Simplifying Specialty Care: A Patient-First Approach from CVS Health
For millions of Americans living with complex, chronic, or rare conditions, navigating the healthcare system to begin and maintain specialty therapies can feel overwhelming. From lengthy prior authorization processes to difficulty accessing medications affordably and conveniently, patients often face unnecessary roadblocks just to begin treatment.
At CVS Specialty, part of CVS Health, the mission is clear: to simplify specialty care for everyone — patients, providers, payors, and pharmaceutical manufacturers — by removing friction and delivering streamlined, patient-centered solutions that speed up time to therapy and support adherence.
The High Stakes of Specialty Care
Specialty therapies are used to treat conditions such as multiple sclerosis, cancer, rheumatoid arthritis, and rare genetic disorders. These therapies are typically high-cost, require careful administration, and often involve complex benefit requirements. Any delay in access — whether due to administrative bottlenecks or lack of coordination — can have serious clinical consequences for patients.
“Specialty care is not just about managing a condition — it’s about improving and protecting lives,” says Lucille Accetta, Chief Pharmacy Officer and Head of CVS Specialty Operations. “The patient experience is at the center of everything we do. We combine our clinical expertise with advanced technology to simplify the process, so patients can focus on what matters most.”
For patients managing complex regimens or newly diagnosed with a rare disease, this approach can mean the difference between timely access to life-changing medications and a stressful delay that could compromise outcomes.
A Holistic Ecosystem Built Around the Patient
CVS Specialty supports approximately 2 million patients annually, offering access to nearly all specialty medications, including those with exclusive or limited distribution. This is made possible through an integrated ecosystem that connects patients, providers, payors, and pharma partners — streamlining workflows and reducing inefficiencies across the board.
Central to this approach are CVS Specialty’s CareTeams — cross-functional teams of pharmacists, nurses, patient care advocates, and benefit specialists — who provide personalized clinical, financial, emotional, and social support tailored to the unique needs of each patient.
These CareTeams receive extensive training in condition-specific care, including rare and ultra-rare disease certification. Over 500,000 patients are connected to more than 35 Centers of Excellence, focused on rare disease and ultra-rare condition support. These Centers ensure that even the most medically complex patients receive consistent, expert-level guidance and care.
Fast-Tracking Access to Therapy
One of the most critical hurdles for patients starting specialty therapy is onboarding — a multi-step process that includes verifying benefits, obtaining prior authorizations (PAs), coordinating with payors, and ensuring financial access. Traditionally, these steps can take days or even weeks, delaying treatment and risking disease progression.
CVS Specialty has transformed this process through digital innovation and system automation:
- Real-time benefits checks are integrated early to provide patients and prescribers with accurate cost and coverage information.
- Prior authorization requirements are automatically pre-checked and missing data flagged. When allowed, the system proactively submits PAs electronically — dramatically reducing the administrative burden on providers.
- Electronic Health Record (EHR) integration allows access to over 80% of specialty records, further accelerating onboarding steps.
These enhancements don’t just streamline workflow for prescribers — they also provide patients with peace of mind and faster initiation of care.
Engaging Patients Digitally — From the Start
Specialty care is inherently high-touch, often requiring regular engagement and follow-up. CVS Specialty ensures that every patient is met with flexibility and support — whether through phone, in-person consultations, or digital tools. The goal is to meet patients where they are and provide them with choices that fit their lifestyle.
Digital engagement has become a cornerstone of the CVS Specialty experience:
- Around 98% of patients opt into digital communication tools, allowing for real-time updates, reminders, and two-way communication.
- Over 95% of patients value having multiple delivery options, including home delivery or pickup at any CVS Pharmacy — a particularly helpful option for refrigerated medications or urgent fills.
- The CVS Health app provides patients and caregivers with a centralized platform to manage prescriptions, refill medications, track shipments, and contact their CareTeam.
This tech-enabled engagement improves satisfaction, but more importantly, it drives better adherence and clinical outcomes.
Predictive Insights to Improve Adherence and Outcomes
Starting therapy is just the first step. Ensuring patients stay on their prescribed regimen over the long term is critical to achieving optimal outcomes — particularly in chronic and rare diseases where nonadherence can result in hospitalization or worsening of the condition.
CVS Specialty uses predictive analytics and data-driven insights to identify patients at risk of nonadherence. The system can flag early warning signs — such as missed refills or delays in medication pickup — and proactively reach out to patients and prescribers to intervene.
Additionally, CVS Specialty tracks symptoms and side effects using digital tools and patient self-reporting. This data allows CareTeams to respond quickly to issues like medication intolerance or dosing confusion, helping prevent drop-off and maintain continuity of care.
Colleagues and providers also benefit from access to real-time prescription status updates, scheduling tools, shipment tracking, and communication platforms, ensuring that all stakeholders remain informed and aligned.
A Trusted Partner Across the Healthcare Spectrum
The CVS Specialty model is built not only around patients, but also around collaboration — with prescribers, payors, and pharmaceutical manufacturers. By reducing inefficiencies, removing barriers, and demonstrating measurable value, CVS Specialty has become a preferred partner in the specialty space.
For payors, streamlined onboarding and adherence support translates into cost savings and improved clinical performance across their member populations.
For pharmaceutical manufacturers, CVS Specialty offers nationwide reach, specialized distribution support, and patient engagement at scale — including programs for limited-distribution therapies and real-world data collection.
And for prescribers, integrated tools and proactive support reduce paperwork and follow-up burden, allowing more time for direct patient care.
Driving the Future of Specialty Care
By investing in digital infrastructure, personalized support, and clinical excellence, CVS Specialty is setting a new standard for how specialty care is delivered.
“We’re simplifying care across the entire specialty ecosystem,” says Lucille Accetta. “From digital innovations that cut through red tape, to predictive models that help keep patients on track, we’re making it easier for patients to start and stay on therapy — without unnecessary stress or delay.”
In an increasingly complex healthcare environment, simplicity isn’t just a convenience — it’s a necessity. CVS Specialty is meeting that need, not only by delivering medications, but by delivering confidence, continuity, and compassionate care for those who need it most.
Key Highlights at a Glance:
- 2 million+ patients supported annually
- 98% of patients opt-in to digital communications
- 95%+ prefer choice in delivery options
- 80%+ of specialty records accessible via EHR
- 500,000+ patients supported through Centers of Excellence
- 35+ Centers focused on rare and ultra-rare diseases
- Real-time benefits checks and electronic PA submission streamline onboarding
- Predictive analytics enhance adherence and outcomes
