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    CVS-Aetna deal could be costly for independent physician practices

    Nearly a year ago, physicians’ groups were celebrating a federal judge’s decision to block a $37 billion merger between insurers Aetna and Humana, calling it a win for patients and physicians.

     

    FURTHER READING: Top 10 challenges facing physicians in 2018

     

    Now, those same groups are trying to figure out the implications of Aetna’s sale to CVS Health in another multi-billion-dollar blockbuster billed as a game-changer for U.S. healthcare.

    The pharmacy chain’s announcement that it was purchasing Aetna for $69 billion was described as a boon for consumers by both companies. Aetna’s more than 23 million medical members—many of whom likely see private practice physicians for care—will now have “greater consumer access” via 9,700 CVS Pharmacy locations and 1,100 MinuteClinic walk-in facilities, according to a press release. 

    For CVS, this means millions of patients can pick up prescriptions and many other health and wellness products in their stores. For Aetna, it’s clearly cheaper to pay for care at a MinuteClinic staffed by non-physician providers than at physician practices.

    And there is this lingering question: Will CVS require patients to go to MinuteClinics instead of the physician they are used to seeing? The press release announcing the acquisition says CVS Health plans to “connect” the payer’s provider network with “local care solutions” (i.e. retail stores) to improve patient outcomes.

    But if CVS starts diverting patients from primary care physicians to “local care solutions” for services like flu shots, diabetes education and other activities now taking place in physicians’ offices—even on a voluntary basis—doctors will lose reimbursement opportunities for those services.

    Next: "Convenient” care isn’t always the best care

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    • Anonymous
      Wouldn't this be a STARK violation?
    • UBM User
      From my small pediatric practice, I look at Aetna/CVS as more of "bigger is better", and as evidence that patients' medical homes have been reduced to their EHR's. I fully expect CVS to become the primary care site for Aetna patients, especially with the Medical Practices Act making nurses independent from collaborative agreements. In my view, because Aetna has been the worst insurer with referrals and prior authorizations, such a move will decrease headaches for my staff. But, it will cost money, if we can't fill the empty appointment slots. And, who's up next, to further erode the doctor-patient relationship? After 34 years of building relationships with families, through multiple generations, I see that there could actually be an end to it, with convenience and metrics becoming more important than relationships. The CVS/Aetna merger may be the beginning of the end of independent practices, and the longitudinal, individual relationships that help make medicine more than a job. I've always said, that when it's no fun, anymore, I'm done, and this moves that day a little closer

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