CVS Health stands as a giant in the U.S. healthcare landscape, serving over 100 million people annually and generating more than $357 billion in revenue in 2023. But behind these impressive numbers lies a quiet revolution: the integration of artificial intelligence (AI) into nearly every facet of its operations. This transformation is not just about efficiency—it's about delivering more personalized care, improving patient outcomes, and responding to public health needs at an unprecedented scale.
Personalizing Pharmaceutical Workflows: Tackling Medication Non-Adherence
Medication non-adherence is a persistent challenge in healthcare, costing the U.S. system an estimated $528 billion each year. Many patients, especially those with chronic illnesses, struggle to follow their prescribed regimens, leading to poorer health outcomes and higher costs. CVS Health recognized this as both a business and a public health problem—and turned to AI for a solution.
By harnessing machine learning models on platforms like Databricks Lakehouse, CVS Health analyzes a wealth of patient data: prescription histories, insurance claims, health conditions, demographics, and real-time pharmacy interactions. This data-driven approach allows CVS to predict which patients are at risk of missing doses and to tailor outreach accordingly.
Instead of generic reminders, patients receive communications that match their preferences and behaviors—whether that's a timely text, a phone call from a pharmacist, or a personalized refill reminder. For those who consistently delay prescriptions, the system can flag them for more intensive support. This targeted approach has already led to a measurable 1.6% improvement in adherence rates—a small percentage with massive implications when scaled across millions of patients.
The real magic lies in unifying data silos and focusing on near-term behaviors, not just static profiles. This enables care teams to intervene more effectively, supporting those who need it most without overwhelming staff with unnecessary tasks.
Actionable Takeaway: If you're managing a healthcare operation, consider how AI can help you move from one-size-fits-all interventions to truly personalized patient engagement. Even modest improvements in adherence can yield significant clinical and financial benefits.
Augmented Intelligence: Streamlining Testing and Vaccine Delivery
The COVID-19 pandemic put CVS Health's operational agility to the test. Tasked with scaling testing and vaccination services from just 50 sites to nearly 1,000 in a matter of weeks, CVS turned to an augmented intelligence platform built on DataRobot. This system aggregated data from sources like CDC forecasts, local appointment trends, workforce availability, and supply chain signals to generate dynamic recommendations for staffing and resource allocation.
The result? CVS could predict demand fluctuations, allocate mobile units where needed, and ensure that each site had the right amount of staff and supplies—reducing wait times and avoiding costly over- or under-supply. Human experts remained in the loop, using AI-generated scenarios as decision support tools rather than replacements for clinical judgment.
This approach enabled CVS to deliver over 29 million COVID-19 tests and 59 million vaccine doses nationwide. The same forecasting capabilities now support seasonal vaccination surges and other public health campaigns, demonstrating the long-term value of AI-driven planning.
Actionable Takeaway: For organizations facing complex logistics, AI-powered forecasting can be a game-changer. By integrating real-time data and keeping human decision-makers at the center, you can respond faster and more effectively to changing conditions.
The Human-AI Partnership: Enhancing, Not Replacing, Expertise
A key theme in CVS Health's AI journey is the partnership between technology and people. AI provides the insights and recommendations, but human experts make the final calls. This ensures that care remains compassionate and context-aware, even as operations become more data-driven.
Actionable Takeaway: When implementing AI, focus on tools that empower your teams rather than replace them. Augmented intelligence can help scale expertise and improve outcomes without sacrificing the human touch.
Summary: Key Points
- CVS Health uses AI to personalize patient outreach, improving medication adherence and reducing costs.
- Machine learning models unify data sources for more effective, targeted interventions.
- AI-driven forecasting enabled CVS to scale COVID-19 testing and vaccination rapidly and efficiently.
- Human experts remain central, using AI as a decision support tool.
- The integration of AI in healthcare operations offers actionable lessons for organizations seeking to improve both efficiency and patient care.