CVS-Aetna Megamerger – What This Means For Your Practice

The CVS-Aetna deal may be bad news for the nation’s hospitals, and medical providers, as well.

The CVS-Aetna deal is one of the largest healthcare mergers in history, and while consolidation has generally not been good for patients, this one may be an exception. The merger could lead to reduced costs, a benefit for consumers.

A recent Forbes article noted: the deal is designed to keep patients out of the hospital for as much care as possible while escalating the move away from fee-for-service medicine to value-based care.

CVS plans to expand services in its pharmacies and retail clinics, and even deliver care to customers’ homes as a way to capture patients in lower cost settings and save premium dollars paid by Aetna clients, employers and those covered by Medicare and Medicaid insurance.

Although many hospitals now operate urgent care centers, the megamerger will give the retail pharmacy 22 million health plan members who can take advantage of its 1,100 retail clinics, notes Forbes.

The new deal may prove costly to physician practices, as well. The merger will increase competition and provide more choices for patients who need preventive care and urgent care services.

5 things to know about the CVS-Aetna deal

Recent articles by the AJC.com and FierceHealthcare describe some of the key facts about how the merger will impact medical providers and hospitals:

1. Aetna will operate as a standalone subsidiary. Aetna will continue to be led by the insurer’s current management team, including CEO Mark Bertolini. He and two other top Aetna executives will also be added to the CVS Health board of directors and will play significant roles in the new combined company.
2. CVS stores will undergo a transformation. CVS stores—which already offer select healthcare services via its Minute Clinics—will soon include space for wellness, clinical and pharmacy services, vision, hearing, nutrition, beauty and medical equipment, the companies said. And many locations will function as a “community-based health hub” that aims to answer patients’ questions about prescription drugs, insurance coverage and their own health conditions.
3. Health IT will play a role in the new company’s strategy. The companies said their combination will result in broader use of data to help coordinate care, lower costs, and provide a more holistic view for each patient. They also plan to pilot other tech-focused projects like using home devices to help monitor patients after they’re discharged from the hospital and remote monitoring diabetes patients’ blood glucose levels.
4. The companies expect $750 million in near-term synergies. Those will come from efforts like streamlining redundant corporate functions and shifting care to lower-cost settings.
5. CVS says the deal won’t affect its contract with Anthem. Before announcing its deal to buy Aetna, CVS agreed to partner with Anthem on its initiative to create its own pharmacy benefits manager, IngenioRx.

Competing with the big guys

Retail healthcare has continued to expand. The majority of consumers using those services have their own primary care physician but are attracted to walk-in clinics for their speed and convenience.

Tired of seeing patients going to competitors who offered walk-in care, opening your own walk-in clinic to allow patients access to care they need quickly and shorter waiting periods, may be something to consider.

What does this mean for your practice?

If you’re interested in learning more about funding options to grow your practice, talk to Aquina today and see how we can help.

• Industry Updates