Simplified Healthcare
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CVS Health® makes health insurance simpler and more affordable for Americans
Prnewswire· 2026-01-22 13:00
Core Insights - CVS Health aims to simplify and make healthcare more affordable for American consumers, emphasizing partnerships with the Administration and Congress to achieve these goals [1] - The company has made significant progress in reducing prior authorizations, hospital readmissions, and emergency room visits while lowering prescription drug costs [1] Simplification - Aetna, part of CVS Health, is committed to removing friction in the healthcare system, improving the experience for healthcare professionals and patients [2] - The prior authorization process has been streamlined, addressing issues related to incomplete data and technology interoperability [2] Affordability - CVS Health serves 185 million Americans, focusing on providing the right care at the right cost, including low-cost primary care and free virtual care [3] - The company has shifted 80% of Medicare spending to reward providers for keeping patients healthy, leading to lower costs and improved satisfaction [3] - CVS Health's Medicare Advantage plans have received industry-leading Star Ratings from the Centers for Medicare and Medicaid Services (CMS) for member satisfaction and health outcomes [3] Prior Authorization Process - Aetna has the fewest medical services subject to prior authorization in the insurance industry, approving over 95% of eligible requests within 24 hours [4] - The company is enhancing cross-payer interoperability and bundling prior authorizations for certain conditions to streamline the process [4] - Aetna is embedding nurses within major health systems to support patient care and reduce readmissions, projecting a 5% reduction in 30-day readmissions and hospital length of stay [4] Community Impact - In 2024, CVS Health contributed $474 billion to the U.S. economy and employs over 300,000 people, indirectly creating an additional one million jobs [5] Accessibility - More than 85% of Americans live within 10 miles of one of CVS Health's 9,000 community pharmacies, emphasizing the company's commitment to simplifying healthcare [6] Company Overview - As of September 30, 2025, CVS Health operates approximately 9,000 retail locations and serves over 87 million plan members through its pharmacy benefits manager [7] - The company's integrated model focuses on personalized, technology-driven services to enhance access to quality care and lower overall costs [7] Drug Cost Management - CVS Health is promoting competition to lower drug costs, introducing biosimilars that have generated significant savings for clients [8] - Since 2019, Aetna has shared negotiated pharmaceutical rebates directly with members, benefiting 25 million of its 87 million members [8]