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CVS Caremark enlists Aetna unit’s clinical intelligence

CVS Caremark Corp. has entered a three-year agreement for evidence-based clinical decision support from Aetna subsidiary ActiveHealth Management.

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WOONSOCKET, R.I. — CVS Caremark Corp. has entered a three-year agreement for evidence-based clinical decision support from Aetna subsidiary ActiveHealth Management.

Under the pact announced Wednesday, CVS Caremark will apply the evidence-based, clinical intelligence of the ActiveHealth CareEngine to health care claims for its pharmacy benefit management customers to identify opportunities for improved pharmacy care.

Plans call for CVS Caremark will employ the CareEngine support for more than 800,000 members starting in April, with more members to be added as the company consults with its PBM clients.

"The ActiveHealth CareEngine offers evidence-based information that can be used to improve the health care of our members and enables us to take our programs to the next level by seamlessly incorporating medical data," Troy Brennan, executive vice president and chief medical officer at CVS Caremark, said in a statement. "This agreement will enhance our existing programs to identify issues related to gaps in care, potential drug-to-drug interactions and duplicative care — information that is important to bring to the attention of the member’s physician."

Given today’s flood of new clinical data, ActiveHealth created the CareEngine to help health providers with the challenge of keeping up to date on issues that affect their patients. ActiveHealth’s team of physicians, pharmacists and registered nurses constantly review the latest clinical evidence and guidelines and build them into the CareEngine system, which then reviews the available clinical data on patients, compares it with evidence-based guidelines, and delivers "Care Considerations," or "care alerts, " that doctors can act on to improve care.

"CVS Caremark is a leader in pharmacy care and is committed to improving the efficacy of medication therapy. Our expertise in clinical decision support will help improve their members’ health outcomes as well as better engage those members in their health," stated Gregory Steinberg, chief executive officer of ActiveHealth Management.

ActiveHealth’s technology is expected to help CVS Caremark identify and address gaps in care and other opportunities to improve care for its members. In a study of more than 39,000 individuals, ActiveHealth’s clinical decision support technology identified potentially serious medical errors for nearly one of every 20 people and helped reduce hospitalizations among the study population by 8.4%.

"Initially, these messages will be shared only with members’ physicians, but we believe there is an opportunity to improve member engagement and their compliance with pharmacy care recommendations by sharing that information directly with members," Brennan added. "This is especially critical for patients with chronic or complex conditions who see multiple physicians and take multiple medications."

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