New Aetna Pilot Aims To Improve Medicaid Member Engagement, SDOH

Aetna’s new partnership leverages the pharmacist-patient relationship to improve Aetna’s Medicaid member engagement and better address social determinants of health, CVS Health announced through a US News article.

One of the major challenges in addressing social determinants of health, particularly in Medicaid, is finding the right channel for communication with beneficiaries.

Medicaid beneficiaries have a broad range of preferences when it comes to channels of communication. In a small study of Louisiana Medicaid beneficiaries, the participants named four different channels or platforms—snail mail, email, text, or phone calls—as preferred forms of communication.

While not all Medicaid beneficiaries share the same contact preference, they have at least one pattern that is similar: they are likely to visit the pharmacist.

In 2017, nearly seven in ten registered voters (69 percent) went to the pharmacy once a month or more frequently, a study conducted by CVS Health found.

Furthermore, Medicare beneficiaries visit their pharmacist about twice as often as they visited their primary care provider, according to a separate study. These results are relevant because approximately 20 percent of the Medicare population is dually eligible for Medicaid.

“Because of their ongoing relationships with patients, pharmacists often have a better understanding of other factors that might be influencing a person’s health, such as struggles with food insecurity, personal issues causing stress, a lack of transportation keeping them from doctor’s appointments and other potential challenges associated with social determinants of health,” the announcement argues.

CVS Pharmacy’s HealthTag pilot works with pharmacy employees to target Aetna Medicaid beneficiaries with important member engagement messages.

First, Aetna analyzes Medicaid beneficiary claims data to find those who retrieve their medications from pharmacies that are participating in the HealthTag pilot.

Aetna then provides the local pharmacy employee with additional messages to share with that beneficiary—beyond prescription-related information—to support their social determinants of health needs.

Additionally, in their prescription bags, beneficiaries will find information about community services coordinated through Aetna’s partner, Unite Us. The suggested local organizations can address a wide range of social determinants of health relevant to the beneficiary.

Beneficiaries can enroll on the Unite Us platform. There they may discover local support such as housing opportunities or, if they are diabetic, they may be able to find a local nutritionist who can help them access healthy food options.

“Out of about 6,000 waking hours in a year, most people only spend a handful in a doctor’s office or hospital,” the announcement points out. “Providing people who need help the most with local resources through a trusted resource that they see on a regular basis – such as their pharmacist – gives us a real opportunity to improve the health of individuals and communities.”

This partnership will serve Aetna Medicaid beneficiaries in Louisiana and West Virginia.

The support may be especially welcome for Louisiana’s Medicaid beneficiaries, who have been caught in the middle of a major Medicaid managed care contract dispute for about two years.

The Unite Us HealthTag pilot falls under CVS Health’s Destination: Health program.

Destination: Health was CVS Health’s first joint program with Aetna after the two companies merged. The program seeks to leverage relationships with community-based organizations through the Unite Us social care coordination platform.

“We want to form partnerships with community-based organizations in a way that improves health person by person and elevates the entire wellbeing of a community,” Garth Graham, MD, president of Aetna Foundation and vice president of community health & impact at CVS Health, told HealthPayerIntelligence at the time.

“We understand that we need to support individuals in identifying and accessing resources available to them in their communities – this is part of our promise to be local and to create simple solutions to improve people’s health.”

Updated 12/1/2020: This article has been updated to correct the title of the pilot to "HealthTag." A previous version referred to the program as “Health Tag." Additionally, this article previously referred to HealthTag as a "program," but this has been corrected to reflect that HealthTag is a pilot. Lastly, a previous version suggested that only pharmacists engage in this pilot, but this has been corrected to express that pharmacy employees, not just pharmacists, participate.