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We are transforming health care. We are lowering costs. We are making it simple. We are doing even more. We are improving engagement. We are supporting communities. We are CVS Health. 2018 Annual Report We are transforming health care. CVS Health is well positioned to engage patients and tackle a system whose challenges have resulted in unnecessary spending and suboptimal outcomes. For many, our company name remains uniquely powerful platform that will our programs and services into their synonymous with the nearly 10,000 open a new front door to health care existing routines. retail locations we operate across the and reshape the consumer experience. The current system drives patients to United States. Today’s CVS Health is, Three strategic imperatives guide our be health care decision makers, but of course, so much more than that. transformation efforts: be local, make they lack the tools needed to navigate CVS Caremark® makes us the nation’s health care simple, and improve health. effectively. We’re going to change that largest pharmacy benefits manager, and CVS Health offers more consumer and help guide patients along their we are also the leader in retail clinics, touchpoints than any other health health care journeys by providing more specialty pharmacy, and infusion. care company, and this enables us convenient access to the information, With our recent acquisition of Aetna®, to offer care where, when, and how resources, and services they need. And CVS Health operates one of the nation’s patients need it—in the community, by aligning the capabilities of Aetna premier health benefits companies in the home, or even in the palm of with our consumer-centric assets, as well. These businesses, working their hand through digital devices. we will more effectively deliver on our together as an enterprise, create a And because we already engage with purpose of helping people on their path one in three Americans as part of their to better health. everyday activities, we can simply build CVS Health enablers Core suite of transformation initiatives Community-based Digital Common chronic Readmission Site-of-care assets capabilities disease management prevention management Data & analytics Partnerships Primary care Complex chronic disease optimization management “Our businesses are industry leaders in their own right. Taken together, though, they provide us with opportunities to create unique products and services that no other company can. We are primed to transform the health care industry as we know it today.” Alan M. Lotvin, M.D. Executive Vice President – Transformation 2018 Annual Report 1 We are lowering costs. A focus on chronic disease management, avoidable hospital readmissions, and site-of-care management are core to our medical cost savings strategy. 2 CVS Health Numerous studies estimate that up to medical benefits, rich clinical data, and programs to identify at-risk patients $500 billion, or 25 percent, of the total initiatives we are implementing in our at the point of discharge and by annual spend on chronic conditions CVS Pharmacy® locations. engaging them in our stores. In one in the United States is avoidable. pilot, we are enabling Aetna care In-store pharmacists have already Through CVS Health’s combination with managers to facilitate the scheduling started providing adherence outreach Aetna, along with our other integrated of MinuteClinic® follow-up visits within and counseling to Aetna members assets, we are developing solutions 14 days post-discharge when patients identified to be at high risk for an to meaningfully reduce that figure. are unable to see their provider. And adverse health event. We’ve also For example, we have targeted better through our Coram® infusion services, launched a specialized program to help management of five common chronic we are increasing utilization of lower- support Aetna members being treated conditions: diabetes, cardiovascular cost sites of care, including the home for cardiovascular disease. We expect disease, hypertension, asthma, and where appropriate. The hospital to make these offerings available to our behavioral health. We’ll accomplish readmission rate for Coram infusion health care partners as well as through this through, among other things, patients nationwide is nearly half that an open platform model. tighter integration of pharmacy and of the national average for patients To reduce costly hospital readmissions, receiving care at inpatient settings. we are utilizing Aetna’s clinical Aetna had 470,000 hospital discharges in 2017; 47,000 were readmitted at an Approximately Nearly Up to average cost of $14,000. 60% 90% 25% If readmissions were of American adults of health care of chronic reduced by 50%, live with a chronic spend is on care spend is we’d remove condition people with a preventable chronic condition $300 million in costs and create a better patient experience. “Waste is pervasive in our health care system, and inefficiencies in the delivery of goods and services lead to avoidable health care costs. When you combine the strength of Aetna’s products and services with CVS Health’s local community footprint, we are in the strongest position to develop solutions that reduce spend- ing, decrease complexity, and positively impact consumer health.” Karen S. Lynch Executive Vice President and President – Aetna 2018 Annual Report 3 We are making it simple. MinuteClinic Video Visits and our real-time benefits solution are just two of the many ways in which we are making care more accessible for patients. 4 CVS Health Our more than 1,100 MinuteClinic locations and for those who require member-specific information into the locations help people on their path help outside of core business hours. hands of health care professionals at to better health by making high- Currently available in 19 states, we the point of prescribing. As a result, quality medical care more convenient expect that MinuteClinic Video Visits doctors can know the cost of a selected and affordable. Thanks to our new will be available nationwide by the drug based on the specific patient’s collaboration with Teladoc, patients with end of 2019. plan design. We also suggest clinically minor illnesses or injuries can schedule appropriate alternatives, identify Too often, someone has picked up a a MinuteClinic Video Visit without restrictions, and confirm whether a prescription only to discover that its leaving the comfort of their homes. selected pharmacy is in-network. We cost is higher than expected, that the are now reaching 100,000 prescribers, Available through the CVS Pharmacy drug isn’t covered by their plan, or that and our data shows that physicians app or at minuteclinic.com, this service the pharmacy is no longer in-network. are switching patients to a different matches each patient to a board- Through our real-time benefits solution, medication approximately 75 percent certified health care provider licensed we’re making this problem a thing of the of the time when the requested in his or her state. This option has past for CVS Caremark plan members. medication isn’t covered. improved access to care for people Working across about two dozen EHR who live too far from one of our and e-prescribing systems, we put Information across all points of care can help inform smarter decisions and save money 1/3 of patients using MinuteClinic Video Provider: Pharmacist: Member: Visits indicated they preferred a 77% 62% 91% telehealth visit to of scripts are written of consumers prefer of consumers an in-person visit electronically; to hear about lowest- are looking an opportunity to cost offers from their for better price streamline experience pharmacist transparency “Who hasn’t had the experience of picking up a prescription only to find out that it’s far more expensive than expected? Our real-time benefits solution is a powerful example of our efforts to make prescription costs more transparent —at the point of prescribing, through our digital capabilities, and at the pharmacy counter.” Derica W. Rice Executive Vice President and President – CVS Caremark 2018 Annual Report 5 We are doing even more. Our latest solutions run the gamut from better access to prescriptions to innovative treatment of chronic kidney disease, diabetes, and rheumatoid arthritis. 6 CVS Health With the 2018 launch of same-day Medicare population. Through a new Our Transform Care® programs help delivery in six cities, we’ve made it CVS Health initiative that includes early plan members manage chronic condi- easier than ever for CVS Pharmacy identification of the disease, patient tions effectively by drawing on our full customers to receive their prescriptions. education, and an expansion of home range of assets and identifying person- Using the CVS app, customers can dialysis, we are working to redefine alized improvement opportunities. For arrange for delivery within three hours kidney care. Our unique enterprise example, Transform Diabetes Care® and can include vitamins and other assets —Coram, CVS Specialty®, and lowers pharmacy costs through aggres- select non-prescription items with their Accordant® among them — create a sive trend management and decreases orders as well. We expect our same-day unique value proposition. Moreover, medical costs by improving medication delivery program to grow substantially we have developed groundbreaking adherence, A1C control, and lifestyle in 2019. technology, set for a clinical trial later this management. Transform Rheumatoid year, that is designed to make home- Arthritis CareTM, which leverages our Chronic kidney disease costs Medicare based hemodialysis simple and safe for specialty pharmacy and embedded $100 billion annually. Despite this high patients to facilitate longer, more frequent AccordantCareTM nurses, is helping level of spending, Medicare patients treatments. Based on clinical research, clients better manage care and costs for treated with traditional in-center hemodi- this approach improves quality of life, this complex autoimmune disorder. alysis suffer mortality rates up to reduces hospital stays and readmissions, 10 times higher than among the general and lowers mortality by 45 percent.