CVS plans to launch a first-of-its-kind healthcare engagement platform, banking that perennial gripes about poor entry and navigation will incentivize each customers and rival corporations to signal on.
The platform will embody knowledge and companies provided by CVS’ totally different well being companies — and people of taking part trade companions. The objective is to create an built-in healthcare expertise for customers, hopefully enhancing their expertise with the trade, reducing prices and bettering outcomes, CVS executives mentioned Tuesday throughout the healthcare large’s investor day in Hartford, Connecticut.
CVS can be banking that the platform can even be a income by driving customers to CVS services they may not find out about in any other case.
CVS didn’t reply to questions on how a lot it’s spending to construct the platform or how a lot income the corporate expects the platform to generate. The platform’s eventual worth will depend on if CVS is ready to persuade its friends within the insurance coverage and pharmacy sectors to combine their very own knowledge and merchandise — not a positive wager in at present’s hyper-competitive healthcare panorama.
But the app ought to assist drive development, in line with one analyst.
“We sit up for listening to extra however see the totality of the CVS enterprise as ripe for constructing out a platform like this,” Leerink analyst Michael Cherny wrote in a Tuesday be aware on the corporate’s investor day.
The engagement play
Bettering buyer engagement is a white whale for the healthcare sector at a time when roughly one-third of People don’t actually have a main care supplier. Doctor shortages, excessive healthcare costs, and complicated and complicated processes have made it tough for the typical American to entry healthcare, with excessive percentages of customers reporting delaying or eschewing care altogether resulting from such elements.
The healthcare sector was laser-focused on turning into extra consumer-centric previous to the COVID-19 pandemic, spurring hospitals and insurers to take a position extra closely in initiatives to enhance client engagement and expertise. Although such initiatives have yielded few concrete enhancements systemwide, healthcare executives say they continue to be a excessive precedence. And consumerism’s significance continues to be evident in rising direct-to-consumer initiatives — particularly within the pharmacy area.
Now, CVS is hoping that its new “engagement as a service” platform can additional enhance People’ experiences with the healthcare system, driving extra income to its companies alongside the best way.
“Sturdy client engagement — a variety of corporations have stood up right here and mentioned that they’re going to try this. It nonetheless stays elusive,” mentioned Prem Shah, CVS’ govt vice chairman and group president, throughout the investor day. “Our trade has chased engagement however nobody has but caught it.”
Executives mentioned that CVS will have the ability to succeed because of the firm’s broad client attain throughout its Aetna medical health insurance, pharmacy profit supervisor Caremark and retail pharmacy companies.
Of CVS’ 185 million customers, roughly 62 million interact with the corporate digitally. Twenty-one million have given CVS permission to achieve them in real-time by way of push messaging, in line with Tilak Mandadi, CVS’ chief expertise and expertise officer.
Creating an “every part app” combining a number of companies into one platform is an concept CVS has been toying with for years. The corporate has taken steps by constructing out its CVS Well being app, which now contains well being advantages, pharmacy advantages, prescriptions and different knowledge pulled from CVS’ personal companies.
However the brand new open engagement platform will go notably additional. The platform will embody a complete profile for every client by pulling knowledge from digital well being information, pharmacy claims, and residential well being and wearable units.
It is going to be capable of assist customers discover new medical doctors, schedule visits and exams, and handle claims and appeals. It could possibly recommend related sources and actions customers ought to take to raised their well being or funds, like the provision of a less expensive different for a drug they’re taking, in line with CVS.
Executives mentioned that the platform is being constructed with synthetic intelligence at its core, and can embody an agentic AI chatbot to assist customers navigate protection and care choices.
A graphic of CVS’ new open client expertise platform shared throughout the firm’s 2025 investor day.
Rebecca Pifer/Healthcare Dive
However the largest factor that may set CVS’ platform aside from the some-250,000 digital well being apps accessible within the U.S. is its potential integration with different healthcare corporations.
Betting on trade buy-in
When CVS workers had been creating the platform, they realized that individuals need integration throughout all healthcare entities, not only one, in line with Mandadi.
CVS had already executed many of the work vital to incorporate outdoors corporations within the platform, so figured it may very well be provided as much as the trade as a service, the chief mentioned.
It’s unclear whether or not mentioned corporations — particularly the most important conglomerates like UnitedHealth — will step onboard a platform managed by certainly one of their rivals, a lot much less share their knowledge.
Interoperability, or the free change of knowledge, is a big downside within the healthcare area. Regardless of regulatory efforts, sufferers’ knowledge is usually siloed between totally different corporations, making it tough to get a complete view of their well being journey. There’s a enterprise incentive for hospitals and insurers to maintain knowledge shut, which makes it harder for sufferers to get well being companies elsewhere or swap plans, consultants say — one potential roadblock for broad trade buy-in to CVS’ new platform.
Mandadi acknowledged that outdoors corporations could also be cautious. However the engagement platform will assist individuals, he argued.
For instance, pharmacies may turn out to be higher at managing prescriptions and drug adherence, whereas insurers will have the ability to spur conduct change of their members. Additionally, taking part corporations will have the ability to create new and extra personalised merchandise from the info insights generated from the platform, Mandadi mentioned.
“These and lots of different worth drivers we really feel are going to compel a variety of companions within the trade to take part within the platform,” Mandadi mentioned. “A few of them in all probability don’t need to. Nevertheless it doesn’t matter. We’re very assured we’ll turn out to be a vacation spot of alternative and the customers are going to implement it. ‘It is advisable be a part of this platform’ — that’s going to return from the customers.”
CVS didn’t reply to questions on exterior curiosity within the platform. However CVS is having “severe” conversations with a number of companions that it thinks might be built-in with the platform upon its launch subsequent 12 months, Mandadi mentioned.
CVS didn’t reply questions concerning the monetary preparations between CVS and corporations taking part within the platform, together with whether or not they may pay CVS for entry or for any new enterprise they generate from the app.
The Rhode Island-based healthcare large is attempting to create a brand new development lever for its companies throughout a turnaround interval. It’s been a tough few years for CVS, as unexpectedly excessive medical prices have slammed its insurance coverage arm and reimbursement troubles have dogged its legacy pharmacy enterprise.
CVS has tried to proper the ship by reshuffling its govt bench, exiting unprofitable insurance coverage markets and pivoting to new pharmacy reimbursement fashions. These efforts have yielded some success this 12 months. CVS has elevated its 2025 earnings steering every of the final 4 quarters, and once more upfront of Tuesday’s investor day.
