Connecting the dots with a whole-health approach to pharmacy

Perspective: Connected care | Capability: Pharmacy | By: Carelon

Addressing the evolving needs of patients requires an integrated approach that removes barriers from the traditionally complicated healthcare system. When we take a whole-health approach, we can drive significant cost reductions for health plans that can then be reinvested to support quality outcomes, holistic treatment, and long-term support across a patient’s health journey.

In the following article, we explain how CarelonRx is addressing the role of integration in supporting patients with complex illnesses.


What does integrated care mean?


Integration in healthcare is focused on the customer and what’s most important to them. For our customers, we’ve identified three key things that can impact their healthcare experiences: affordability, access, and simplicity.

At CarelonRx, and more broadly within Carelon, solutions are constructed to keep our customers and patients at the forefront. Not only do we enable simple and accessible care at a reasonable cost, but we also focus on whole-person health, especially for those with complex and chronic conditions. For us, that means bringing medical, pharmacy, and behavioral care together in a seamless way.

For example, among patients on a specialty pharmacy medication, a percentage of that group may also have a behavioral health condition. If that drug is oncology-related, that percentage may increase. That’s why it’s incredibly important for us to simplify and integrate the experience for that patient by connecting behavioral health and pharmacy services.

Why is collaborative healthcare important when supporting patients with complex illnesses?

Complex illnesses such as cancer, Crohn's disease, or multiple sclerosis (MS), need active clinical management, medication education, and logistical support for administering and optimizing medications. Without collaboration, it’s difficult for all that to happen efficiently. Connectivity between providers and platforms enables us to support these patients at the level they deserve – and that’s why CarelonRx was built out of a whole-health mindset.

How does an integrated approach to pharmacy drive affordability?

CarelonRx has been working to maximize integration of healthcare technology since 2020. And the proof points to support that work are there. For instance, when we can integrate medical and pharmacy data, health plan customers see a $30 per member per month reduction in cost. For patients that are on specialty pharmacy medications, our customers see a decrease of $105 per member per month. That significant value is the result of our focus on integrated care, whole-person health, and delivering the best outcomes, in tandem with providing affordability and access.


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