The U.S. Department of Health and Human Services’ (HHS) Office of Disease Prevention and Health Promotion (ODPHP) and CVS Health recently formed a public-private partnership. This partnership aims to increase awareness of the availability of convenient, consumer-centered, recommended preventive services using healthfinder.gov. Healthfinder.gov is a source of easy-to-use prevention and wellness information, designed using health literacy and usability principles.
Increasing the uptake of clinical preventive services could avert tens of thousands of deaths and improve the health of many people, according to a report about clinical preventive services for older adults. However, the same report, citing estimates from the Centers for Disease Control and Prevention (CDC), suggests that fewer than half of older adults (65+) and only 25 percent of adults aged 50-65 years are up to date on their preventive services. Several studies have identified barriers to the uptake of preventive services, including limited health literacy, insufficient access to primary care, and poor understanding of benefits and availability of preventive services.
The Affordable Care Act (ACA) is helping transform the focus of health care from treatment to prevention, in part by requiring most health plans and health insurance issuers to provide coverage for certain recommended clinical preventive services without co-pay, co-insurance, or deductible. These services are determined by groups with expertise in translating the latest preventive services outcomes research into recommendations for clinicians (the United States Preventive Services Task Force, the CDC Advisory Committee on Immunization Practices, and the Health Resources and Services Administration, as advised by organizations including the American Academy of Pediatrics through the Bright Futures cooperative agreement). Because health outcomes vary according to the sex, age, and pregnancy status of patients, the clinical recommendations reflect these differences.
As of May 2015, the Office of the Assistant Secretary for Planning and Evaluation estimates that approximately 137 million Americans have gained coverage of preventive services at no additional out-of-pocket cost beyond applicable insurance premiums. This estimate includes 6.7 million newly insured individuals, yet many Americans are unaware of these expanded benefits, and continue to fail to take advantage of them, according to the Kaiser Family Foundation.
Myhealthfinder: Recommendations For Preventive Services
The ACA (Section 4004) requires outreach and education activities on clinical preventive services. To encourage the provision of evidence-based preventive services, HHS offers a free learning tool for consumers, myhealthfinder, an interactive feature of healthfinder.gov. Myhealthfinder provides personalized recommendations for preventive services that most health insurers are required to cover without cost sharing under the ACA.
The list of recommended preventive services is described in plain and actionable language and instructs patients how to discuss these services with their health care provider. Many services are recommended based on age, sex, or pregnancy status, while additional services may be recommended based on family history and other risk factors.
Following the Federal Digital Strategy, which opens government data for public use, myhealthfinder.gov was made more sharable. The ODPHP developed free, publicly available content syndication tools, including an application programming interface (API) that allows website developers to host and share the reliable preventive services and wellness information on healthfinder.gov.
Integration With CVS Health
CVS Health, recognizing the important role of informing and engaging patients about preventive care, saw the potential in using myhealthfinder to educate customers. In May 2015, CVS Health integrated the myhealthfinder API into the MinuteClinic website in a pilot project conducted jointly with the healthfinder.gov team at the ODPHP. The initial goal of this pilot is to determine whether CVS Health’s resources can help increase consumers’ access and use of the interactive myhealthfinder tool and improve the appropriate use of preventive care.
CVS Health communicates with consumers often — specifically, over 5 million Americans visit a CVS/pharmacy every day, and CVS Health communicates frequently with customers via text messaging and email. MinuteClinic, the retail medical clinic of CVS Health, has provided care through more than 26 million patient visits at its more than 1,000 clinics in 33 states and the District of Columbia.
Retail clinics, including MinuteClinic, offer strategies for increasing the uptake of recommended clinical preventive services, offering a convenient and patient-centered way for patients to obtain selected recommended clinical preventive services. MinuteClinic closely coordinates with a patient’s primary care provider about services provided and can share patient records, with permission, to ensure coordinated care.
In the first month and a half following the launch of the pilot, the MinuteClinic website has reached over 2.5 million patients using a banner with a link to myhealthfinder. This compares with healthfinder.gov’s reach of approximately 600,000 exposures to myhealthfinder during the same period. CVS Health’s greater reach, even in this limited test case, holds promise for dramatically increasing health care consumers’ opportunity to learn about preventive services that may be available to them without co-pay, co-insurance, or deductible.
It is promising to note that this public-private partnership has significantly extended the reach of myhealthfinder, and we expect individuals to become more informed and active consumers of clinical preventive services.
To extend the reach of federal programs that improve health literacy, and encourage prevention and healthy behaviors, we believe the HHS and CVS Health collaboration could be a model for other retail clinics, which, according to a perspective published in The New England Journal of Medicine, are also expanding their presence in the health care delivery space.
Because of retail pharmacies’ consumer and convenience focus, and their important role in connecting patients to and sustaining their relationships with primary physicians, retail pharmacies add valuable perspective and insight to the assessment of preventive care. HHS hopes to continue to collaborate with non-Federal entities as a key pathway to making prevention more convenient and easier to navigate for patients.