The bid to purchase health-insurance giant Aetna by pharmacy super-giant CVS would be more than just a merging of corporate interests. It also would affect consumers in some very palpable ways.
It’s not at all clear whether some of the changes would be positive or negative for consumers overall. But the merger could provide some clear benefits for people with diabetes, who are likely to find more healthcare services at their local CVS that are conveniently close and might save them visits to the doctor or hospital.
That’s because part of the plan is for Aetna to encourage its members to seek out care for minor issues at CVS’ Minute Clinics instead of at traditional doctor’s offices. The clinics are now located at 1,100 of CVS’ nearly 10,000 stores but that number is likely to grow dramatically. The clinics also would offer a larger range of services provided by nurses or physician’s assistants.
For people with chronic health issues such as diabetes that require monitoring and related services, this could be a real help. In fact, a press release from the two companies specifically mentioned the up sides for people with diabetes in their press release.
“Patients with diabetes will receive care in between doctor visits through face-to-face counseling at a store-based health hub and remote monitoring of key indicators such as blood glucose levels,” the press release said. “When needed, patients can receive text messages to let them know when their glucose levels deviate from normal ranges. As a follow up, patients can receive counseling on medication adherence, pick up diabetes-related supplies and engage ancillary services such as counsel on weight loss and programs designed to reverse diabetes through nutrition.
“This will result in better control of their blood sugar levels and better health, which should be appreciated by both patients and their doctors.”
It also would streamline billing and health management for patients and the company, because the patient/customer would be receiving medications and medical care from the same company that insures those medical benefits. In that way, it would be similar to a managed care company like Kaiser Permanente.
“They’ll be pretty much a soup-to-nuts health company … except for the hospital part of it,” Craig Johnson, president of retail consulting firm Customer Growth Partners, told CNBC.
The merged company would benefit in several ways. Its insurance arm would enjoy lowered costs from fewer medical visits and hospitalizations. It’s also a way to drive more customers to brick-and-mortar CVS stores and build brand loyalty. Once inside the door, they might decide to pick up some toiletries, snacks or greeting cards.
If services for people with diabetes are as comprehensive and well implemented as the companies claim they would be, they also would result in healthier patients who find it easier to seek out care within a few miles of home and who also save money by avoiding unnecessary doctor and hospital bills.
CVS CEO Mark Bertolini likened it to the Genius Bar at Apple stores, where people can get expert help without searching for an independent computer expert to fix the problems with their laptops or phones. Except Apple has only about 500 stores; CVS has close to 20 times that many. As with the Genius Bar, the Minute Clinic would theoretically provide an easily accessible service at lower cost.
Still unclear is whether those clinics also will benefit people who don’t get their health care through Aetna. Patients also might be unhappy if their insurer is pushing them to go to their local pharmacy when what they wanted was to go see their regular doctor—although uninsured patients might find cheaper medical care at the clinics than by seeking out a doctor’s care or going to an urgent care center.
Pharmaceutical prices also are a special concern for people with diabetes, and the forecast of how the proposed merger would affect drug prices is still unclear. Spokesmen for the two companies have said consumers would benefit because the huge new company would have more leverage to negotiate with pharmaceutical companies and cut out middlemen.
Craig Garthwaite, a health economist with Northwestern University’s Kellogg School of Management, told the New York Times that this scenario could well prove true, at least in the short term. Over time, however, consumer costs could rise as the merged company faces less competition.
“In the long run, it might be harder for new insurers to enter the market because they won’t be able to negotiate lower drug prices than the larger firms,” Garthwaite told the Times. And that, as with so many aspects of the merger big, makes it hard to predict the costs and benefits for patients.