Can Integrated Healthcare Work?

Skepticism surrounds CVS's claims that the $69 billion merger will redefine and reshape the delivery of healthcare in this country.
By: | January 8, 2018 • 5 min read

High-quality service. Improved access. Lower costs.

That’s what CVS Health hopes to achieve by acquiring the insurer Aetna, which awaits the approval of industry regulators and shareholders of both companies.

But time will tell whether this deal offers substantial savings and benefits to employers and their workers. So far, experts say, the track record of healthcare mergers or acquisitions intending to improve consumer experiences and drive efficiencies has been mixed. Although the potential exists for the combined company to hit its targets, skepticism surrounds the $69-billion acquisition about how its proposed system will redefine and reshape the delivery of healthcare in this country.

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The concept behind the deal, experts say, is that by managing both the medical and pharmacy benefits of patients, the combined company can better coordinate treatment, which in turn, will lower health care and pharmacy costs for both consumers and employers.

Part of its strategy includes growing the number of CVS’ community clinics – called MinuteClinics –  in its nearly 10,000 retail stores. So far, it operates 1,100 MinuteClinics inside CVS Pharmacy and Target stores in 33 states and the District of Columbia. Since their 2003 launch, the clinics have recorded 34 million visits.

“What this transaction potentially does is allow Aetna though its insurance products to utilize a combination of physicians in the community and expanded CVS MinuteClinic blueprint to bring more options for people to access primary and preventive care in the local community,” says Jim Winkler, chief innovation officer at Aon Health Business in Norwalk, Conn.

Because CVS and Aetna are also active players in the Medicare marketplace, he adds, the combined company could creative new alternatives for how companies with significant retiree populations can offer them healthcare.

However, much of the details are still unknown, experts acknowledge. Will employers have to use both Aetna and CVS to maximize this new ecosystem? Will HR will need to change its plan designs or strategies? Should co-pays stay the same when visiting either a doctor or a MinuteClinic?

“Employers would be wise to pay attention [to industry changes] in the next 12 to 18 months,” says Winkler, citing new deals between Optum and DaVita Medical or Optum’s MedExpress and Walgreens Boots Alliance that are also launching urgent-care centers in Walgreen stores.

And many HR professionals are keeping track of the possible changes, according to a new Aon survey that asked 450 HR leaders about the CVS-Aetna implications on their healthcare strategies.

Based on the survey’s results, 85 percent expect significant or moderate changes in how or where people will access healthcare. Another 60 percent are likely to make changes to their healthcare strategies, with 38 percent adopting a wait-and-see approach. Yet, based on responses from a subgroup of 210 individuals, 52 percent of respondents report having medical and pharmacy managed by separate companies and therefore anticipate no changes to their company’s approach.

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