How Interoperability Achieves Cost Savings in Specialty Pharmacy

The pandemic has shown firsthand the important role digital connectivity can play in managing complicated health challenges. It required complex navigation of our often fragmented health care system, managing differing state and local eligibility guidelines, multiple vaccine types, and patient vaccination status. Using tools like electronic health records (EHRs) we supported the largest vaccine rollout in history, administering nearly 50 million COVID-19 vaccines. Interconnectivity continues to play an important role in tracking second doses and boosters.

The same connected capabilities can help CVS Specialty members on their medications faster, and stay more adherent. Today, we can see EHRs for almost 70 percent of our specialty patients and approximately 30 percent of specialty prior authorization requests are submitted with the diagnosis and treatment information in them, without needing additional provider outreach. This means patients can get the most appropriate medication quickly, avoiding unnecessary costs. It also helps shorten the specialty pharmacy onboarding process to as little as three days.

The impact of interoperability has been significant for providers, payors and patients alike and we continue to make investments in its future applications. We’re working to create a clinical data repository that is a central resource to make evidence-based information and medical histories accessible to care providers across our entire enterprise. This can break down both internal and external silos across the health care system by integrating with other providers. Our goal is to create more efficiency, ensuring our members receive high-quality care while managing costs for the long term.