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CVS Caremark

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The Employers Health PBM program, delivered through CVS Caremark, covers approximately 1.1 million lives in all 50 states and is responsible for more than $2.2 billion in prescriptions each year. Advantages include:

  • Centralized contracting, managed by the EH legal team and supported by outside consultant expertise.
  • Annual market check negotiations ensure your plan benefits from updated pricing and contractual terms.
  • An annual claims audit ensures CVS Caremark’s compliance with the contract.
  • Contract performance management, including reconciliations of performance guarantees, rebates and pricing guarantees.
  • Employers Health pharmacy experts provide analysis and advice on plan performance and future strategy.
  • A focus on keeping participants happy, through a host of proactive vendor management initiatives and participant satisfaction surveys.

Many Employers Health team members have previous experience working for pharmacy benefit firms. Our team helps plan sponsors find strategies that maximize savings and care. As many employers work to slow their health care costs, the unique relationship between Employers Health and CVS Caremark is an added benefit to help control the rising cost of health care spend.

CVS Caremark – Helping People on Their Path to Better Health

Negotiated savings are just the beginning. As a pharmacy innovation company with an unmatched breadth of capabilities, CVS Caremark continually strives to improve health and lower costs. CVS Caremark is reinventing pharmacy to provide caring expert guidance, new cost-effective solutions, and even more convenient access to care. You might not expect this from a pharmacy or a PBM, but you can expect it from a pharmacy innovation company. That’s CVS Caremark. Helping people on their path to better health. It’s our purpose, our promise, our passion…every day.

CVS Caremark helps people on their path to better health with programs that get the medicine right – helping ensure evidence-based, cost-effective pharmacy care – and get the behavior right – engaging members using the best of science and consumer insights.

Reducing Health Care Costs

  • Achieve superior adherence outcomes in chronic conditions
  • Provide leading solutions to help manage chronic disease for members using mail service and retail

Managing Pharmacy Costs

  • Provide innovative, creative solutions to manage pharmacy and specialty trend
  • Expand mail pricing and value to retail
  • Position for the future with Genetic Benefit Management solutions
  • Promote low-cost generics to manage trend

Specialty Pharmaceuticals

  • Promote evidence-based guideline management for all specialty conditions
  • Control specialty drug trend with case referral and coordination
  • Ensure appropriate utilization of high-cost specialty pharmaceuticals
  • Implement solutions to manage pharmacy spend under the medical benefit
  • Improve access and convenience for members using specialty medications

Member Engagement

  • Provide consistent and personalized member counseling across channels
  • Support improved member health behaviors

Service Excellence

  • Strategic benefit design consultation with a customized savings analysis
  • Analytics and outcomes supports the outcome initiatives of pharmacy, clinical and health management programs by evaluating drug trends, member compliance, the impact of plan designs and the savings from generics and clinical programs
  • No-charge, ad hoc reporting tools
  • Book-of-business benchmarking shows clients how they compare to their peers
  • Best-in-class dedicated account support continually reviews plan design structure, drug coverage, and management reports in order to make recommendations based on your needs and to keep your plan running effectively
  • Quarterly and annual meetings for clients
  • Extended pharmacy discounts: Employers Health provides the pharmacy engine behind three community prescription assistance networks, one each in Stark and Summit counties, and one shared by Wayne and Holmes counties. These programs receive free access to our pharmacy discounts and rebates, and Employers Health donates all related access fees collected from CVS Caremark back to the programs

Our solutions are designed to make the best use of your pharmacy investment. We’ve organized them in two categories: those that manage bad trend and those that promote good trend.

Our Bad Trend solutions target and control unnecessary pharmacy spend through the use of generics, low-cost channels and utilization management tools.

Promoting Good Trend means helping patients receive the most cost-effective appropriate therapy and helping them stay adherent. Our good trend solutions are focused on helping to control medical costs by improving medication adherence and reducing gaps in care.

Maintenance Choice®

Improved member access and satisfaction with this program that offers the same price savings for 90-day prescriptions at mail and retail.

Pharmacy Advisor®

Improved member clinical quality with face-to-face member counseling and physician outreach resulting in increased adherence and decreased gaps in therapy for targeted drug classes.

Drug Discount Card Program

Employers Health clients can save more at the point-of-service through the Drug Discount Card Program, offering a discount off the list price of certain medications.

Interactive resources to help you learn how CVS Caremark is helping people on their path to better health.
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Maintenance Choice: Employer Video
Mail Service Pharmacy
Generic Step Therapy