Moriarty Discusses Health Care Leadership with U.S. News & World Report

Moriarty Discusses Health Care Leadership with U.S. News & World Report
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At the 2019 World Economic Forum, Tom Moriarty, Chief Policy and External Affairs Officer, and General Counsel for CVS Health, sat down with Bill Holiber, President and CEO of U.S News & World Report, to discuss how leadership in the health care industry can drive meaningful solutions for patients.

The conversation first focused on the important role leaders can play in driving a transformative vision forward. Moriarty explained that leaders, particularly in health care, need to listen and engage at a very human level.

Emphasizing the importance of providing human interactions in health care, Moriarty outlined CVS Health’s commitment to delivering high-quality, community-based care. According to Moriarty, the democratization of care delivery – giving patients greater control of their health care decisions – provides an opportunity to help patients find the right care at the best possible cost.

As an example, Moriarty referenced the real-time benefits program, which improves transparency for patients and their prescribers by showing what patients will pay for a specific drug under their benefits plan and presenting up to five lower-cost, clinically appropriate alternatives. Moriarty described the potential for solutions like this to improve health care outcomes and reduce overall costs to the system, so that those savings can be reinvested in other societal priorities, like education and infrastructure.

For more information about CVS Health’s efforts to improve access to quality care across the nation, visit our Quality & Access information center and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our bi-weekly health care newsletter.

Tom Moriarty and Bill Holiber talk at Davos.
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Moriarty Discusses Community Health Innovation at Wall Street Project Economic Summit

Moriarty Discusses Community Health Innovation at Wall Street Project Economic Summit
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Tom Moriarty, EVP, Chief Policy and External Affairs Officer and General Counsel, recently sat down with civil rights activist Rev. Jesse Jackson Sr. at the 22nd Annual Wall Street Project Economic Summit to highlight how our newly combined company can accelerate the improvement of health care for individuals and families across the country.

Moriarty emphasized how the path to better health and stronger communities can be achieved through local support and targeted engagement. At CVS Health, we know how much human interactions matter. The millions of patients we interact with every day each have unique backgrounds and needs. Every day, we utilize our community footprint to build trust with patients on a personal level.

Addressing Local Barriers to Care

Today, approximately 30 to 40 percent of physician-ordered lab tests aren’t completed – oftentimes as a result of lab and testing facilities not having extended hours and lacking access from public transportation routes. Moriarty emphasized how CVS Health can help patients achieve better health by expanding access to testing and monitoring in the communities where they live and work.

Complementing Primary Care

Due to inadequate access to care, it can be difficult for patients to locate the coordinated care and health services they need to get and stay healthy in between doctor visits. CVS Health serves 10,000 communities nationwide with more than 9,800 retail stores and 1,100 walk-in clinics and we’re pursuing new ways to elevate our retail stores as a local health care destination. 

Through the introduction of HealthHUB® locations at CVS Pharmacy stores in Houston, Texas, we have the opportunity to serve as an extension to primary care. With personalized pharmacy support programs and MinuteClinic services, the HealthHUB pilot is improving care for patients managing chronic conditions with a focus on recommending next best actions and driving medical costs savings.

Moriarty shared several examples of how the HealthHUB pilot will provide meaningful and frequent touchpoints to care. For a patient living with diabetes, we can be there more frequently to provide counsel on lifestyle and dietary needs. In the case of respiratory disease, a respiratory therapist will be on-site to help patients track their conditions and provide them with personalized counsel. These interactions will help coordinate care across a patients’ full care teams.

Improving Health Outcomes and Lowering Costs

About 80 percent of current medical spend is on chronic conditions, such as diabetes and cardiovascular disease. At the same time, the number of Americans impacted by these conditions continues to grow.

Moriarty shared how the pharmacy can help prevent these conditions and improve population health by serving as a first line of defense in the community. Our newly combined company will deliver a unified strategy aimed at making a measurable impact on the health of communities nationwide. Through our Building Healthier Communities initiative, CVS Health will make significant investments in the areas of managing chronic disease, including the expansion of Project Health to provide more screenings for the social determinants of health that affect personal well-being and the broader community, such as education, housing and access to fresh food.

For more information about CVS Health’s efforts to improve access to quality care across the nation, visit our Quality & Access information center and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our bi-weekly health care newsletter.

Tom Moriarty and Reverend Jesse Jackson shake hands.
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Leaders on the Road: Key Themes from 2018 Events

Leaders on the Road: Key Themes from 2018 Events
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Throughout 2018, CVS Health leaders participated in industry-leading events and public forums to address some of the most pressing issues in our health care system. From Washington to Los Angeles, our leaders shared their vision for transforming the consumer health experience by making health care more local, easier to navigate and more affordable.

Key themes included:

Bringing Care Closer to Home

Serving as the front door to health care in 10,000 communities nationwide, CVS Health has long been committed to connecting patients to care when and where they need it. In 2018, our leaders highlighted how our combination with Aetna will build on this commitment by integrating care delivery at a local level and making our touchpoints to care more accessible and convenient.

Improving Care Coordination and Connectivity

Health care can be fragmented for many Americans, which can impose barriers for patients across various settings. In 2018, our leaders emphasized the need to improve connectivity and communication across the care continuum to help patients and their providers better manage conditions. 

  • Larry Merlo at Town Hall Los Angeles: “Today, nearly 70 percent of Americans across the country live within three miles of a CVS Pharmacy. You can walk right in and see a pharmacist to get information about your prescription or a nurse practitioner at one of our more than 1,100 MinuteClinics to get chronic condition monitoring or a lab test, with the results sent directly to your primary care doctor.”
  • Tom Moriarty, EVP, Chief Policy and External Affairs Officer, and General Counsel, at a POLITICO Health Care Innovators event: “Health IT is key to getting past the fragmentation we see in health care. If you come into a MinuteClinic or are seen anywhere else in the CVS world, we can port that information back to your physician, or back to the health care system that serves as your primary care center.”

Addressing Rising Drug Costs

Nearly eight in ten Americans express concerns about prescription drug costs and the impact on their families’ budgets. At CVS Health, we recognize that one the most important things we can do is to help people take their medications, which improves overall health and lowers costs. Our leaders emphasized why integrating digital tools that enhance price transparency and expanding access to generics and biosimilars are key in our efforts to connect patients to the right medicine at the lowest possible cost.

  • Larry Merlo at the Aspen Ideas Festival, Spotlight Health: “We’re in the process of embedding our patients’ plan designs into [their] EHR so when the physician goes and puts a prescription in, he or she will be able to see the patient’s out of pocket costs, and up to five alternative [prescription medications] and the costs associated with each.”
  • Tom Moriarty at the POLITICO Pro Summit: “There are a number of solutions that we can implement today within the existing statutory and regulatory framework to reduce overall prescription drug costs in the system and for patients while also driving improved health outcomes through increased adherence.”

For more information about CVS Health’s efforts to improve access to quality care across the nation, visit our Quality & Access information center and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our bi-weekly health care newsletter.

General Counsel Tom Moriarty speaks at a POLITICO event
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Meeting the Nation’s Primary Care Needs

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Angela Patterson, DNP, FNP-BC, NEA-BC, and Chief Nurse Practitioner Officer of MinuteClinic, offers her thoughts on how future primary care provider shortages will affect health care, and what CVS Health is doing to help.

It’s well established that the demand for physicians in the United States is outpacing the supply. In fact, the Association of American Medical Colleges recently released data revealing that by 2025, we face a shortfall of up to 94,700 physicians overall, including up to 35,600 primary care physicians.

While these figures may seem alarming at first glance, they reflect the changing face of the medical profession in the United States. Gone are the days of house calls by a local doctor with prescription pad in hand. Today, our health care provider ecosystem — more commonly known as the “medical neighborhood” — includes primary and specialty care physicians, nurse practitioners and physician assistants, pharmacists, nurses, occupational and physical therapists, and a host of other care providers. Making better use of the providers in the medical neighborhood can help fill the gaps as demand for primary care grows.

A Team-Based Solution

Team-based care not only improves care coordination, it expands access and promotes efficiency, especially when each health care provider is able to work at the highest level permitted by his or her education and training. With thousands of providers on the front lines of delivering high-quality, affordable health care, CVS Health is playing an important role in supporting primary care within the medical neighborhood:

  • Our pharmacists in more than 9,600 CVS Pharmacy locations provide care, medication and counsel to patients every day, promoting medication adherence and closing gaps in care.
  • Nurse practitioners and physician assistants at our more than 1,100 MinuteClinic locations diagnose and treat common health conditions and minor injuries, perform health screenings, assess and monitor chronic conditions, provide wellness services and deliver vaccinations. More than 30 million patient visits have taken place at MinuteClinic.
  • Through affiliations with nearly 70 major health systems, CVS Health has established collaborative programs, including the development of joint clinical programs and electronic health records integration, to connect care across the health continuum.

Supporting Primary Care

We believe all patients should have access to a primary care provider-led medical home, and to coordinated, continuous care. For the 50 percent of MinuteClinic patients who do not have a primary care provider, we help connect them to available providers in their communities. In addition, we support educational efforts such as the Health is Primary campaign, which provides resources to consumers on when, where and how to access services offered through the medical neighborhood.

By combining a focus on primary care with our suite of best-in-class pharmacy and health interventions, CVS Health is proud to help build a more coordinated and efficient health care system, which can benefit patients, providers and payers alike.

Pharmacists and nurse practitioners play an important role in primary care.
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Improving Integration across Care Settings through Technology

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Health leaders rank care coordination as one of the biggest challenges to address in order to improve population health,https://www.qualityforum.org/Setting_Priorities/Improving_Healthcare_Quality.aspx underscoring the importance of arming providers with the right tools and technologies to deliver highly-personalized care solutions to patients.

By coupling the expertise of a pharmacy innovation company and a health plan, we are well-equipped to help providers address unmet needs in patients care. CVS Health and Aetna are expanding the use of technology and data to help complement providers’ holistic view of their patients’ health. Through our combined assets, we have the ability to improve connectivity among patients’ primary care providers to ensure high-quality care and continuity across care settings. This will, in turn, allow us to improve population health across the U.S.

Complementing Primary Care

One in three Americans views access to quality care as the most important health priority in their community. That’s why we are looking to narrow the distance between patients and their caregiving facility by leveraging digital data and making health care accessible in community locations. As a first step, we will be focused on staying in touch with the primary care doctor and integrating the care of the patient in a complementary way.

A combined company with our end-to-end capabilities enables better communication technology between the primary care provider, pharmacy and patient.

“We want to make health care easier to use by better connecting people,” says Dr. Alan Lotvin, Executive Vice President of Transformation at CVS Health.  “We are empowering the consumer to take a more active role in their health care by providing them with convenient tools and services that are seamlessly integrated within the overall health care ecosystem.”

For example, a connected glucometer could help monitor a patient's blood sugar and send an alert to a CVS Health provider for intervention if a patient's levels are too high. Between regular doctor visits, a patient with a chronic condition such as diabetes or hypertension could see a MinuteClinic provider for a series of tests to help understand how their medications are working, make adjustments to their therapeutic regimen, and receive tailored counseling on adherence and lifestyle management. In addition, telemedicine can also help fill the gaps between in-person visits to a local CVS Pharmacy or primary care provider. All information gathered during these visits could be captured and shared with their primary care provider and care team to help ensure connected care. This high-touch, integrated model could also be used to help patients transition from a hospital stay back to their home in order to help prevent unnecessary, costly emergency room visits or hospital readmissions.

Improving Population Health

Today, just five percent of the U.S. population is driving approximately 50 percent of total health care spending at more than $50,000 per patient annually. Many of these patients have common chronic diseases which, when unmanaged, can result in costly and sometimes debilitating medical complications.

Dr. Troyen Brennan, Executive Vice President and Chief Medical Officer at CVS Health, believes that reaching the dual goal of helping Americans achieve better health and reducing costs requires a combination of digital health tools and face-to-face interactions. According to Brennan, combining CVS Health’s community presence with Aetna’s data will help ensure that patients are receiving the right care and managing their conditions efficiently.

“We can take the local ability to interact with patients, and combine it with the ability to understand population management based on the data that comes with an insurance company,” says Brennan. “We want to take the programs that Aetna has been running and utilize them to improve interactions between patients and providers in our stores – allowing our pharmacists, nurse practitioners and people who are informed about benefits to counsel patients and make sure they’re doing the right thing for their health.”

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Welcome to the Medical Neighborhood

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CVS Health and family physicians team up to educate patients about how the “medical neighborhood” can help them get and stay healthy.

Health care experts have often lamented that the U.S. has the most expensive health care system in the world, yet we rank almost last among industrialized countries in patient health outcomes.Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally, 2014 Update, The Commonwealth Fund, June 2014 How can this be? What can we do about it?

While the problem is complicated, one way we can work to address these challenges is by creating a connected “medical neighborhood” for patients, focused on improving access, bolstering quality and driving down costs. The medical neighborhood model focuses on collaboration, coordination and communication among patients and their providers. 

A Centralized Model

In a medical neighborhood, all parts of the health care system are represented: primary care, pharmacy, retail clinics, acute and post-acute care, diagnostic services, public health, and community and social services. All play an important role in keeping patients healthy, but rather than following a sometimes fragmented path from one provider to another, a patient’s care is led by a primary care or family physician (also known as a “medical home”). This focus on primary care has many benefits, including decreased costs, improved health outcomes and even increased longevity.

To strengthen the medical neighborhood, CVS Health is collaborating with Health Is Primary, a campaign sponsored by the nation’s eight leading family medicine organizations. These include the American Academy of Family Physicians, the American College of Osteopathic Family Physicians and the North American Primary Care Research Group.

The joint initiative is aimed at increasing coordination of care between different parts of the health care system, specifically primary care providers and our CVS Pharmacy and MinuteClinic locations. Through the collaboration, CVS Health will support the campaign’s efforts to help patients understand when, where and how to access the services they need within the medical neighborhood.

Extending the Hours of the Medical Neighborhood

“When done right, retail clinics can play an important complementary role to primary care in the medical neighborhood,” says Dr. Glen Stream, a family physician and President and Board Chair of Family Medicine for America’s Health, a coalition of the nation’s eight leading family medicine groups and the sponsor of the Health Is Primary campaign. “We believe the CVS Health approach to integration and collaboration with primary care physicians and health systems to improve and provide a coordinated medical neighborhood for patients is a model for how retail clinics can support and promote primary care.”

With more than 1,100 locations across 33 states and the District of Columbia, MinuteClinic retail clinics are well positioned to play a key role in patient health by extending the hours of the medical neighborhood to evenings and weekends. MinuteClinic makes it easier to access care when it’s needed, focusing on acute care, preventive care and supporting management of chronic conditions, while also ensuring connection and communication with the patient’s medical home.

CVS Health and MinuteClinic are also affiliated with more than 60 of the nation’s leading health systems, building strong connections with institutions like the Cleveland Clinic, Henry Ford Health System and Emory Healthcare.

These clinical affiliations foster collaboration between MinuteClinic and health system physicians, facilitate joint programs for treatment of chronic disease and enable communication between electronic medical records. As a result, MinuteClinic providers can send a care summary to a patient’s primary care physician following the visit. Patients who do not have a primary care physician are encouraged to obtain one, and are even given a referral list of local physicians who are accepting new patients, to help them get started.

“We know that patient health and outcomes improve when patients use the resources available to them throughout the medical neighborhood and when providers across the health care system are working together,” says Andrew J. Sussman, M.D., President of MinuteClinic and Executive Vice President and Associate Chief Medical Officer, CVS Health. “By partnering with primary care and family medicine, we will continue to improve provider collaboration and help ensure all patients have access to primary care within a coordinated medical neighborhood.”

To learn more about the benefits of a medical neighborhood and the Health Is Primary campaign, visit www.HealthIsPrimary.org.

Patient outcomes can improve when they use the resources available in the medical neighborhood.
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Scope of Practice in the Changing Health Care Landscape

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Scope of practice, the set of services a health care practitioner is licensed to provide, is a growing topic of interest in health care, particularly as it relates to the Affordable Care Act and advanced care practitioners, such as nurse practitioners (NPs) and physician assistants (PAs). CVS Health and POLITICO recently hosted a forum that brought together a number of experts who participated in a panel discussion and working group to discuss recent developments and changes related to scope of practice, a follow-up to a similar discussion we hosted in 2013.

Participating experts included Tammi L. Damas, PhD, MBA, WHNP-BC, RN, Associate Dean, Division of Nursing, College of Nursing and Allied Health Sciences, Howard University. Dr. Damas set the scene for the discussion by noting that 21 states now allow nurse practitioners (NP) to practice with full authority. And since the original forum in 2013, seven states have taken action to give NPs wider authority. The discussions revealed three themes that will continue to impact scope of practice: provider supply, policy developments and payment issues.

The Physician Supply Shortage Creates Strain and Presents Opportunities

According to panelists, physician supply issues present opportunities for the broader health care team. Patricia Pittman, PhD, Associate Professor, Department of Health Policy and Management; Co-Director, Health Workforce Institute, George Washington University, underscored the severity of the physician shortage and noted the increasing demand for services. She pointed to NPs and PAs as resources that can help fill those gaps.

Jeffrey Katz, PA-C, DFAAPA, President and Chair of the Board, American Academy of Physician Assistants, echoed concerns about unmet mental health needs, highlighting a severe shortage of mental health care providers and a gap in continuity of care, especially in rural areas.

Scope of Practice Policies Vary by State and Impact Care Delivery

Scope of practice is regulated by many different entities, including the federal Medicare program, state legislatures, and state governing boards, creating significant differences across state lines. While developments continue at a steady pace overall, individual states differ in speed of adoption, contributing to varying policy and cultural health care landscapes.

Jeffrey Katz noted that prescriptive ability for PAs has expanded in some states to include controlled substances. However, laws and regulations have not yet fully adapted to the changing standards of practice in some areas, resulting in additional and unnecessary office visits when a physician is not immediately available. As a result, NPs and PAs tend to migrate to states that have less restrictive scope of practice laws. Rural areas, where PAs and NPs are already more likely to practice, may be able to boost access to care by expanding scope of practice, Dr. Pittman noted.

Provider Payment Structures Can Also Affect Access to Care

Provider reimbursement systems can also present challenges to comprehensive care. Panelists discussed several issues, including a lack of reimbursement for care of mental health conditions during a physical exam, and incentives to bill higher rates through physicians’ license numbers, rather those of the NPs and PAs who treat patients directly.

Panelist Eugene Rich, MD, Senior Fellow and Director, Center on Health Care Effectiveness, Mathematica Policy Research, noted we are moving away from fee-for-service models and towards alternative payment systems. Dr. Rich explained that this will give clinicians the potential to earn bonuses by participating in an advanced alternative payment model, encouraging movement towards team-based care.

Jeffrey Katz shared his perspective that MACRA, a Medicare payment reform policy going into effect in 2019, could be a force driving the health care team toward collaboration.

Experts Believe Team-Based Care is Here to Stay

With the strain on physician supply creating more opportunity for other members of the health care team, and payment model reforms in development, experts agreed that the environment increasingly will support team-based care. We echo their sentiments and support the efficient use of all health care professionals on the care team. Our health care model supports connecting patients along the continuum of care, as well as championing broader efforts to support a patient-centered medical home.

Health care experts gathered at a POLITICO event to discuss scope of practice.
CVS Health and POLITICO convened national health care experts, including (L to R) Tammi Damas, Howard University; Jeffrey Katz, American Academy of PAs; Patricia Pittman, George Washington University; and Eugene Rich, Center on Health Care Effectiveness.
Health care experts gathered at a POLITICO event to discuss scope of practice.
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Bringing Change to Health Care: Merlo at Economic Club of Washington, D.C.

Bringing Change to Health Care: Merlo at Economic Club of Washington, D.C.
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Larry Merlo, President and Chief Executive Officer for CVS Health, presented to the Economic Club of Washington, D.C. — a forum for business leaders and policymakers to address top social and economic issues — to share his vision for transforming health care for Americans. Merlo emphasized how the combination of CVS Health and Aetna will improve health care by bringing care closer to home and helping patients manage their conditions more seamlessly. According to Merlo, the combined company will play a critical role in complementing primary care, which will in turn improve health outcomes.

To illustrate how the combined company will integrate care delivery for patients, Merlo shared an example of “Diane” — a hypothetical patient newly-diagnosed with diabetes. Consider, for example, that “Diane” leaves the doctor’s office with a new care plan including instructions for a new medication, lab instructions to measure her blood sugar levels and instructions for diet and exercise regimens. But will she know how to execute her care plan effectively? Her doctor has warned her that if she doesn’t get her blood sugar under control, her risk increases significantly for diabetes-related complications like heart damage and kidney damage. It is at this point where she is not just a patient; she is now a consumer of health care. 

“This is where the combination of CVS Health and Aetna can make a difference. We can leverage our community assets to deliver more targeted and timely interventions,” said Merlo.  “Whereas a patient might only see his or her physician four to five times a year, they will likely to see their pharmacist as many as 18-24 times in the same year. With a presence in 10,000 communities across the country, our combined company will be able to offer many options to access care — whether in the community at retail pharmacies and clinics, in the home, or through digital tools.” 

Serving as a Trusted Resource in the Community 

David Rubenstein, President of the Economic Club of Washington, D.C., asked Merlo about the role of the pharmacist and how they can help patients manage their health and well-being. Merlo emphasized how pharmacists — as the most accessible health care professionals — expand access to community care, offering a knowledgeable and trustworthy touchpoint for medication management, preventive services and advice in between doctor’s visits.

 

Convenient, Extended Access to Quality Care 

When asked about the care available at our 1,100 MinuteClinic locations nationwide, Merlo highlighted how nurse practitioners and physician assistants help complement primary care by providing 125 health services during evening and weekend hours. MinuteClinic was the first retail clinic to receive a Gold Seal of Approval from the Joint Commission — helping provide peace of mind that care delivered conveniently can also be high-quality.

For more information about CVS Health’s efforts to improve access to quality care across the nation, visit our Quality & Access information center and the CVS Health Impact Dashboard. To stay informed about the latest updates and innovations from CVS Health, register for content alerts and our bi-weekly health care newsletter.

No Offer or Solicitation

This communication is for informational purposes only and not intended to and does not constitute an offer to subscribe for, buy or sell, the solicitation of an offer to subscribe for, buy or sell or an invitation to subscribe for, buy or sell any securities or the solicitation of any vote or approval in any jurisdiction pursuant to or in connection with the proposed transaction or otherwise, nor shall there be any sale, issuance or transfer of securities in any jurisdiction in contravention of applicable law. No offer of securities shall be made except by means of a prospectus meeting the requirements of Section 10 of the Securities Act of 1933, as amended, and otherwise in accordance with applicable law.

Additional Information and Where to Find It

In connection with the proposed transaction between CVS Health Corporation ("CVS Health") and Aetna Inc. ("Aetna"), CVS Health filed a registration statement on Form S-4 with the Securities and Exchange Commission (the "SEC"), which includes a joint proxy statement of CVS Health and Aetna that also constitutes a prospectus of CVS Health. The registration statement was declared effective by the SEC on February 9, 2018, and CVS Health and Aetna commenced mailing the definitive joint proxy statement/prospectus to stockholders of CVS Health and shareholders of Aetna on or about February 12, 2018, and the special meeting of the stockholders of CVS Health and the shareholders of Aetna was held on March 13, 2018. INVESTORS AND SECURITY HOLDERS OF CVS HEALTH AND AETNA ARE URGED TO READ THE DEFINITIVE JOINT PROXY STATEMENT/PROSPECTUS AND OTHER DOCUMENTS FILED WITH THE SEC CAREFULLY AND IN THEIR ENTIRETY BECAUSE THEY CONTAIN OR WILL CONTAIN IMPORTANT INFORMATION. Investors and security holders may obtain free copies of the registration statement and the definitive joint proxy statement/prospectus and other documents filed with the SEC by CVS Health or Aetna through the website maintained by the SEC at http://www.sec.gov. Copies of the documents filed with the SEC by CVS Health are available free of charge within the Investors section of CVS Health's Web site at http://www.cvshealth.com/investors or by contacting CVS Health's Investor Relations Department at 800-201-0938. Copies of the documents filed with the SEC by Aetna are available free of charge on Aetna's internet website at http://www.Aetna.com or by contacting Aetna's Investor Relations Department at 860-273-0896.

Cautionary Statement Regarding Forward-Looking Statements

The Private Securities Litigation Reform Act of 1995 (the "Reform Act") provides a safe harbor for forward-looking statements made by or on behalf of CVS Health or Aetna. This communication may contain forward-looking statements within the meaning of the Reform Act. You can generally identify forward-looking statements by the use of forward-looking terminology such as "anticipate," "believe," "can," "continue," "could," "estimate," "evaluate," "expect," "explore," "forecast," "guidance," "intend," "likely," "may," "might," "outlook," "plan," "potential," "predict," "probable," "project," "seek," "should," "view," or "will," or the negative thereof or other variations thereon or comparable terminology. These forward-looking statements are only predictions and involve known and unknown risks and uncertainties, many of which are beyond CVS Health's and Aetna's control.

Statements in this communication that are forward-looking, including projections as to the closing date for the pending acquisition of Aetna (the "transaction"), the extent of, and the time necessary to obtain, the regulatory approvals required for the transaction, the anticipated benefits of the transaction, the impact of the transaction on CVS Health's and Aetna's businesses, the expected terms and scope of the expected financing for the transaction, the ownership percentages of CVS Health's common stock of CVS Health stockholders and Aetna shareholders at closing, the aggregate amount of indebtedness of CVS Health following the closing of the transaction, CVS Health's expectations regarding debt repayment and its debt to capital ratio following the closing of the transaction, CVS Health's and Aetna's respective share repurchase programs and ability and intent to declare future dividend payments, the number of prescriptions used by people served by the combined companies' pharmacy benefit business, the synergies from the transaction, and CVS Health's, Aetna's and/or the combined company's future operating results, are based on CVS Health's and Aetna's managements' estimates, assumptions and projections, and are subject to significant uncertainties and other factors, many of which are beyond their control. In particular, projected financial information for the combined businesses of CVS Health and Aetna is based on estimates, assumptions and projections and has not been prepared in conformance with the applicable accounting requirements of Regulation S-X relating to pro forma financial information, and the required pro forma adjustments have not been applied and are not reflected therein. None of this information should be considered in isolation from, or as a substitute for, the historical financial statements of CVS Health and Aetna. Important risk factors related to the transaction could cause actual future results and other future events to differ materially from those currently estimated by management, including, but not limited to: the timing to consummate the proposed transaction; the risk that a regulatory approval that may be required for the proposed transaction is delayed, is not obtained or is obtained subject to conditions that are not anticipated; the risk that a condition to the closing of the proposed transaction may not be satisfied; the outcome of litigation related to the transaction; the ability to achieve the synergies and value creation contemplated; CVS Health's ability to promptly and effectively integrate Aetna's businesses; and the diversion of and attention of management of both CVS Health and Aetna on transaction-related issues.

In addition, this communication may contain forward-looking statements regarding CVS Health's or Aetna's respective businesses, financial condition and results of operations. These forward-looking statements also involve risks, uncertainties and assumptions, some of which may not be presently known to CVS Health or Aetna or that they currently believe to be immaterial also may cause CVS Health's or Aetna's actual results to differ materially from those expressed in the forward-looking statements, adversely impact their respective businesses, CVS Health's ability to complete the transaction and/or CVS Health's ability to realize the expected benefits from the transaction. Should any risks and uncertainties develop into actual events, these developments could have a material adverse effect on the transaction and/or CVS Health or Aetna, CVS Health's ability to successfully complete the transaction and/or realize the expected benefits from the transaction. Additional information concerning these risks, uncertainties and assumptions can be found in CVS Health's and Aetna's respective filings with the SEC, including the risk factors discussed in "Item 1.A. Risk Factors" in CVS Health's and Aetna's most recent Annual Reports on Form 10-K, as updated by their Quarterly Reports on Form 10-Q and future filings with the SEC.

You are cautioned not to place undue reliance on these forward-looking statements. These forward-looking statements are and will be based upon management's then-current views and assumptions regarding future events and operating performance, and are applicable only as of the dates of such statements. Neither CVS Health nor Aetna assumes any duty to update or revise forward-looking statements, whether as a result of new information, future events or otherwise, as of any future date.

Larry Merlo at Washington Economic Club
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