The challenges you face in improving the health of your members may seem daunting. From ensuring quality care while managing cost, to keeping up with emerging therapies and technology, we’re here for you.
Our programs and services are as unique and varied as your members’ health needs. We answer those needs with personalized solutions that help you and your members realize better outcomes.
In a world where mental health is still a stigmatized topic, we are disrupting the silence by bringing you inMyndSM. This new clinical program offers a thoughtful and connected solution that helps both patients and payers better recognize, treat and support mental and behavioral health conditions.
Combined with medication-centric coaching, prescriber outreach and digital cognitive behavioral therapy*, inMynd features the industry’s first predictive models for the progression of anxiety, depression and insomnia, allowing us to meet each member on their personal mental health journey, proactively.
*program is available as a carveout with the inMyndRx solution offering
More and more organizations are considering family building and fertility coverage as a part of their comprehensive benefit package. We’re offering a solution to nurture the future of growing families that helps avoid unnecessary costs for both plan sponsors and their members. And unnecessary stress for hopeful parents.
Evernorth FamilyPathSM is a comprehensive solution that provides holistic care coordination across the health care system, and offers flexible benefit design options to fit a variety of different plan needs. It can be a complicated experience for members to get started on the right treatment, with the right doctor, or with the right adoption provider.
That’s why FamilyPath simplifies the experience with dedicated fertility advisors, assistance in finding a provider or clinic, fertility treatment guidance, on-time medication support, lower out-of-pocket costs, and emotional wellbeing resources. We know when this combination works together, members and plans reap the benefits. Members with fertility coverage are more likely to rely on the right treatment paradigm, potentially resulting in 40% savings.
How do you improve the health of your members when you have a limited line of sight across the care continuum? It takes a 360° view of your patients and population to drive the 180° impact you want.
Health Connect 360SM is the most comprehensive clinical management model in the industry. It bridges pharmacy, medical, lab and patient engagement data on a daily basis, with unrivaled precision and analysis. Identifying more relevant, actionable gaps in care or health opportunities, we get those insights and alerts back to your pharmacies, physicians, nurses and case managers. Then, we leverage patient-specific risk and engagement scores to trigger the most effective, personalized intervention for each patient.
Health Connect 360 is a fully guaranteed, outcomes-based approach. It helps you maximize clinical outcomes, deliver better member experiences and improve financial results, all while achieving the clinical goals you set for your population.
Evernorth SafeGuardRx® addresses the most complex and expensive health care issues: improving patient care while controlling costs.
Through a multi-program platform, SafeGuardRx combines our specialized clinical model and value-based contracting strategies, delivering better outcomes and increased value for patients living with critical diseases states.
SafeGuardRx helps patients realize better medication adherence, higher therapy completion rates and greater compliance with clinical guidelines, while helping lower costs for plan sponsors. In 2020, enrolled clients saved more than $6 billion.
The SafeGuardRx platform is continuously evolving, identifying new opportunities in critical disease states in addition to those currently covered: cholesterol, diabetes, hepatitis C, inflammatory conditions, migraine, oncology, pulmonary conditions, multiple sclerosis, HIV and rare conditions.
The opioid crisis doesn’t discriminate. Anyone is vulnerable and everyone is affected – your members included. Advanced Opioid Management® is a clinically-driven solution created to combat this nationally recognized crisis. Advanced Opioid Management maximizes safety and minimizes early opioid exposure, then helps prevent progression to overuse and abuse.
Providing a dynamic and much-needed way to fight opioid abuse across the care continuum, Advanced Opioid Management touches the pharmacist, the patient and the prescriber. In just 2 years, the program has prevented 1.4 million days’ supply of opioids from being dispensed, while directing patients to safer, short-acting alternatives.
Patient results include:
- A 57% reduction in average day supply per claim
- 96.5% of new patients starting with a 7-day supply or less
- 77% of patients redirected from long-acting opioid to safer, short-acting alternatives
We’re in an era of continuously developing health technology giving people greater control over their health and well-being. However, a constant flow of new digital health solutions is streaming into an already crowded market. This technology is still emerging and hasn’t gone through rigorous validation.
To make it simpler to navigate the vast landscape of personal health technologies and interventions currently available, we've reimagined the digital health landscape by introducing the industry’s first, stand-alone digital health formulary.
The Evernorth digital health formulary vets every solution we include for clinical effectiveness, stringent security and privacy compliance, value, affordability, and a user-friendly experience. This helps ensure the safety, effectiveness, and usability of the health technology tools available to members.
People living with a chronic health condition deserve responsive, straightforward answers from experts who understand what they're going through – experts who have the training and experience needed to help.
We believe the best care for these patients comes from specialists, not generalists. Our Therapeutic Resource Centers® (TRCs) are dedicated to serving patients diagnosed with complex disease states. We're committed to connecting patients with the right care, specific to their individual need.
For example, patients with cancer are served by pharmacists, nurses and other health care experts in our Oncology TRC, which offers compassionate, comprehensive cancer-specific care.
We help patients achieve their best health outcomes by providing personalized care and resources they may not get anywhere else.
The price tag for lifesaving therapies has ballooned into a costly and serious problem that’s increasingly impacting the health and wellbeing of patients diagnosed with chronic conditions. From 2006 - 2016, out-of-pocket drug costs for these patients rose by 54%.1
Alarmingly, 3 in 10 adults don’t take their medication as prescribed because of cost.2
Patients deserve better. Addressing the need for affordability and access, our Patient Assurance Program® ensures that those eligible in participating plans pay no more than $25 for a 34-day supply of preferred, participating diabetes and cardiovascular products.
Medication affordability is a complex problem. But we believe, together with our clients, we can get one step closer to solving it — and eliminating the tragic and expensive medical consequences of patients rationing their medications.
Learn more on how the Patient Assurance Program increases adherence an reduces costs for both members and plan sponsors.
RationalMed® improves patient health and safety – integrating medical, pharmacy and laboratory claims data to initiate changes and correct errors in care, lowering both medical and prescription drug costs.
Gaps in care lead to higher costs. Using predictive modeling, ScreenRx® closed 37% of medication adherence gaps, recording $188.6 million in total health savings for our clients.
In partnership with leading high-tech companies, we’re helping members monitor their health status in real-time. To improve outcomes, our solutions are always paired with clinical support through our Therapeutic Resource Center®pharmacists.
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2 Kaiser Family Foundation