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Pharmacy Solutions to America’s Health Care Challenges Thomas M. Moriarty Executive Vice President, Chief Policy & External Affairs Officer and General Counsel

Impact of Chronic Disease 1 in 2 Americans have a chronic disease. 1 in 6 Americans have three or more chronic conditions. 85% of all health spending on Americans with chronic conditions. 46% of all Medicare dollars spent on patients with 6+ chronic conditions Source: 2013 CVS Caremark Enterprise Analytics. Projections based on CVS Caremark data. Individual results will vary based on plan design, formulary status, demographic characteristics, and other factors

Integrated Delivery Models to Improve Access, Cost and Outcomes 27 Specialty pharmacies 12 mail-order pharmacies 9,700 retail pharmacies 34,000 pharmacists, nurses, nurse practitioners, physician assistants 12,000+ long term care facilities served 1,100 MinuteClinics in 33 states and DC with more than 37 million patient visits 25% market share

Enhancing Value Throughout the Continuum of Care Clinical Services Payment Models Promote accessibility of pharmacists and NPs and create a path for third party and value-based payment models.   Increasing access to healthcare and driving value with “top-of-license” practitioners. Optimize provider workflow and quality of care by modernizing and aligning practice and payment regulations.   Patient Connectivity Bridge care gaps and co-manage patients through creative IT and workflow solutions for continuity of care.   Regulatory Alignment

Prescribing Authority Optimizing Pharmacy Care By Improving Provider Regulations and Scope of Practice Rules Immunizations Point of Care Testing Prescribing Authority Patient access and convenience for critical prevention services Population disease prevention and control for Flu, Pneumonia, HPV, Hepatitis A/B Improved quality and performance for health plans Convenient, affordable access to testing and treatment to reduce Emergency Room visits for minor illness Monitoring to reduce cost and burden of chronic diseases such as diabetes Evaluation, treatment of minor ailments to reduce ER visits, fill PCP accessibility gaps & address issues when least expensive to treat Support patient adherence to chronic care and emergency medications

MinuteClinic as Low Cost Site for Quality Care Low-Cost Care Population Health Patient Engagement and Access Up to 80% less expensive than other sites of care MinuteClinic Savings Strategy can further reduce costs More than 50% of the U.S. population is within 10 miles of a MinuteClinic Address gaps in care with providers, payors and PBMs Provide health risk assessments/biometric screenings Electronic record integration with health systems Investing in: Scheduling tools and walk-in options Expansion of primary care services Telehealth The growth of retail clinics could be improved by addressing antiquated corporate practice of medicine rules in some states.

Next Generation e-Prescribing to Increase Consumer Cost Transparency Patient leaves Physician’s office with lower cost formulary diabetes medication

Greater Utilization of Pharmacy Benefit Care in Medicaid In order to cut costs and drive better outcomes, 44 States & D.C. have carved a majority of their Medicaid pharmacy benefits into managed care. By carving Rx benefits in managed care in 2013, Ohio reduced its prescription drug outlay by 13.3% below the collective average costs of states without prescription managed care. In Medicare, the consistent use of pharmacy adherence measures tied to meaningful incentives has driven quality improvement over the last 5 years of Star Ratings. This has led to significant improvements in medication adherence rates for chronic disease, like diabetes. CMS and the States should support Medicaid quality improvement in a way that consistently measures pharmacy outcomes and that provides transparent incentives for health plan and provider performance.

Combating the Opioid Epidemic to Improve Care and Reduce Costs Pharmacists Teach program has reached 275,000+ students with prescription drug education. Availability of overdose-reversal medication at pharmacies across 43 states. Nearly 800 take-back disposal units in operation across the country. Advocating for new measures: more moderate prescribing limits e-prescribing for controlled substances national prescription drug monitoring system

Pharmacy Solutions to America’s Health Care Challenges Thomas M. Moriarty Executive Vice President, Chief Policy & External Affairs Officer and General Counsel

Wireless Access SSID: cwag2017 Password: cwag17