Aetna MA Q1 Insights Newsletter

Communication produced by Aetna on 2/23/21:

Aetna Insights for consultants and brokers:

News you can use:

• Breaking News: Leadership announcement
• Top Story: CVS Health® and Aetna®: Where you want us to be — Caring, Connected and Closer to Home
• Legislative Update
• COVID-19 Update: Supporting you and your clients through the next phase of the pandemic
• Local Focus:
o CVS® HealthHUB™ expansion continues in the Ohio and Kentucky market
o Learn about Aetna Whole Health – Cleveland Clinic plan



Daniel Finke named President of Health Care Benefits Segment
Daniel Finke is now Executive Vice President, CVS Health® and President, Health Care Benefits Segment, Aetna. His appointment was effective February 1. He takes over from Karen S. Lynch, current President and CEO of CVS Health. She stepped into that position after Larry Merlo’s retirement in early February.

“It’s an honor to lead the Health Care Benefits segment and to support our customers, members, providers and colleagues,” said Finke. “I’m committed to simplifying the health experience for members using digital solutions and bringing to market CVS Health integrated products that demonstrate our unique ability to serve the needs of our customers.”

Finke brings more than 25 years of diverse health care experience to the company. He joined Aetna in 2014. Most recently he was leading the Commercial Business and Markets organization. He also held leadership roles in network and clinical services and was a key leader on the transformation team during the integration with CVS Health.

Before joining Aetna, Finke served as President and Chief Operating Officer of EmblemHealth. He previously spent more than a decade at Anthem in various national executive roles in healthcare operations, government programs and pharmacy benefit management.


CVS Health® and Aetna®: Where you want us to be — Caring, Connected and Closer to Home
Both CVS Health and Aetna separately have long-standing commitments to their customers and members. We put them at the center of everything they do. Together, we’re showing how CVS Health and Aetna can reimagine the health care experience.

Leveraging the assets of both CVS Health and Aetna has created unique benefits and advantages for customers and members that show the value of an integration of these two companies. These include:
• A more personalized, simplified member experience that meets people where they are
• More connected care that offers better end-to-end solutions, improved outcomes and lower costs
• Unmatched engagement that promotes behavior change
We are bringing solutions to the market that deliver a health experience that is more caring, connected and closer to home.
Caring: Reinventing the member experience
We’re transforming the way members manage their health like never before. We make it more seamless and relevant at every stage of their health journey. We do so by combining retail convenience, face-to-face engagement, expanded telehealth care and bundled products and services. Taken together, we deliver an improved health care experience that fits our members’ individual needs and lifestyles.
Connected: More connected care
We’re connecting care for both members and providers throughout the health journey. We use innovative technology that connects our data and expertise. This means we can offer end-to-end solutions that help members manage their care, and costs, in ways that no one else can. With deeper connectivity and richer data exchanges among Aetna, CVS Pharmacy and members’ own providers, we can create a more holistic awareness of member health, helping providers have access to the same electronic medical records. Driven by rich data and analytics, we can identify health opportunities. At the same time, members have an entirely seamless, connected interaction.
Closer to home: Unmatched engagement for our members
Combining CVS Health and Aetna means making care more accessible. When this happens, we can better engage members. This empowers behavior change, resulting in better health outcomes earlier for members. Over 4.5 million Americans engage with our enterprise daily. With nearly 10,000 CVS Pharmacy stores, Americans have access to thousands of community-based CVS pharmacists who can provide face-to-face clinical advice.

With unique channels that are both in-person and virtual, no one can engage members like we do.
Why it matters: For you and your clients
The integration of medical and pharmacy benefits continues to yield savings. Our 2020 study confirms savings of $6 to 11 per member per month each year. That’s an average of $95 per member per year. And that’s a savings of 1.5 to 3 percent annually.1

Our medical cost savings from integrated pharmacy benefits grew due to our unique approach to member engagement. This is especially true for members with chronic conditions such as behavioral health, diabetes and COPD.

Key capabilities and expertise from both Aetna and CVS fuel innovations and enhancements in how we support Specialty patients and manage Specialty spend. Full adoption of Specialty Rx programs, and PrudentRx for further copay optimization, can mean up to 27 percent in total savings across specialty medical and pharmacy.2

CVS Health and Aetna also has the power to go beyond just pharmacy and medical integration. Together, we can see a total cost-of-care savings for plan sponsors of as much $50 per member, per month.3

CVS Health and Aetna aren’t waiting for the future ¬. We’re defining it today. And we’re willing to prove it. Ask your Aetna Account team about our Integrated Value Guarantee.*


Legislative Update

New year, new president, new administration and congress. We expect a wave of health care related changes this year. Efforts to curtail the ongoing pandemic will likely take the spotlight.

The Biden administration has proposed, and Congress is actively considering the America’s Recovery Plan stimulus plan. This plan proposes an increase of the Affordable Care Act (ACA) Premium Tax Credit. It will cap enrollee payments at no more than 8.5 percent of income for coverage. Subsidies are currently capped at 400 percent of the federal poverty level. In addition, the administration proposes to extend subsidies for people to afford their COBRA insurance though the end of September 2021. In general, CVS Health® supports strengthening employer sponsored insurance and promoting affordable access to coverage.

Longer term, the new administration’s health care agenda also includes pushing for broader access to health care. The goal is to improve the ACA marketplace and strengthen Medicaid services. President Biden has signed Executive Orders expanding the enrollment period for ACA. He’s also urged agencies to review and rescind policies that make enrolling in ACA and Medicaid programs more difficult.

CVS Health has a long track record of supporting affordable health coverage for all Americans. We support strengthening the ACA. It has already brought affordable coverage to millions of Americans. This can be done by enhancing federal reinsurance, funding cost-sharing subsidies, providing states with incentives to expand Medicaid, and maintaining protections for those with preexisting conditions.

Also, we are committed to strengthening the employer-based insurance system, particularly during the public health emergency. CVS Health supports preserving coverage by providing subsidies for employer-sponsored coverage during the public health emergency and expanding pre-deductible coverage for primary and preventive care.

We also expect the Biden administration and congress to turn their attention to lowering drug costs. The price of prescriptions is still too high and out of reach for far too many. Lowering drug prices is a prerequisite to controlling health care costs. In turn, drug costs affect affordability, access to care and improving outcomes.

CVS Health believes that lower drug prices can be achieved by:
• More competition in the pharmaceutical marketplace by increasing the number of approved drugs available to patients and removing barriers to market entry for new ones
• Comprehensive reform to the Medicare Part D program that caps Medicare beneficiaries’ out-of-pocket costs and better aligns incentives between manufacturers, plans and the government
• Drug patent reform, including ending pharmaceutical manufacturer gaming of the drug patent system
• Improving access to generic drugs and biologically similar medicines by changing provider reimbursement to give physicians incentives to prescribe and administer lower-cost drugs
CVS Health is actively working with members of congress, their staff, and the new Biden administration to consider policies to help:
• Get the COVID-19 pandemic under control
• Improve access to quality health care
• Lower costs for consumers



Supporting you and your clients through the next phase of the pandemic

Aetna, as part of CVS Health®, remains committed to supporting our consultants, clients and members during the pandemic.

CVS Health® is one of the distribution partners for the vaccine. CVS Pharmacy® will play a prominent role in administering vaccinations across the nation. Aetna®, as part of CVS Health, is staying close to the vaccine developments. And we’re committed to making it easier for your clients and their employees to get the latest information at the right time to help inform their decision making.

The following captures some of our actions that are already underway:

  • On February 11, 2021, CVS Health® began offering COVID-19 vaccinations to eligible populations at a limited number of CVS Pharmacy locations in 11 states. CVS Health will receive about 250,000 doses from the federal government. Click here for more details.
  • Aetna is preparing to support essential worker vaccinations using our national CVS Pharmacy footprint and immunizers. This will follow the vaccination of frontline health care workers and long-term care residents, and prior to the availability to the general population. For employers that meet requirements, an onsite or dedicated COVID-19 vaccine clinic for essential workers may be an option.
  • All Aetna insured and self-funded plans, including Aetna Funding AdvantageSM plans offer members a $0 cost share for the vaccine at both network and out-of-network providers. This approach follows the federal mandate.
  • Access our COVID-19 and vaccine resource page on for frequently asked questions and the latest tools and information. There’s also a state lookup tool that connects members to state resources on vaccine eligibility and rollout phases.

* For more details and client eligibility requirements, contact your Aetna account representative.

For the latest information, visit our COVID-19 support site. You can also check out the CVS Health COVID-19 resource center for information on managing health and well-being.


At CVS Health and Aetna, we set out to reimagine what the health care experience could be – we are revolutionizing community-based health care by safely connecting people to care, when and where they need it, with CVS® HealthHUB™. Despite the challenges of COVID-19 last year, our commitment to continue the expansion of CVS HealthHUB locations exceeded our goal for the end of 2020, and since December 2020, an additional 159 locations were opened in 28 states across the country.  We are excited to continue the momentum and reach 1,300 locations nationally by the end of 2021.

Now more than ever, the need for convenient care is paramount.  When health care is coordinated and timely, and data and technology are utilized effectively, people can be better engaged in their care. This can help improve outcomes and reduce health care costs. CVS HealthHUB locations help connect people to care, when and where they need it, by:

  • Serving as a channel for member engagement and personalized care support with a professional care team and our consumer-centric model that ensure your supported every step of the way
  • Delivering on the continued need for convenient and affordable care that’s available 7 days a week, including evenings, virtual or in-person
  • Supplementing the in-store experience for consumers with integrated digital and telephonic resources

To learn more about our approach to community-based health care delivery, and see what’s behind the scenes at a CVS HealthHUB, watch this quick video watch this quick video  and experience how we’re revolutionizing community-based health care.

CVS HealthHUB locations in the Ohio and Kentucky market

The Ohio and Kentucky market has 58 open CVS HealthHUB locations and 6 additional planned openings through second quarter 2021.

Recently opened locations:
1949 West Market Street
418 East Main Street
1331 North Fairfield Road
7230 Market St.
601 East Main Street
16801 Chillicothe Rd.
Chagrin Falls
1495 West 5th Ave.
7470 Sawmill Rd.
60 N. Stygler Rd.
3761 Massilon Rd.
4961 Roberts Road
111 South Memorial Drive
1443 Richmond Rd.
900 Coshocton Ave
Mount Vernon
1339 N. Main St.
North Canton
620 S. Cleveland Ave.
6005 Som Center Rd.


The power of two – Aetna and the Cleveland Clinic – offering care that’s simple, engaging and affordable for Northeast Ohio employers

The Aetna Whole Health – Cleveland Clinic plan is a multi-faceted collaboration with a co-branded insurance plan and the strength of the world-renowned Cleveland Clinic.

This unique plan offers Northeast Ohio employers and their employees:

  • Improved clinical outcomes
  • A more engaging experience, and a
  • Stronger bottom line