High-cost hospitals could end up holding the short end of the stick if new integrated pharmacy benefit models take hold.
CVS Health's rumored Aetna takeover bid, tallying $66 billion, could harness 9,700-plus retail stores and more than 1,100 walk-in Minute Clinic locations to funnel patients through lower-cost settings and deliver more comprehensive care by leveraging big data.
Such a deal would also bolster CVS Caremark, the retailer's pharmacy benefit management arm, to compete on more equal footing with the likes of UnitedHealth's OptumRx, as well as Anthem's new PBM IngenioRx, which will launch in 2020. Aetna and CVS said they wouldn't comment on rumors and speculation.
"The Aetna or Optum model is predicated on keeping people away from hospitals with market power and high prices, which is an interesting construct," said Dr. Kevin Schulman, a professor of medicine at Duke University. "Whether Minute Clinic is enough of a primary-care base to pull it off is another story."