CVS Specialty Helps Patients Overcome Barriers to Care Through Whole-Person Support
For patients living with chronic and complex health conditions, managing a treatment plan often involves much more than taking medications and attending medical appointments. Everyday circumstances, including access to food, stable housing, transportation, financial resources and basic household necessities, can significantly influence a person’s ability to remain engaged in their care.
Recognizing these challenges, CVS Specialty is taking a broader approach to patient support by addressing social and environmental factors that can affect health outcomes and medication adherence.One example is Diane Brighton, PAH Nurse Clinical Coordinator at CVS Specialty, who spends a significant portion of her working week visiting patients in their homes. These visits provide her with an opportunity to understand aspects of patients’ lives that may not be visible through medical records, routine clinical assessments or vital signs.
A patient’s home environment can reveal practical challenges that may directly or indirectly affect their health. Someone may be struggling to pay an electricity bill, experiencing food insecurity or lacking equipment needed to monitor a chronic condition. In some cases, even relatively simple needs, such as having a scale available to monitor weight, can become an obstacle when a patient is managing a condition that requires regular monitoring.
Through its resource connection platform, CVS Specialty can help clinicians identify these needs and connect patients with community organizations and other resources that may be able to provide assistance.
The approach reflects a broader concept of whole-person care, in which healthcare providers consider not only a patient’s medical condition but also the social circumstances and environmental factors that can influence their ability to achieve better health outcomes.
Looking Beyond Medication
Specialty medications can play an important role in managing chronic and complex conditions, but access to medication alone does not guarantee that patients will be able to successfully follow their treatment plans.
Patients may face a variety of obstacles outside the clinical setting. Financial hardship, food insecurity, housing instability and limited access to essential resources can create additional pressure for people already managing demanding health conditions.
For specialty patients, these challenges can become particularly significant because treatment may require regular monitoring, ongoing communication with healthcare professionals and adherence to complex care plans.Whole-person care recognizes that these circumstances can influence a patient’s overall ability to manage their condition.
CVS Specialty’s approach seeks to identify these barriers and help patients connect with appropriate community-based resources. The objective is to provide support that goes beyond the traditional relationship between a patient and their medication.
The Importance of Social Determinants of Health
Social determinants of health refer to the conditions in which people live, work and interact with their communities. These factors can include access to food, housing, transportation, financial resources, social support and other basic necessities.
According to a report from the U.S. Department of Health and Human Services, social determinants of health can have a substantial influence on health outcomes, with some estimates indicating that they may influence health outcomes by as much as 50% in certain circumstances.
This underscores why healthcare organizations increasingly recognize the importance of addressing social needs alongside clinical care.
For patients with complex conditions, the relationship between social circumstances and health can be particularly important. A person who is experiencing financial hardship, for example, may have difficulty prioritizing healthcare-related needs when basic household expenses are competing for limited resources.
Similarly, someone experiencing food insecurity may face challenges maintaining adequate nutrition, while housing instability can make it more difficult to store medications properly, maintain routines or attend appointments.
These circumstances do not necessarily appear in a patient’s medical chart. They may only become apparent when healthcare professionals take the time to understand the patient’s daily environment.
Home Visits Provide a Broader Perspective
Diane Brighton’s home visits provide an example of how healthcare professionals can gain a deeper understanding of patients’ circumstances.Visiting patients where they live allows clinicians to see aspects of everyday life that may not be visible during a traditional clinical encounter.
A patient may appear stable during an appointment, but their home environment may reveal challenges that could affect their ability to manage their condition.For example, a patient may need assistance with essential household expenses, have difficulty accessing nutritious food or lack equipment necessary for routine health monitoring.
These observations can help clinicians identify potential barriers before they become more significant problems.For Brighton, the home visit is therefore more than a clinical interaction. It is an opportunity to understand the patient as an individual and identify practical challenges that may influence their ability to remain on therapy.
Connecting Patients With Community Organizations
Identifying a social need is only the first step. Patients also need access to organizations or services that can help address that need.CVS Specialty uses a resource connection platform that allows CareTeams to connect patients with a network of community organizations and resources.
The platform is intended to help match patients with organizations that may be equipped to address specific needs.
These needs can include:
- Food insecurity
- Housing instability
- Financial hardship
- Utility assistance
- Access to essential household resources
- Other social and environmental challenges
Instead of simply giving a patient a general list of phone numbers, the approach is designed to connect patients with resources that are more closely aligned with their individual circumstances.Brighton describes the process as being more than simply providing a phone number. The goal is to help patients find the appropriate resources for their specific situations.This personalized approach can make it easier for patients to navigate available community support.
Addressing Financial Challenges
Financial hardship is one of the barriers that can affect a person’s ability to focus on healthcare.Patients managing complex medical conditions may face additional expenses related to treatment, transportation, monitoring equipment and everyday living.
Brighton’s home visits can reveal situations where patients need assistance with basic expenses, such as electricity bills or groceries.Connecting patients with community organizations that can potentially help with these needs may reduce some of the external pressures they face.
While community resources cannot eliminate every financial challenge, providing patients with information and connections can give them additional options for addressing immediate needs.This can be particularly valuable for individuals whose health conditions already require significant time and attention.
Supporting Patients With Practical Care Needs
Sometimes the barriers to care are relatively simple but still important.For example, certain patients may need to monitor their weight as part of managing a chronic condition. Having a scale at home may therefore be an important component of their care.
If a patient cannot afford one, the lack of equipment can become a practical obstacle.Through connections to community resources, CVS Specialty can help identify potential solutions for patients who need support with these types of needs.
This illustrates the broader philosophy behind whole-person care: seemingly small challenges can have a meaningful impact when they affect a patient’s ability to follow a treatment plan.Addressing those challenges may help make the overall care experience more manageable.
A Personalized Approach to Specialty Care
Patients with chronic and complex diseases often require long-term relationships with healthcare professionals.Their needs can change over time, and the challenges they face outside the healthcare system may evolve along with their condition.A personalized approach allows CareTeams to consider these changing circumstances rather than focusing exclusively on medication management.
CVS Specialty’s model combines clinical support with efforts to identify social and environmental needs.The process begins with understanding the patient’s circumstances. Clinicians such as Brighton can identify challenges through home visits and conversations with patients. The CareTeam can then use its resource connection platform to identify relevant community organizations.
This creates a pathway from identifying a need to connecting a patient with potential support.
Helping Patients Stay on Therapy
One of the important objectives of addressing social barriers is supporting patients’ ability to remain on therapy.Specialty treatments may require consistent adherence and ongoing monitoring. When patients face significant social or environmental challenges, maintaining that consistency can become more difficult.
For example, financial instability may create competing priorities. Food insecurity can affect overall well-being. Housing problems can disrupt routines. Lack of basic monitoring equipment can make it harder for patients to follow recommended care practices.
By helping address some of these barriers, CVS Specialty aims to support patients throughout their treatment journey.The approach does not replace medical care. Instead, it complements clinical services by addressing factors outside the traditional healthcare setting that may influence a patient’s experience and outcomes.
CareTeams Play a Central Role
CVS Specialty CareTeams are an important part of the resource connection process.These teams can help identify patients who may benefit from community support and facilitate connections to appropriate organizations.The approach also allows healthcare professionals to focus on their primary clinical responsibilities while helping patients navigate additional resources.
For patients, navigating community assistance programs can sometimes be difficult. They may not know which organization to contact or what services are available.A coordinated resource connection process can help simplify that experience by identifying organizations that may be relevant to the patient’s particular circumstances.
Whole-Person Care as Part of the Patient Journey
The broader shift toward whole-person care reflects an increasing understanding that health is influenced by much more than clinical treatment.For people living with complex diseases, successful healthcare management may depend on whether they have access to basic necessities, a stable environment and appropriate social support.
CVS Specialty’s approach seeks to incorporate these realities into the patient experience.By meeting patients where they are, including in their homes, clinicians can gain a more complete understanding of the factors affecting their care.
By connecting patients with community organizations, CareTeams can help address some of the practical challenges that may otherwise interfere with treatment.Together, these activities support a more comprehensive approach to specialty healthcare.
Building Stronger Connections Between Healthcare and Communities
Healthcare organizations increasingly recognize that improving outcomes requires collaboration beyond traditional medical settings.
Community organizations often provide services that healthcare systems themselves may not directly offer, including food assistance, housing support and financial resources.Connecting healthcare patients with these organizations can create a bridge between clinical care and community-based support.
CVS Specialty’s resource connection platform is designed to facilitate this relationship.For patients, the benefit can be greater awareness of resources available in their communities. For healthcare professionals, it provides another way to respond when social needs are identified.
CVS Specialty’s approach demonstrates how specialty healthcare can extend beyond medication management to address the broader circumstances affecting patients.For Diane Brighton and other CareTeam members, understanding what happens inside a patient’s home can provide valuable insight into the challenges that may affect treatment.
Whether the issue involves paying an electricity bill, obtaining groceries, securing stable housing or accessing equipment needed for health monitoring, these practical concerns can become important parts of a patient’s healthcare journey.
Through its resource connection platform, CVS Specialty helps connect patients with community organizations that may be able to address these needs.The strategy reflects the principles of whole-person, patient-centered care: understanding the individual, identifying barriers and helping connect them with appropriate support.
For patients managing chronic and complex conditions, that additional layer of support can make healthcare feel more personalized and accessible. By recognizing the social and environmental factors that influence health, CVS Specialty is working to help patients overcome barriers that can make it difficult to stay on therapy.
Ultimately, the approach reinforces the idea that effective healthcare involves more than diagnosing conditions and providing medications. It also involves understanding the realities of patients’ everyday lives and helping them access the resources they need to manage their health.
By combining clinical expertise with community connections, CVS Specialty aims to provide patients with a more comprehensive care experience—one that considers not only their medical needs but also the circumstances that can influence their ability to achieve better long-term outcomes.
Source link: https://www.cvshealth.com/
