Transparency in Coverage

Case Study

Transparency in Coverage

Case Study Transparency in Coverage

Services:

Data Integration, User Experience Enhancement, Compliance Management

Challenge:

The Transparency in Coverage Act mandates a critical change in the way we present prescription drug prices to our customers through the Caremark app. Specifically, it requires that our app includes the prices of prescription drugs not only from CVS Pharmacy locations but also from competing pharmacies located within a 20-mile radius. This requirement has been put in place to enhance transparency in the healthcare market, empower consumers, and foster fair competition.

While the overarching goal of this legislation aligns with our commitment to providing transparent and accessible healthcare services, it presents a multifaceted challenge that we, as a company, are addressing proactively. The challenge is threefold:

Solution:

Data Integration: To ensure that our Caremark app displays accurate and up-to-date pricing information from competing pharmacies, we are actively working on integrating data feeds from multiple external sources. This process involves complex data integration, standardization, and validation to provide our customers with comprehensive and reliable pricing data.

User Experience Enhancement: Presenting pricing information from competing pharmacies in a user-friendly and intuitive manner is paramount. We are investing in user experience enhancements to ensure that our customers can easily compare prices, make informed decisions, and access the care they need.

Compliance Management: Ensuring ongoing compliance with the Transparency in Coverage Act is a priority. We have established a dedicated compliance team to monitor and audit our data sources, pricing accuracy, and app functionality to meet the legislative requirements consistently.

Results:

While addressing these challenges, we see this regulatory change as an opportunity to strengthen our commitment to customer-centric healthcare services. By embracing transparency, we aim to empower our customers with the information they need to make informed choices about their healthcare, ultimately improving their overall experience with CVS Health.