CVS Health Offers Virtual Primary Care Solution to Aetna Members

CVS Health will be offering a virtual primary care solution to its Aetna members and CVS Caremark clients.

The solution will connect members to primary care services including mental healthcare and chronic disease management through a digital platform. 

While the service itself is virtual, the platform mirrors the company’s in-person care at MinuteClinics. Members who use the virtual care service can also go into a MinuteClinic to see a provider in person and in-network. Each member’s electronic health record aims to enable interoperability, allowing members to go between in-person and virtual care more smoothly.

The model centers on a care team that the member selects. The team may include nurse practitioners, licensed vocational nurses, and registered nurses and they can coordinate medication management with a CVS pharmacist. Members connect with their care team through the digital platform.

Members who need specialized care can receive referrals to in-network specialists from their virtual care providers.

The solution was designed to cut down members’ wait times for primary care and improve access to care.

“By offering a connected care team where providers can easily exchange clinical information on behalf of their patients, and an extensive local footprint for in-person care follow-up, we’re able to provide consistent, high-quality care. This model shifts from reactive to proactive care that can ultimately improve outcomes and help lower costs,” said Creagh Milford, DO, vice president of enterprise virtual care at CVS Health.

Additionally, the press release indicated that the solution’s care coordination capabilities and consolidated clinical data will help members access affordable healthcare.

The service will become available to members of self-insured, fully-insured health plans on January 1, 2023. CVS Caremark members will also have access but their access will be delayed until the second quarter of 2023. CVS Caremark will also introduce virtual care for specialty care on the same digital platform in 2023, the press release projected.

Aetna started the move toward introducing a more accessible virtual care option a little less than a year prior to this announcement in 2021 when it launched its virtual primary care service. 

The service offered a zero-dollar copay for virtual primary care visits, a zero-dollar copay when using CVS MinuteClinic or a CVS HealthHUB, 24/7 urgent care, mental health counseling, and dermatology services.

The payer has taken an omnichannel approach to care by offering virtual care and in-person care solutions side-by-side, particularly for mental healthcare services. CVS Health conducted a pilot with 12 HealthHUBS in three cities that were outfitted to address mental and behavioral healthcare demands. 

As it developed this in-person solution, the payer also began creating a virtual care solution that would mirror the in-person services for patients who could not access in-person care for a variety of reasons.

Based on Aetna’s 2021 Environmental, Social, and Governance (ESG) report that leverages company data from January 1 to December 31, 2021, Aetna focused on increasing access to virtual care in 2021 as well as working toward greater access to mental healthcare and improved health equity.

The report found that the virtual-first primary care health plan improved access to primary care for members. In 2021, CVS Health and Aetna members completed 19 million virtual care visits, ten million of which were related to addressing members’ behavioral healthcare needs.

“We’re meeting people where they are on their health care journey and providing care that is more convenient and easier to access. When we make it simple, we can help people lead healthier lives,” Milford said.