The driving drive behind a unprecedented evolution.
WOONSOCKET, R.I. — The mixture of CVS Health and Aetna marks a brand new period in U.S. well being care. Finalized in late November, the $69 billion deal paves the means for the mixed firm, whose experience and belongings contact almost each facet of affected person care, to revolutionize well being care supply and, in the course of, full the transformation of the drug retailer into a real neighborhood well being care middle.
“This is a transformative moment for our company and our industry,” says Larry Merlo, the driving pressure behind the firm’s extraordinary evolution. “Our integration efforts continue to make great progress; our teams are working extremely well together to assure that we can immediately begin to execute on our groundbreaking work to create a new, innovative health care model that is easier to use, less expensive and puts consumers at the center of their care. As the front door to health care, our new company will have a local focus, engaging consumers with the quality care they need when and where they need it, will make a complicated system simpler for all, and will help people achieve better health at a lower cost.”
As a way to do this, he provides, CVS Health should, in the beginning, be an innovation firm. “We are committed to leading change in health care by challenging the status quo with new technologies, business models and partnerships,” he says. “To fundamentally change the consumer health care experience, we are beginning to make significant long-term investments in new products, services and platforms, some of which we will begin to pilot in early 2019. And being one company will allow us to develop new benefit designs and pricing models reflecting the power of combining health and pharmacy benefits, making the experience easier for both payers and patients. We believe revolutionizing the customer experience will be an increasingly important competitive differentiator for us.”
In recognition of Merlo’s visionary and daring management in constructing a corporation with the potential to reinvent the approach well being care on this nation is delivered, the editors of Chain Drug Evaluation have named him the publication’s Health Care Executive of the Year.
Merlo and his colleagues have cast a strong new firm that encompasses an in depth array of belongings — Aetna’s conventional, voluntary and consumer-directed medical insurance merchandise that serve 39 million individuals, a rising Medicare Benefit enterprise and analytics capabilities, and CVS Health’s 9,800 drug shops, 1,100 walk-in clinics, pharmacy advantages supervisor with 93 million affected person lives, and long-term care and specialty pharmacy models. These assets, along with the $245 billion in annual income they’re anticipated to generate, give the firm the attain and scale essential to affect the trajectory of the whole well being care system.
“CVS Health has a broad suite of assets and extensive health care experience to execute on cost savings initiatives, and this is augmented by the Aetna transaction,” feedback Merlo. “We’re advancing options to deal with these areas the place clients’ wants are usually not being crammed — strong supply choices, easy and intuitive consumer interface. These options enhance the expertise for shoppers and sufferers and supply them entry to what they want the place and once they want it.
“CVS Health also has the power of the human touch. We are local — offering convenient access for consumers — and we have more than 30,000 clinicians who consumers can trust with their health needs.”
The corporate might want to draw on all of these strengths as it really works to develop new, simpler approaches to well being care supply. Like many others, CVS Health is targeted on fixing the riddle of the best way to improve affected person entry and enhance outcomes whereas concurrently decreasing general prices.
“Clients and consumers will benefit from our combined company in a multitude of ways. First, as our costs go down, consumers will see the benefits in terms of premiums that will be lower than they would have been otherwise,” Merlo says. “Second, we intend to invest these savings into improving the quality of services we offer to consumers. These cost savings will improve consumers’ experience in ways beyond merely the cost of their premiums. Third, patients using lower-cost sites of care would also be able to take advantage of lower out-of-pocket costs.”
One instance of the advantages that may accrue to stakeholders that he cites is the integration of pharmacy and medical info. The holistic view that outcomes will permit CVS Health to interact with sufferers regularly and supply preventive care that may assist keep away from the improvement of critical circumstances which might be pricey to deal with.
“The combination of our pharmacy services with Aetna’s expertise in medical benefits will significantly improve our ability to help patients manage their chronic illnesses,” notes Merlo. “If we will interact with even a small portion of that inhabitants, we will scale back well being care prices for payers and sufferers.
“The combination of CVS and Aetna also will allow us to explore new benefit designs with zero co-pays or reduced cost sharing. As one example, the combined company can design benefit plans that incentivize use of clinics and home infusion. This will reduce costs compared to more expensive hospital care, such as unnecessary emergency department visits.”
The linchpin to attaining these outcomes is efficient exchanges with sufferers and their caregivers.
“If we can improve the customer experience, then we can drive greater consumer engagement,” Merlo says. “The extra engaged the shopper is with the proper care, the extra their well being and wellness improves. And higher well being means decrease complete well being care prices.
“This is what the combination of CVS Health and Aetna is all about. And we are uniquely positioned to accelerate these changes across health care. Because we touch one in three Americans with our assets today, and with over 400 health plan relationships, we will make these new offerings available across that spectrum of customers and clients.”
An overarching objective for CVS Health is to simplify the course of of using well being care providers. By extending the continuum of care, the firm intends to step up involvement with particular person sufferers and their caregivers.
“By placing consumers at the center of their health care decisions through a seamless, more connected system, we will make it easier for them to access the information, resources and services they need,” remarks Merlo. “Entry is a crucial element of constructing an easier, extra responsive and extra reasonably priced well being care expertise for shoppers.
“As such, CVS Health choices, together with retail pharmacy providers, specialty pharmacy and long-term care, walk-in medical providers and PBM providers, will proceed to be absolutely accessible to different well being plans.
“In addition, Aetna members will continue to have a broad network of pharmacies, including community-based independent pharmacies, available to fill their prescriptions. CVS Pharmacy will continue to participate within the pharmacy networks for other PBMs and health plans.”
One of the keys to attaining that imaginative and prescient is Aetna’s strong capabilities in affected person knowledge and analytics. These instruments might be leveraged to create actionable insights to reinforce outcomes at the level of care and in the day by day lives of sufferers.
“By fully integrating Aetna’s medical information and analytics with CVS Health’s pharmacy data, we can enable more effective treatment of the whole patient based on a more complete picture of their health,” says Merlo. “Consequently, sufferers will profit from earlier interventions and better-connected care, main to raised well being outcomes and decrease medical prices.
“Coordination among physicians, other health care providers and caregivers, and the health care teams at CVS, combined with expanded health screenings and advanced connected devices, can help providers predict and prevent major health events before they occur by, for example, identifying prediabetes symptoms or the warning signs of a heart attack. This will be done by remotely monitoring key health vitals or helping to ensure patients with chronic diseases take their medications as prescribed, which can improve patient health and avoid costly adverse events.”
CVS Health is starting to pursue its terribly formidable agenda towards a public coverage surroundings that is still unsettled. Controversy about the Reasonably priced Care Act, the laws handed in 2010 that established the present framework for well being care protection on this nation, continues. Federal district courtroom decide Reed O’Connor struck down the much-contested regulation late final month in a ruling that is positive to be reviewed on attraction and finally be determined by the Supreme Courtroom. Regardless of the ongoing uncertainty, Merlo is assured that coverage makers are united in the perception that the well being care system must be improved.
“I believe the current administration and Congress recognize the important and proven role that the private sector plays as an innovator in health care, and are supportive of our plans to transform the consumer health care experience,” Merlo notes. “From our perspective, we see our position as working with each private and non-private sector payers to proceed to drive pharmacy and profit plan innovation to decrease prices for the well being care system.
“Health care supply is altering earlier than our eyes, and we’re excited to be in the vanguard of that change. With a bodily presence in virtually each group throughout the nation, we’ve the unmatched capacity to satisfy shoppers the place they’re and supply the care and providers they want, both face-to-face or with the distinctive set of digital and bodily supply service capabilities that extends our bodily presence in actual time to satisfy their wants.
“CVS Health and Aetna are key health care disruptors and pivotal players in helping define a new competitive health care landscape. Together, we will help address the challenges our health care system is facing, and we’ll be able to offer better care and convenience at a lower cost for patients and payers. That is why we are excited about CVS Health and why we believe the Aetna transaction will accelerate our progress toward this goal.”
Whereas the public coverage image in Washington stays dynamic, with Republicans in management of the White Home and Senate, and a newly put in Democratic majority in the Home of Representatives, there is little question about the unanimity in help of their mission amongst the individuals at CVS Health, together with the hundreds of new colleagues who’ve come over from Aetna.
“Both companies share a deep commitment to improving health care through our products and services, diversity, corporate social responsibility and community involvement,” Merlo says. “As we move forward as a combined company, we will continue to embrace CVS Health’s values of innovation, collaboration, caring, integrity and accountability, as well as our purpose of helping people on their path to better health.”