Aetna’s Virtual Primary Care Plan Could Be Industry Trendsetter

Aetna, the health insurance arm of CVS Health Corp., has launched what it calls the first national health plan built around virtual primary care. The benefit design, which is a further expansion of CVS’s longstanding relationship with virtual care provider Teladoc Inc., will be available to self-funded plans — and experts say that the model could generate strong demand from such clients, which are looking to cut costs and increase member satisfaction.

According to a CVS press release, the new plan is designed with an emphasis on continuity of care and convenience, starting with “a continuous relationship with a virtual care physician beginning from the first 30-45 minute comprehensive primary care visit and extending to every visit thereafter,” and it promises “timely primary care appointments.” The plan also aims to keep incidental care events like testing and urgent care in-house by offering members a “$0 co-pay for virtual primary care visits and select in-person services at MinuteClinic and CVS HealthHUB locations.” In addition, members will have access to “a virtual nurse care team through unlimited in-app text or phone” while retaining access to “in-person visits with in-network health care providers with no referral requirements [and] existing Aetna virtual care offerings such as mental health counseling, dermatology services, and 24/7 urgent care.”

Experts say that this sort of plan design was easy to see coming.

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Peter Johnson

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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