CVS' plan to catch Aetna up to its value-based care competitors

Aetna is a "little bit behind" its peers in value-based care, but it can get ahead by leveraging the rest of the CVS Health business, Aetna President Brian Kane said. 

At CVS Health's 2023 investor conference on Dec. 5, Mr. Kane said the company is "under-penetrated" in value-based relationships in Medicare Advantage but plans to change this over time. 

"Our value-based opportunity, I believe, is unmatched. Aetna, today, is a little bit behind our competition, but we actually have an opportunity to leapfrog our peers, not only because of the strength of our diversified portfolio, but importantly because of the CVS assets, both Oak Street and Signify, all the touchpoints — our pharmacies, our PBM," Mr. Kane said. 

CVS Health closed a $10.6 billion acquisition of primary care company Oak Street Health in May and an $8 billion acquisition of home health company Signify Health in March. CVS is refocusing its healthcare services efforts, rebranding Oak Street and Signify, along with its in-store MinuteClinics and pharmacy benefit manager Caremark, as CVS Healthspire. 

Both Oak Street and Signify are payer-agnostic, serving Medicare beneficiaries with and without Aetna coverage. Integrating CVS Health's payer, provider and pharmacy operations are key to the company's value-based care strategy, according to its investor presentation.

The company is setting targets to engage more Aetna members in Oak Street and Signify services. The company plans to double the number of Aetna members receiving Oak Street care since it acquired the provider by the first quarter of 2024. 

"Using CVS assets and driving growth through them, and they driving our success at Aetna is something we're going to be very focused on," Mr. Kane said. 

Around 850,000 Aetna Medicare Advantage and Part D members live in areas with Oak Street Clinics, according to its investor presentation. Oak Street has 204 clinics in 25 states.

Aetna is also engaging value-based care opportunities in its other business lines — commercial, individual and Medicaid. 

"We believe that value-based care is not just for Medicare," Mr. Kane said. "It's also for the commercial business. We're working with Oak Street now on how we manage some of our most acute individual and commercial patients, because we think the model applies." 

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