Allina Doesn’t See CVS Deal Upending Its Venture With Aetna

Dec. 05--Allina Health System, one of the largest operators of hospitals and clinics in the state, said Monday it doesn't think its plans to sell insurance coverage next year in Minnesota will be hurt by the fact that its partner in the venture, Aetna, plans to be acquired by a drugstore chain that has dozens of community clinics in the Twin Cities.

CVS Health announced on Sunday that it plans to acquire insurance giant Aetna in a deal valued at $69 billion. The deal, which must be approved by regulators, is designed to give consumers a new "front door" for routine health care services that is easier and less expensive than traditional hospitals using Aetna's data analytics and CVS Health's retail clinics.

Meanwhile, Allina and Aetna earlier this year created a new for-profit joint venture called the Allina Health and Aetna Insurance Co. that aims to offer insurance plans to large employers next year. The new stand-alone business wants to streamline connections between insurer and provider and manage routine needs for chronic care through community-based care teams.

"We don't believe the acquisition of Aetna by CVS will have any direct impact on plans for the Allina Health and Aetna Insurance Company to bring an innovative, new health insurance option to employers and patients in 2018," an Allina Health spokesman said. "Allina Health is looking forward to discussing with Aetna how the relationship with CVS can add value to our joint venture over time."

Insurance industry observers said it's not clear that Aetna's partnerships with health care providers, including its venture with Allina, have even been considered in the context of such a large corporate deal.

"There are probably assurances being given," said Jon Christianson, a health policy and management professor at the University of Minnesota. "But how that will play out over time as CVS gains control over the whole operation is really hard to guess."

CVS Health employs more than 4,000 nursing professionals to staff its 1,100 MinuteClinic walk-in clinics around the country. The clinics can diagnose and treat illnesses, injuries and skin conditions, and provide vaccinations, physicals, screenings and monitoring services for chronic conditions. Unlike traditional health care providers, MinuteClinics also post prices online: It generally costs $99-$129 plus lab fees for a urinary tract infection or $35 for rapid strep test, for example.

St. Louis Park-based health care industry analyst Allan Baumgarten said the CVS-Aetna deal may actually create new opportunities for Allina, rather than siphon off patient volume from Allina clinics.

Baumgarten noted that MinuteClinics use the Epic electronic health record system, which is the most widely used system in the country. Allina has long used an electronic health record system based on Epic. In theory, test results provided at a MinuteClinic and recorded in Epic should be viewable at other facilities that use Epic.

"I think in the talking points they would say that doesn't worry them because [by] diverting less-complex needs into a less-complex setting, namely the retail clinic, you free up the resources of the physician clinic to focus on the more complex needs of the patient, and that that's a good thing," Baumgarten said.

Asked whether patients in an Allina-Aetna health plan will eventually face restrictions on where they can get prescriptions filled because of CVS' ownership of Aetna, Baumgarten predicted there wouldn't be any changes in the first few years of the deal.

Eventually, CVS is likely to use its market power, he said. Rather than excluding private pharmacies or Walgreens locations from provider networks, CVS is more likely to encourage people to fill their prescriptions through CVS.

"You might see people with Aetna insurance getting some fairly clear signals or incentives to fill their prescriptions at CVS, as opposed to the Walgreens," he said. "Walgreens may remain in the network, and of course they are a huge presence, particularly in certain cities, but it's possible for a health plan to create certain incentives so that people are more likely to fill their prescriptions at CVS as opposed to Walgreens."

In addition to Allina-Aetna's entry into Minnesota's insurance market, UnitedHealthcare has announced plans to begin selling commercial policies in the state in 2018. Both Allina-Aetna and UnitedHealthcare plan to sell Medicare Advantage plans in Minnesota starting in 2019.

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