A look at CVS’ march toward a simpler patient experience

(upbeat music) Today is Wednesday, July 29, and you're listening to Pod Moses, the pulse of the healthcare industry. I'm your host, Aila Ellison. I recently learned that there is a national lipstick day, which happens to be today. So whether your preferred shade is classic red, barely there, or something with a name like very mysterious, today is your day. Now, on to healthcare, an industry that some say could benefit from being a little less mysterious. Patients are often expected to find the right clinician, understand what their insurance will cover, compare costs and figure out what comes next, all while they're sick, worried, or caring for someone they love. CVS Health says it wants to make that experience simpler. The company is investing in technology and bringing together different parts of its healthcare business through initiatives such as Health 100, which its chief medical officer compares to Google Maps for healthcare. In this episode, fierce healthcare senior writer, Paige Minimier, talks with Dr. Amy Compton Phillips, CVS Health's chief medical officer. About those efforts, the role technology can play, and what a healthcare experience designed around the patient might actually look like. Let's get into it. (upbeat music) - Well, Amy, thank you so much for joining us today. I am delighted to be here, Paige. Thanks for having me. - Just to kind of kick things off, I wanted to ask you to talk a little bit about your career journey and kind of the path to joining the CVS team. What drew you to the company? And are there any challenges in healthcare that you think you're kind of uniquely positioned to solve now that you're at CVS? - I feel like I was born to work in the job that I'm in right now. So I started out my career as a physician with a very large integrated care delivery system at Kaiser Permanente. It was there for over two decades and really believed in the value of value-based care, meaning better care at affordable costs. Right? - Yeah. - Something that Kaiser really does a great job with. And then I got recruited over to Providence Health System, so a large, much more traditional fee-for-service-based healthcare system up and down the West Coast, which was a great opportunity, fantastic physicians, dedicated administrators, but fundamentally working in a predominantly fee-for-service enterprise, they were insented on volume, not value. And so while I loved the work and I loved the people, I wasn't really sure it was the right place for me. And from there I moved on after the experience of living through COVID and the financial crisis and the racial justice crisis and the workforce crisis that came out of right. Yeah, like the Polly crises. Right? I went over to a health company, Presghini, that was really focused on the experience of care. And where I learned that the complexity of the healthcare system that had evolved was burning out clinicians and frustrating patients that we really were not set up as an infrastructure to do the right thing. So when I got a phone call from CVS Health, which has a premise that value-based care is a future that has ambition to simplify health and has the goal to be the most trusted healthcare organization in the US, how could I not say yes? I mean, that's exactly how I want to spend out the rest of my career is trying to simplify health in a way that re-erns the trust that this ultimate service industry really should have. And as you just touched on certainly healthcare is very complicated and patients often struggle to navigate the journey that they're on. From CVS's perspective, what does a simpler patient experience look like? Again, nobody has intentionally done the wrong thing to create this incredibly complex healthcare system that we have. There have been myriad decisions made, right? One decision at a time that has added an incredible amount of complexity into the system. And I think the areas that frustrate everyone involved with healthcare right now are access navigation and payment. And so at CVS Health, we're trying to really help with all three of those things. That access, how do we make it simple and easy to get the care you need, when and how you need it. And so that might be having on-demand care through AI and Abled Front Door, right? That might be in Minute Clinic where we're not only providing urgent care, but now our 900 Minute Clinics are working on now providing primary care. That might be through including virtual primary care, virtual behavioral health. So we have a myriad of options for us to be able to provide better access. Navigation. Once you get into the healthcare system, figuring out what the next step is, and especially if you have anything challenging. Imagine you have cancer and trying to figure out how do you put together going from primary care to radiology to an oncologist to a surgeon. It's really, really hard. And so our groups have been working together to help build a tool called Health 100. And I think of it Health 100 is like the Google Maps for healthcare. It used to be incredibly difficult to get around London or Boston where streets are twisty and windy and change names or the other block. And so you need a map, right? To get around. It used to be really hard to get around those cities. Now it's pretty simple because you got Google Maps. So how do we actually have a way to navigate from one clinician to the next knowing what the next step is, having a pair path of this is what usually happens. Here's where you are and what you can expect. So that's the navigation part. And then the last part is affordability. Being able to know what things cost ahead of time, being able to understand the incredible amount of complexity in what's a copay, what's a deductible, what's a cost share, what's a-- There's a lot of words that you and I don't understand sometimes. And then being able to not just predict, but then comparison shop to say, where am I going to get the best outcomes at the best price? And so we have tools to allow for that. So I think that is like a really effective way that we're trying to stitch across the entire ecosystem, the ability to access, navigate, and pay for care. When I definitely want to dive into a couple different pieces that you just touched on, but first, you mentioned Health 100. And I know that that launch brought together a lot of different pieces of the company. Can you talk a little bit about just the role you see tech playing and in supporting kind of this simple patient experience and where CVS is investing in some of those innovations? So many places that we're investing. And a lot of the investments are because we need them ourselves to make it better for ourselves. And so just start at the front door that-- and we have 9,000 farm-- 85% of Americans live within 10 miles of CVS. So there's probably-- virtually everybody listening to this podcast has been into a CVS in the past year. So yeah, right? So how do we make it so that the text who get the prescription and then the pharmacists who fill the prescription and then the patients who get the prescription? How do we make that simple and easy? So instead of paper coming in and people typing prescriptions and pills being manually checked for dates and-- what can we do to use technology to simplify and take a lot of the human labor out of that? Because one thing is safer. And the second thing, it's more efficient and the more efficiencies we can have in the back end stuff, the more affordable we can keep health care. So that's like the front end. And that kind of is that same idea is all these things that we're doing to take the administrative layers out of the work that we do that-- honestly, it's not like our people love typing in prescriptions, transcribing one. One piece we got. So the more we can automate-- and I'm quoting our head of our digital transformation team here at Tlaqumadaadi. He's like, we're getting rid of the stupid stuff. The stuff that nobody wants to do because it's just burdensome. And as we get rid of that stupid stuff, it allows us to simplify the work that our people do and it allows to simplify the experience that our patients and our members and our consumers have. And you touched a few times as well just on the fact that simplifying the health care experience also helps to drive affordability and access and support that. And how are you seeing those kind of crossover and how are you thinking about that affordability equation? So we're thinking about it in so many different ways. Part of affordability is driven by the fact that we're so dependent on human beings to do everything in health care. And again, back to think about the way things like prior authorization evolved. That we recognized back in the day, 20 years ago, that we were utilizing a lot of services, not all of which had evidence behind those services. The Dartmouth Atlas came out and there was huge variability in the number of times people got hip replacements and got heart surgery, right? And with no differences in the patient populations, you'd have 2X the heart surgery done in Miami compared to Minneapolis, for example, right? So that was known 20 years ago. So. Insurance companies said, well, patients can't afford care, employers can't afford these contracts. What can we do? I know we can look at what the criteria are and we'll try to make sure that only the evidence-based procedures get approved, right? So that meant they threw people at that problem. And then health systems threw people at appealing that problem. And then insurance companies threw people at fighting the appeals. And so there was just kind of this ratcheting up. And every person, of course, is there to do the best job that they can. So they add kind of kinds of layers of complexity into that system. Yeah. And so a big part of what we're trying to do is to say if we can take some of those people that are doing work out that may or may not add value in the law into the patient's outcome, then we can save dollars. And so we can streamline the work that we're doing. We can simplify the process. And that simplification means taking out a lot of people that today are sitting there scanning through charts. And now if we can use AI to summarize charts and find the data element that's missing, and then send that completed set of information to a person, then we have one person doing what before. It took lots of people scanning through all kinds of medical records that as we know, literally can be as long as one piece if patients have been in ICU. It takes a long time to read more in peace. And so if you have a person scanning through a medical record for that one element of information they need, it's not nearly as efficient as having tools that allow us to do that. And so it's that kind of, okay, so that we're saving on people time, but we're also, we're able to do different things. Wanna hear something kind of cool that I was reading about earlier today? - Yeah, absolutely. - I don't wanna like get ahead of releasing the real study that we're doing, but something we're able to do now is we know probably part of the country that's under a heat dome at the moment because so much of the country is. Or with wildfire smoke that's unhealthy, right? And we know that there's a significant bump of in hospitalizations for dehydration, for falls, for people who are at risk, right? When that weather comes out. We know who's at risk. We know the bad weather's coming. We know the zip codes that are coming to. We can actually start sending messages to people to say, hey, a heat wave is coming. Here's how you stay hydrated. Here's a cooling center near you. Call us if you have any trouble at all so that we can help you stay safe during this heat wave. And we've been able to show a significant drop in hospitalizations who've received those messages that we could identify ahead of time and keep them from getting the bad effects of being overexposed to high heat. That's the kind of thing, that's a great way to save money, right? In your healthcare system, that's not like just carving out roles that people don't have to read medical records anymore. That's actually truly transforming healthcare. And that's the way we think that CVS health can be looking ahead to say the best care is the care that in the long run isn't even needed because she stayed healthy and well. Certainly, I think maybe in Silicon Valley and these places where they're really leading the charge on technology and innovation, they're sort of a, if you build it, they will come kind of mentality. But I think we don't necessarily see that bear out in healthcare at least not immediately. I mean, how are you thinking about building that trust that's necessary to kind of get patients to embrace some of these tools and platforms and new models that can really ultimately end up benefiting them? In my past life, we've hired in people that came from large highly successful tech companies that everybody knows the name of and they were incredibly helpful, but it wasn't as easy as they thought it was going to be to use technology to solve healthcare's problems. And they were incredibly skilled technologists that had done amazing things in their career. They made their money and they wanted to give back to healthcare. I mean, so just truly dedicated human beings. And often they came in and are like, "Oh, healthcare people, you don't have technology here. "We're here to help." And you've seen how much that at least up to this point that the tech companies have succeeded in healthcare. And it's because it's just a really complex endeavor and hasn't necessarily, although that's changing with AI, it hasn't necessarily been the trusted front door per care, right? Where I think CVS has the right to win is that right now CVS sees about 185 million individual consumers a year and a large proportion of those are, use our app to help navigate the stores and navigate their prescriptions. And my team might be, I'm happy with me if I get the number wrong, but I believe it's 26 million active monthly users on our app. That's a pretty good starting point. Of 10% of the US population almost uses the app on a monthly basis. We can tell what people find useful and find interesting. And so they way can build on what people find useful and interesting and helpful to them. 'Cause that's the thing is the app should solve and the CVS app is going to be forming the backbone of Health 100. The app should be solving problems for patients, not building it, assuming that if they come here we can solve their problems, right? So I think that if we start with what knowing what works and then building out from that, we have a much better likelihood of using the app to actually meet the needs of the people we're trying to meet. - And we've touched on this a little bit, I think, but as you're looking at Health 100 and these other initiatives, what does the kind of breadth of what you have at your disposal at a company like CVS allow you to do to really get at some of these challenges? - Okay, can I give you a preview of something I am super excited about? Because it's the kind of thing that I think we could only do at sea. - Yeah. - Okay, all right, 'cause I think examples like make it make it much more real for the people. - Totally, I agree. - I am 100% agree. - All right, all right, great. So thinking about we've got these amazing assets, this the retail footprint, like I mentioned, 85% of Americans living within 10 miles of CVS. We have our healthcare delivery infrastructure with minute clinic and Oaks Creek Health and signify and we've got a payer in Etna. We've got a medication, a pharmacy benefit manager, which allows us to get medications at an affordable price, right? And if you have all of those assets, what can you do that's different than the traditional healthcare system can do? So that's thing one, put that off to the side. - Yeah. - Thing two is I believe it is absolutely appalling that if you add together heart disease, stroke, kidney failure and people dying from diabetes, it's a million Americans die each year. 80% of those deaths are completely preventable by managing people's blood pressure, cholesterol and blood sugar. - Right. - And there are cheap, affordable, easy to take, well tolerated medications as well as simple to execute on behavioral changes that allow people's blood pressure cholesterol and blood sugar to get under control, right? So a million people die each year, easy to control, as long as people know their numbers, they can own their health, right? So I believe that with the array of assets that we have across CVS, we have the ability to knock heart disease off its pedestal as the number one killer of Americans, right? If we make it so that people can leverage our retail footprint to know their numbers, to get a blood pressure check and to get blood work done, so that they know what their numbers are, that our clinical pharmacists that supported by the rest of our ecosystem can actually help patients get the health behavior change they need, sleep more exercise, watch out for simple, refined sugars, kinds of stuff, right? - Right. - Together with medications that can help them control their risk factors, and that we literally could change the demographics of the country, that people do not have to die unnecessarily of heart attacks and stroke, and they can keep their kidneys and their feet. So like, it would be wonderful to have people live healthier lives because an integrated company like CVS Health makes it possible. - As we wrap up, I wanna ask you to kind of take out your crystal ball a little bit and look ahead to the future. If we're kind of in an ideal world, what does the future of the patient experience look like from your perspective, and where do you see opportunity at CVS to kind of push that forward? - Yeah. I will admit my crystal ball is murky, but I believe the ARCA history along, and it bends towards simplicity access and clarity, that things that can't go on forever don't, and that if we truly believe that access to better health is something that we should make available, someone will figure it out, and I believe CVS Health has the right and the capacity and the will and the people and the dedication to figure it out. - Great. Well, Amy, thank you again for taking the time out to join us. - I so appreciate you inviting me in. Thank you so much, Paige. (upbeat music) (upbeat music) - Thank you for listening to Pod Nosis. I'm Aila Ellison. You can find out more about this topic in our show notes at fearshealthcare.com, look for podcasts, and don't forget to tune in every Wednesday morning to Pod Nosis, where healthcare is our beat. (upbeat music) (upbeat music)