- CVS Health and Aetna’s $US69 billion merger would create an entirely new healthcare company, one that contains an insurer, pharmacy, and a company that negotiates prescription drug costs, among other businesses.
- The deal would put a lot more of the healthcare system under CVS’s oversight and change the way people access their healthcare.
- It might mean, for instance, that a lot more healthcare happens outside a traditional doctor’s office.
The combined companies, which altogether include a health insurance business, retail pharmacies, and a company that negotiates prescription drug prices with drugmakers called a pharmacy benefits manager, would have a lot more control over how people access and pay for healthcare.
The intent of the deal is to create “health hubs,” where communities can better improve their health, in a way that they might not if their pharmacy was separate from their urgent care and their insurance company.
Here’s how Aetna CEO Mark Bertolini explained it on a call with investors on Monday:
“The real important part here is that we need to understand that almost 60% of Americans don’t have a regular doctor. A lot of people can’t get in to see the doctor they want to see. So I view the offering – I think it’s less about what the store looks like and more about the offering, and the experience the customer gets is really about a patient-centered medical home model, where we’re supporting interaction with the medical community, preparing people for appropriate compliance, preparing them for their visits, setting up appointments, eliminating prior ops, doing all those other sorts of things to help navigate that system for them. So the relationship becomes one of trust. And what I want to use over and over and over again because it makes it so much simpler.”
The “patient-centered medical home” model that Bertolini refers to is a kind of primary care model in which primary care is more of a team effort, beyond the relationship between just a patient and his or her doctor. It might mean that a lot more healthcare happens outside a traditional doctor’s office.
Bertolini envisions CVS pharmacies serving a lot like the Genius Bar that Apple has to provide tech support to customers.
“Think of the Genius Bar at Apple, for example, and this ability to walk in the store and get help,” Bertolini said. “I think this is the kind of idea we want to create in the stores, and I think we want to get going on the projects and pilots as soon as we can.”
While CVS might be best-known for its roughly 10,000 pharmacies around the US, CVS as a company operates a number of different businesses, including a pharmacy benefits manager, its MinuteClinic health clinics that are staffed by health care professionals, specialty pharmacy fulfillment and management services, mail prescription services, and long-term care services.
Here’s the full breakdown of all the parts of the healthcare system CVS touches on its own:
With Aetna, CVS picks up a few more pieces of the healthcare system, such as medical benefits and population health tools. The addition gives CVS a lot more data to analyse as well.