Will the 69 billion $ CVS-Aetna deal affect US health care for better or worse?

Thu, 2018 / 01 / 04

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Ihr Ansprechpartner Prof. Matthias P. Schönermark, M.D., Ph.D.

Prof. Matthias P. Schönermark, M.D., Ph.D.
Founder and Managing Director

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The merger of the US pharmacist CVS Health with the health insurer Aetna in the beginning of December was considered the largest of its kind in 2017, focusing public attention on the adjusting health care sector and on players which used to be largely invisible to the public. With the CVS-Aetna deal, the nation’s third largest health insurance Aetna joins the already influential pharmacist CVS Health. The merger is likely to strongly contribute to a consolidation in the sector of health care provision, which was already submitted by the US’ largest health insurer UnitedHealth Group. United Health has began to break down the barriers between insurance and care provision by acquiring a growing network of clinics and surgical care centers.

For CVS Health, while being by far the largest acquisition, the Aetna deal is not the first extension of the core business of drug retail and pharmacy benefit management. Instead, CVS has already built up diverse touchpoints to consumers, such as a pharmacy advisor program, 70 million “ExtraCare Memberships” and 1,000 MinuteClinics for treatment of e.g. minor illnesses, vaccinations, and physicals.

The outcome for patients is discussed controversially: CVS announces to “provide consumers with better experience, reduced costs and improved access to health care experts in homes and communities across the country”. For that purpose, CVS provides health insurance services to the 22 million medical members of Aetna directly at CVS retail stores, which allows direct contact with patients, reminding them of their medicines and taking care of minor health issues. Patients have easier access to their health insurance representatives in the tight web of retail and pharmacy stores. Especially in urban areas, contact to medical aid should be eased. As a result, tighter care is expected to reduce follow-up costs for emergency care of preventable diseases and conditions.

Doctors and patient representatives are afraid that CVS will try to cut medical costs by actively pushing insured patients into cheaper care instead of high-quality care in hospitals and emergency rooms. Medical and advisory services in MinuteClinics and other walk-through clinics are not comparable to emergency rooms and large hospitals with specialized doctors. In addition, health care practitioners might be incentivized to selectively provide medicinal products from CVS’ product list. A third concern is the increasing monopolization of the health care sector, potentially driving insurance policies up in the long run.

It remains to be seen whether the positive or the negative influences of the deal will prevail for US-American patients. What can be said for sure is that the CVS-Aetna deal will be not the last cross-industry deal in the health care sector.

BY Prof. Matthias P. Schönermark, M.D., Ph.D., Founder and Managing Director, SKC Beratungsgesellschaft mbH

Sources:
Washington Post - What the CVS-Aetna deal means for the future of health care