CVS Aetna and Diabetes
Although CVS acquiring Aetna has more to do with fending off Amazon than it does diabetes this deal has the potential to change the diabetes management landscape. For years we have been writing about the use of financial incentives to encourage patients to better manage their diabetes. We have argued that attempts at behavior change just don’t work. That patients with diabetes need rewards that are immediate, rewards which impact their lives. Tangible rewards which they can see touch or feel.
Now let’s be very clear here we are in no way implying that patients do not care about better outcomes. What we are stating is that for patients to do all the heavy lifting, all the work, they need something more than just the possibility they will avoid complications from poorly controlled diabetes.
Let’s be even clearer the patients we are talking about are not the minority who are already actively engaged with their diabetes management. These patients will benefit from financial incentives, but they aren’t needed to motivate them. Nor are we targeting the other end of the spectrum as there are also patients who will not respond to any form of incentive financial or others. The sad fact is these patients just don’t want to be engaged with their diabetes.
The patients we speak of are the majority who understand that diabetes is a serious condition. They understand they need to manage their diabetes. They just don’t want their diabetes management to run their lives. They want to live WITH and not FOR their diabetes. They have a chronic condition they did not want, do not understand which requires work to manage properly. Which is why financial incentives work very well with this group as they sure as heck understand and feel saving money.
The combination of CVS Aetna offers multiple options when it comes to financial incentives for patients. Options which ultimately could drive foot traffic in CVS stores or on the CVS web site. Options which ultimately will help CVS make more money and Aetna save money. Here are just a few we can think of quickly.
Patients who opt into a diabetes management platform could receive special coupons for a wide variety of activities. It goes without saying that any such platform would include all the way cool whiz bang way interconnected toys a patient uses. It’s also understood that patients would get more than coaching for sharing their data, they would get a tangible reward. Nearly every action performed by a patient can be tracked and incentivized. CVS could also use their own Minute Clinics to verify results.
We have long contended that it’s only a matter of time before patients buy health insurance like they do auto insurance. That in exchange for sharing personal data they would pay lower premiums or get lower co-payments. With the new generation of CGM’s combined with A1c tests performed at a Minute Clinic CVS/Aetna would have access to all the data. They could if they chose to also incorporate cloud enabled scales plus draw data from apps that count steps or other forms of activity.
As we have said all along getting the data is the easy part, there are plenty of cloud enabled toys. No, the problem has been twofold. First turning this data into patient relevant, patient actionable information. Next to provide the want to which is where financial incentives come in as it provides the want to. Put simply it’s not that difficult to tell the patient what to do, the hard part is getting them to do it.
Now that it looks as if Amazon will be entering the pharmacy business, they too could do the exact same thing. Keep in mind that Amazon and Merck (NYSE: MRK) have worked together so that snarky Alexa is able to assist patients with diabetes. We may have a little fun with Alexa, Siri and Google home but the fact is these voice-enabled digital assistants snarky or not will be part of the diabetes management equation in the not so distant future.
What this comes down to is vision, the willingness to think outside the box. It also doesn’t hurt any that everyone benefits from the use of financial incentives. The patient saves money and CVS makes money. This may fly in the face of conventional thinking that outcomes are what really matters but the reality is to achieve better outcomes nothing else has worked.