Could the CVS and Aetna merger result in a step in the right direction for value-based healthcare and Chronic Care Management, and how is Amazon impacting consolidation in healthcare?
Last week, a merger between American retail pharmacy and healthcare company CVS Health and health insurance provider Aetna was announced, making waves in the healthcare industry. If it receives final approval, it would be one of the largest healthcare mergers in history with a value of $69.9 billion, or closer to $77 billion including debt.
CVS and Aetna Merger: Positive for the Value-Based Care Trend?
CVS makes a significant portion of its revenue as a pharmacy benefit manager, a role in the pharmaceutical chain that does not usually receive much attention from the general public.
Both companies expressed strong optimism that the announcement would lead to long-term benefits for patients and consumers. This could be a move in the direction that healthcare is already shifting -- toward a value-based model instead of fee-for-service, with focus on preventive care and cost savings.
Recently, expansion of value-based initiatives like Medicare’s Chronic Care Management and other care coordination programs that increase reimbursement for improved patient care have driven attention toward these same goals.
CVS could be in a position to offer patients cheaper and easier access to medicine once its pharmacy stores begin to transform into community healthcare hubs. Cheaper medicine would be a benefit to many patients for whom access to treatments is challenging thanks to current healthcare trends of on-the-rise pharmaceutical costs.
Groups that are expected to benefit most are those covered by both Medicare and Medicaid, as well as those with chronic conditions who require a higher level of care.
The traditional healthcare system is not providing adequate patient care, said Larry J. Merlo, the chief executive of CVS. He referred to the merger as an “opportunity to meet a huge unmet need,” a need that includes insufficient patient care coordination.
However, critics are skeptical that the merger would actually result in substantial benefits for consumers. The Coalition to Protect Patient Choice does not support the move, releasing the statement that "mergers like these have a dismal history," and "consumers suffer by paying more and getting less choice for the vital drugs they need."
Antitrust law could block the merger from going through, as several other mergers between large players in healthcare were recently blocked, partly due to fears of overly reduced competition in pharmacy and healthcare. It hasn’t stopped interest among such healthcare and pharmacy players to improve positioning through mergers and acquisitions, though.
Amazon Online Pharmacy Behind CVS and Aetna Merger?
Behind the merger looms the presence of Amazon. The company has made headlines multiple times recently for its ability to completely disrupt industries it enters. Rumors that Amazon is very likely to begin prescription drug distribution has shaken many healthcare players.
This merger marks a potential shift in the future of pharmacy, as well as a need to look at the complicated relationship between Amazon, CVS and Aetna.
Some point to Amazon’s wholesale pharmacy licenses in several states to be evidence that the eventual move is inevitable.
A supply chain consultant who worked for Amazon in the past told The New York Times, “The pharmacy business was always a topic of interest when I was with Amazon, and there was a sincere desire on the part of Amazon to create a better customer experience across pharmacy and healthcare as a whole.”
Health Technology Innovating Value-Based Care
Health technology has been causing changes to healthcare at an increasing speed, as new developments allow for healthcare innovation in treatment, the doctor-patient relationship, and communication throughout the entire healthcare system.
For example, CareSync has used the popularity of mobile health apps and smartphones to improve patient communication with doctors, access to medical records, and the ability of providers to manage patient care and reimbursement for said care. Health technology combined with value-based healthcare policies, like Medicare Chronic Care Management, are driving the company’s growth in a time when both providers and patients are eager for reform. Due to rising costs of medicines, CareSync also introduced a discount pharmacy card for patients to secure savings on medicine.
Digital technology, such as online pharmacy, mobile health apps, artificial intelligence in healthcare, and the like, are all shedding light on the potential for positive changes in the modern healthcare industry that will benefit both providers and patients.
“We see this as a tipping point; we see Amazon as a catalyst or an enabler,” said Richard Evans, an analyst at SSR Health, to The Washington Post. “All these discordant notes that are echoing around, and people are starting to envision what the symphony is going to sound like once the warm-up period is over. Let’s put it this way: something very different.”
For news concerning the benefits of mHealth, patient care coordination, CCM, value-based care, and more, please check this blog regularly. To help improve your patient outcomes and increase practice revenues through between-visit care coordination, contact CareSync, the top choice in Chronic Care Management companies, at 800-501-2984.