage their employees to be more aware and engaged in lower cost services for the routine care, plus help their employees gain access to a Cigna contracted primary care physician,” she says.

Similar efforts have been seen in the industry, say sources. “We are aware of various efforts by some clients to create biometric screening partnerships offered through CVS as well as some other retailers with health clinics,” says Nick Taylor, senior pharmacy benefits consultant for The Segal Group. “There also have been various offerings by companies to provide onsite health clinics/coaches that would be similar in nature to what this partnership is attempting to achieve. Some have very good outcomes while others view it as a nice-to-have service.”

F. Randy Vogenberg, principal at the Institute for Integrated Healthcare, points to similar collaborations between CVS and Aetna Inc. (DBN 5/5/17, p. 3), Prime Therapeutics LLC and Walgreens Boots Alliance (DBN 4/7/17, p. 4), and UnitedHealthcare and various partners, noting that “all are trying out different combinations and selected partners strategically. Nobody’s really sure who is the big winner, but the battle over lives has heated up,” he maintains.

Josh Golden, area senior vice president, client development at Arthur J. Gallagher & Co.’s Solid Benefit Guidance consulting arm, tells AIS Health that “this is actually somewhat similar to the 90-day retail deal that CVS struck with OptumRx, albeit with some additional bells and whistles tacked on. It’s another example of CVS Pharmacy attempting to expand their reach and presence in the supply chain. You could argue that this might empower Cigna to challenge CVS Health a bit more on the PBM side. Like the OptumRx-CVS deal, it puts some unique CVS retail offerings in the hands of yet another CVS Health PBM competitor.”

“I think what you will find across the industry is companies that specialize and/or offer components of this suite of services — but no one organization that offers all of it,” maintains Vanessa Hatch, Pharm.D., vice president of clinical solutions for PSG Insights & Consulting. “This is a unique business model that currently only [CVS Health] can leverage ‘under one roof’ per se. Typically, a health plan or employer would need to collaborate with several companies if they wish to have a similar type of initiative in place.”

Hatch tells AIS Health that “health plans have, however, looked to lower-cost preventive and acute care channels before, for example telehealth. Other similar partnerships could certainly materialize as insurers and providers continue to seek cost-effective routine care options that appeal to both employers and employees. It would be interesting to see a similar collaboration that more directly addresses the component of health care inflation that is increasing at the highest rate — prescription drug costs.”

For Cigna Health Works, “What’s unique in our approach is our go-to-market strategy where we’re sharing our Cigna analytics to create a better experience for our customers — and creating a more holistic approach across all the ways a customer may access care within the retail drugstore — across MinuteClinic, pharmacy, health purchases and engaging our customers for a more connected health care experience,” explains Paige. “CVS can best add to what they do with other carriers or Caremark in this regard. But for Cigna, leveraging our health insights and actions that are directly connected to our clients’ health care benefits plans is designed specifically to ensure their employees/our customers have more value and a better experience when they access care and services under their plan.”

Vogenberg, who is also founding partner of the National Institute of Collaborative Healthcare, tells AIS Health that the partnership offers existing clients value-added services, and “if looking to change, there is some opportunity to show some value add.” The offering, he says, is “clearly targeted against Walgreens by CVS,” adding that “bringing in the local convenience of MinuteClinic could be attractive in selective markets.”

“From the consumer perspective, the ability to save some money when accessing health benefits and/or purchasing ‘everyday’ products — i.e., vitamins, pain relievers — as well as having another, lower cost and potentially more convenient option for routine healthcare via the MinuteClinic versus an urgent care center is appealing,” says Hatch. “From the health care industry perspective, there has been a paradigm shift toward consumerism and having the consumer make more cost-conscious decisions for health care — perceived as cost shifting by some. This collaboration puts the consumer in a controlling position, but also facilitates decision making by providing access to quality, cost-effective wellness, acute care and prescription drug services.”

According to Taylor, “The most appealing part of this partnership for me is the enhanced ability to engage patients and educate them about other programs/services offered as part of their health care benefits. Patients trust pharmacists, and if CVS is able to train their pharmacists to effectively engage the patient and highlight the value of these other services like health and wellness coaches, then you may see higher engagement rates from patients without constantly chasing people on the phone or with text/email messages. One of the biggest problems for carriers like Cigna is effectively engaging patients, which is traditionally and primarily done on the phone or via electronic or mail messaging.”

“This new level of collaboration with Cigna is a part of a growing trend toward consumer-directed care,” Castel tells AIS Health. “By providing information and cues for CVS customers and patients to help them get the most from their Cigna-administered health benefits, we also help them improve their health and reduce their health care costs in a way that’s easy and convenient. CVS Pharmacy is in the midst of broadening its dialogue with PBMs and health plans to demonstrate the value that we bring through our suite of enterprise assets.”

How Should Employers Respond?

“This arrangement should be fairly well-received in the marketplace,” says Golden. “Assuming Cigna offers up this arrangement without a fee, adoption rates should be pretty high.” The payer did not respond to an AIS Health question about whether there is a cost to participate in the program.

“We anticipate a fairly positive response,” says Hatch, who points out that the program will allow employers “to demonstrate a vested interest in the overall wellness and health of their employees by providing access to health-related tools, services and benefits in a cost-effective, consumer-friendly and convenient manner.” However, she adds, “on the flip side, some employers may view the overall medical cost containment value of the offering as somewhat limited given the specific types of conditions that can be treated and the restricted accessibility to MinuteClinic locations.”

“Employers that are struggling with low engagement, rising health care costs and high utilization of emergency rooms and urgent care for routine preventative and acute care will be very interested in leveraging this partnership,” Taylor tells AIS Health. “It all really depends on access to a CVS store and stores that have MinuteClinics, as not all CVS locations include MinuteClinics. Employers will like the sharing of information and the collaboration to lower health care cost for select services and helping patients to further understand what is available to them on their health care journey.”

CVS and Cigna seem to have kept geographic considerations in mind as they roll out the program. The partnership is starting “with a limited market introduction,” says Paige, initially “targeting markets where there is the most acute need and where there is a strong saturation of CVS pharmacies and MinuteClinics.” She tells AIS Health there has been “immediate market interest.”